Anal Warts. Postoperative Pain Management.
The reasons for performing procedures to remove anal warts and condyloma can range from mild discomfort to a severe pain. The reasons are also based on the location and extent of the disease. Various techniques for treatment include topical medication, excision or cauterization. When excision or cauterizing is performed, patients often feel discomfort equivalent to a second degree sun burn. It is best to discuss the treatment of the warts with your colorectal surgeon, also known as a proctologist.
To help manage the pain following removal, several techniques are available:
Expectation of duration of pain.
The intensity of post treatment pain can vary greatly. Pain can be mild or severe and may last for a short period of time, or up to 2 or 3 weeks. Having an accurate window of the recovery can help manage the expectations. Often knowing that an eventual end will be in sight helps as well.
Pain Medication
Often, a standard postoperative pain regimen for condyloma surgery consists of a narcotic such as Vicodin®, Norco®, or Percocet®. These are usually very effective agents for managing any discomfort. One caution is that narcotics as a class will cause constipation. Stool softeners should usually be taken in conjunction with the medication. Some physicians will also employ anti-inflammatory medications such as ibuprofen, or even Toradol® (also known as the generic ketorolac) which have been studied and shown to be extremely useful as an adjunct for pain relief.
Local Anesthetic
Topical lidocaine creams may be effective. Be cautious when using any over the counter creams with a steroid component, as this could cause the condyloma to recur. You may want to discuss other local anesthetic choices with your surgeon as well.
A product called Exparel®, which is a special long acting anesthetic, can be injected during surgery to help with the immediate and long lasting recovery for up to 3 days. When oral ketorolac is started on the third postoperative day following the injection of Exparel®, patients often experience pain relief for a total of 6 or 7 days. On the other hand, standard injected local anesthesia lasts for only 4-6 hours.
Avoiding constipation
Any type of postoperative pain can cause discomfort with bowel movements. This is intensified by harder bowel movements and constipation. Constipation can be made worse by narcotics. Many surgeons will utilize some agents such as stool softeners, fiber, milk of magnesia, or Miralax® to help balance the stool consistency.
Heat
Many patients will find that heat, in the form of sitz baths, or a heating pad will help relieve postoperative pain. 10-15 minutes in a warm bath is sometimes more effective than the pain medication when the discomfort becomes especially unbearable.
A Proctologist, also known as a coloproctologist or colon and rectal surgeon, is specially trained in all diseases of the colon, rectum and anus. The surgeons at Los Angeles Colon and Rectal Surgical Associates are all board certified and available to talk with you, answer all of your questions and help you on the path to recovery.
Los Angeles Colon and Rectal Surgical Associates
Speak with your colorectal surgeon in Beverly Hills, Los Angeles or Culver City to formulate a plan that will help speed and smooth your recovery. The surgeons of Los Angeles Colon and Rectal Surgical Associates are board certified and available to answer all of your questions . Call (310)273-2310 to schedule an appointment. Your consultation will be informative and confidential.
