Papilla excision (papillectomy) detailed surgery recovery timeline and advice
For information on the different symptoms between a papilla and internal hemorrhoid (in my personal experience), please see this post.
Day 1/Surgery Day -
I shall begin by saying that dignity and anal surgery recovery are incompatible concepts in my experience, and you will become very intimate with your poop over the course of your recovery. However, I came out of mine more resilient and proud of the pain I can withstand. Bathing in a tub of your own poop particles is not something I’d advise the layperson, but boy, does it build character.
You may want to purchase gauze in advance as I discovered you need to dress the wound with it daily for as long as two weeks (or until discharge stops), as well as a sitz bath. My doctor provided a sitz bath, but when I got my hemmoroidectomy, I was not given one. Also prepare for the doctor to potentially give you a pain prescription. I got ibuprofen 800 and was told to take it three times a day for three days with each meal, then switch the Tylenol as needed. I only took them the day of surgery and the morning after due to concerns about constipation to which I am extremely prone.
I was put under general anesthesia as well as local anesthesia, and the procedure itself only took 10 minutes, but the prep and recovery in the waiting room afterwards made my whole experience take two hours (not counting hour spent in waiting room before I was called back). I have heard of others only getting local anesthetic and being in and out much more quickly, but my papilla was large and required stitches.
The first day upon returning home, I felt fine. The anesthesia stays with you for a couple hours, and then it’s time to take the other pain meds. The drive home was painless, but I tried not to sit directly on my butt because I didn’t want any added pressure on the area as it heals. I also laid on my side as much as possible for the first day and did not sit at all.
For best recovery, I have read it’s good to get plenty of fiber for obvious reasons (30 g + daily for women) and protein for healing (100 g + daily).
Sugar, alcohol, fatty/fried foods, and processed foods can delay healing and cause constipation, so I am trying to avoid those. Caffeine also does this, but I cannot relinquish my daily espresso shot, surgery be darned haha.
You’ll also want to drink at least 6-8 glasses of water a day, but I think more is better if you are up for it. I talked to someone who advised a gallon a day, and that’s what I shot for.
For women - the gauze they tape to your butt after surgery was placed pretty close to the vagina, so I was very careful while peeing so as not to get it wet, but one time I got distracted and wet all the gauze and had to replace it, which ideally should not be done for 24 hours. I lasted 8, so be careful with that.
I did some research on foods that help the body heal, and here are some options that also have fiber:
- Sweet potato
- Flaxseed
- Spinach, leafy greens
- Berries
- Carrots
- Bell pepper
- Citrus fruits
- Broccoli
Apples and bananas also are a great source of easily digestible fiber.
For protein, here are some foods I found suggested
- Tofu
- Salmon
- Almonds
- Yogurt, especially kefir
- Egg
- Hemp seed (for vegans)
- Beans
- Poultry
I am also taking a multi-vitamin, omega 3 pill, as well as turmeric and ginger powder since they are known to decrease inflammation.
During the night, I took Tylenol for pain and set an alarm to wake up 5 hours after falling asleep to take additional pain meds. Tylenol and ibuprofen are safe to use together. I chose Tylenol at night because ibuprofen needs to be taken with food and is also known to cause constipation.
Day 2 - I had some breakthrough pain at night which felt like a persistent stinging inside my anus, but I was able to manage it with more pain meds.
I began sitz baths 24 hours after surgery as advised by the doctor. I used my normal bath when recovering from my hemmoroidectomy, but now having a sitz bath (which the doctor provided), I can confidently say it’s worth it to get the sitz bath. The sitz bath takes pressure off the anus and is therefore less painful and much easier than doing a sitz bath in the tub. It’s also far easier to clean. I strongly recommend you purchase one for your recovery. I set an alarm to take a sitz bath every 2 hours for 15-20 minutes after which I changed the gauze.
I did not have any bowel movements, so this was an easy day for me. I did have some heavier bleeding in the evening with a small lump of something in it, but the next gauze wasn’t as bad so I didn’t think too much of it.
Day 3 - I had my first bowel movement in the morning. It came with a stinging pain. It was certainly not comfortable and using the bidet to clean was a little uncomfortable as well, but it was honestly less painful than pooping when I still had the papilla (at least while defecating), though the pain immediately after was worse, an unpleasant stinging sensation which the sitz bath helped with a lot.
I should also warn you at this point about potential fecal incontinence. I’m not sure how common this is, but for me, on this day and the next two (and also during my hemmoroidectomy recovery), the poop just started to come out, and I had to waddle to the bathroom with half a poop sticking out of me (see previous note about dignity). I think because the muscles are so stressed, sometimes you can’t really “hold it,” hence the importance of staying close to a toilet!
I used a bidet on the lowest setting to clean what I could, then wet a series of tissues to softly wipe the remaining residue.
Because my doctor used stitches to close the wound, the gauze I was replacing every couple hours had light bleeding. I called to make sure that was normal, and they said it’s normal for the first week.
I was able to take slow walks for ten minutes at a time, and I cut back on pain meds a lot from the day before.
Edit: Post was too long - see comments for continued recovery info day by day