Practical guides for before and after your procedure.

Sedative and anaesthetic drugs remain in your system for up to 24 hours, even when you feel fully awake. For the first 24 hours after your procedure:

• Driving: Do not drive or operate machinery. You can normally resume driving 24 hours after anaesthesia, provided you feel well and are not taking strong opioid pain relief.
• Responsible adult: A responsible adult should stay with you overnight after a procedure involving sedation or general anaesthesia.
• Decisions: Do not sign legal documents or make important decisions.
• Alcohol: Do not drink alcohol.
• Rest: Rest at home — light walking around the house is fine and encouraged.
• Eating and drinking: Eat and drink as you feel able. Start with light foods if you feel nauseous, then resume your normal diet.

Some wound discomfort and minor bruising around the operative site is completely normal and will settle gradually over the first 1–2 weeks. Bruising can spread under the skin and look more dramatic than it is — this is expected and not a cause for concern by itself.

• Most dressings can be left intact for one week or longer. They are designed to stay in place.
• Only remove the dressing if it is irritating your skin, lifting off, or frankly soiled (heavy ooze, blood that has soaked through, or contamination).
• If you remove it, you may replace it with a clean dressing — but it is also perfectly fine to leave the wound uncovered once the dressing is off, provided the wound is dry and not weeping.
• You can shower straight away. The dressings used are waterproof, so they can get wet in the shower without needing to be changed. Afterwards, simply pat dry — do not rub.
• Avoid baths, swimming pools, and spas until the wound is fully healed.
• Most skin sutures are dissolvable and do not need to be removed. If you have non-dissolvable sutures or staples, you will be told when to have them removed.

Constipation is very common after any operation — most often caused by opioid pain relief (e.g. oxycodone, tapentadol, codeine), reduced mobility, reduced oral intake, and the effects of anaesthesia itself. Expecting it and managing it early is much easier than trying to clear severe constipation after it has built up.

• Drink plenty of fluids — at least 8 glasses of water daily.
• Move around — light walking from the day of your procedure stimulates the bowel.
• Increase fibre gradually — fruit, vegetables, wholegrain bread, oats — as soon as you can tolerate normal food.
• Use a stool softener early, particularly if you are taking opioid pain relief — start it on the day of your procedure rather than waiting for constipation to develop. Options available at any pharmacy without a prescription include Movicol, lactulose, and Coloxyl. Take as directed on the packet.
• If a softener alone is not enough after a day or two, add a gentle stimulant laxative (e.g. Senokot, Dulcolax) — also available without a prescription.
• Do not strain — it makes things worse, and after some operations (e.g. hernia repair, anal surgery, haemorrhoidectomy) it places strain on the repair or fresh wound.
• If you have not opened your bowels by day 3–4 despite these measures, or you develop abdominal distension, severe pain, or vomiting, please contact our rooms.

Light walking from the day of your procedure is encouraged — it reduces the risk of clots in the legs and helps recovery. Beyond that, return to activity depends on the procedure you have had; please refer to the procedure-specific aftercare guide, or ask at your follow-up.

• Paracetamol 1 g every 6 hours regularly for the first few days is the foundation of post-operative pain relief.
• Ibuprofen 400 mg three times daily with food — only if you have no contraindication (stomach ulcer disease, kidney disease, certain blood thinners).
• Stronger pain relief will be prescribed where appropriate — take only as directed.
• Continue your usual regular medications unless specifically told to stop.
• If you were prescribed antibiotics at the time of surgery, complete the full course even if you feel well.
• If pain is escalating rather than settling, or feels uncontrolled despite these measures, contact our rooms.

Telehealth reviews after endoscopy and in-person reviews after operative procedures are provided at no charge to you. A standard review fee only applies if you specifically request an in-person review following an endoscopy.

• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Severe pain not controlled by your prescribed analgesia.
• Increasing redness, swelling, warmth, or discharge from the wound.
• Heavy or persistent bleeding from the wound or operative site.
• Persistent vomiting, inability to keep fluids down, or inability to pass urine.
• Calf pain or swelling, or sudden shortness of breath or chest pain — call 000 immediately.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• You must not drive yourself home after sedation. A responsible adult must collect you from the endoscopy unit and should stay with you for the rest of the day.
• Sedative drugs remain in your system for up to 24 hours, even when you feel fully awake. For the first 24 hours:
  • Do not drive or operate machinery — you can normally resume driving 24 hours after sedation, provided you feel well.
  • Do not sign legal documents or make important decisions.
  • Do not drink alcohol.
  • Rest at home — light activity around the house is fine.

• After colonoscopy / sigmoidoscopy: bloating, mild cramping, and the urge to pass wind are common for a few hours afterwards — this is the air or CO2 used during the procedure working its way out. Walking around helps.
• After gastroscopy: a mildly sore throat or hoarse voice for 24–48 hours is common from the scope passing through. Sucking on ice chips or having warm drinks helps.
• After polypectomy: a small amount of fresh red blood on the toilet paper or in the bowl over the first few days is normal. You will be given specific written guidance if the polyp removed was large or required additional treatment.
• You may feel tired for the rest of the day — this is the sedation, not the procedure itself. A normal night's sleep usually resolves it.

• You may eat and drink normally as soon as you feel ready — start with light foods if you feel nauseous, then resume your normal diet.
• If you have had bowel preparation, your first bowel motion may take 1–2 days to return — this is expected.
• After polypectomy of a larger polyp, you may be advised to avoid spicy foods, alcohol, and high-fibre foods for a few days. Specific instructions will be provided.

• Rest for the remainder of the day of your procedure.
• Most patients return to normal activity and work the next day. If you had a large polypectomy or other additional treatment, you may be advised to take it easy for a few extra days.
• Heavy lifting and strenuous exercise can normally resume from the next day, unless told otherwise.

• Resume your usual regular medications as soon as you are able to eat and drink, unless told otherwise.
• Blood thinners (warfarin, rivaroxaban, apixaban, dabigatran, clopidogrel, aspirin) — specific instructions about when to restart will be given at discharge, particularly if you had a polypectomy.
• Diabetic medications — resume your usual doses with your next meal.
• Paracetamol or ibuprofen can be used for any mild discomfort or sore throat.

Biopsy and polypectomy results are usually available within 1–2 weeks. A follow-up review is arranged to discuss findings — this is generally by telehealth (phone or video) and is provided at no charge. Our rooms will contact you to arrange the appointment, and you are welcome to call us at any time if you have questions in the meantime.

If your colonoscopy was normal, the appropriate interval for future surveillance will be advised based on your personal and family history.

• Severe or worsening abdominal pain — particularly if it is sharp, persistent, or accompanied by rigidity of the abdomen (possible perforation, a rare but serious complication).
• Heavy rectal bleeding — passing large clots, more than a small amount of fresh blood, or bleeding that does not stop within 1–2 hours (possible post-polypectomy bleeding, which can occur up to 2 weeks afterwards).
• Vomiting blood or passing black tarry stools after gastroscopy.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Persistent vomiting or inability to keep fluids down.
• Dizziness, light-headedness, or fainting — these can indicate significant blood loss.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• Pressure and fullness: A dull ache, pressure, or sense of fullness in the back passage is common for the first 24–48 hours. Many patients describe it as a constant urge to open the bowels — this is normal and settles quickly.
• Pain: Mild discomfort with bowel motions can be expected for 1–2 days. Regular paracetamol (1 g every 6 hours) is usually all that is needed. Add ibuprofen (400 mg with food) if tolerated and not contraindicated. Stronger pain relief is rarely required — see Medications below for the full regimen.
• Bleeding: Intermittent minor bleeding — a small amount of bright red blood on toilet paper, on the stool, or in the bowl — is common and expected for the first 1–2 weeks. It does not happen with every bowel motion and tends to come and go. This is separate from the larger potential bleed when the band sloughs off (covered separately below).
• Urgency: Some bowel urgency — a stronger or more sudden urge to open the bowels than usual — can occur occasionally during the first 1–2 weeks. It usually settles on its own as the area heals.
• Rest: Rest at home for the remainder of the day of your procedure. If you had sedation, follow the standard 24-hour rules — no driving, no important decisions, no alcohol.

• Eat and drink normally as soon as you feel able.
• Maintain a high-fibre diet and drink at least 8 glasses of water each day — soft stools are kinder to the treated area.
• A daily fibre supplement (e.g. Metamucil or Benefibre) is a good idea for a few weeks, particularly if your stools tend to be hard.
• Do not strain at stool, and do not delay going to the toilet when you feel the urge.
• A short course of a gentle laxative (e.g. Movicol, lactulose) for a few days can help if stools are hard.

There is no specific restriction after banding — resume whenever you feel comfortable.

• Paracetamol 1 g every 6 hours for the first 24–48 hours is usually all that is needed.
• Ibuprofen 400 mg three times daily with food (if tolerated and not contraindicated by stomach ulcer disease, kidney disease, or certain blood thinners).
• A warm bath or sitz bath can ease the sense of fullness if it is bothersome — useful but not essential.
• A prescription for stronger pain relief will usually be sent to you as an eScript by email after your procedure. This is provided as a precaution — most patients do not need it, but it is there if you do.
• Continue your usual regular medications unless specifically told to stop.
• If your pain feels disproportionate or is increasing rather than settling, please contact our rooms.

A small amount of fresh red bleeding at this stage is common and self-limiting. A larger one-off bleed — enough to redden the toilet bowl or fill a pad — occurs in a small number of patients and almost always settles without treatment.

Seek urgent review if the bleeding is heavy or persistent, you are passing clots, you feel dizzy or light-headed, or the bleeding does not stop within 1–2 hours.

Banding is often performed as part of a course of treatment — further sessions may be planned over the following weeks or months. Our rooms will contact you to organise any further appointments, and follow-up reviews are at no charge. You are welcome to call us at any time to book or to discuss any concerns in the meantime.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Heavy or persistent bleeding, passing large clots, or bleeding that does not stop within 1–2 hours.
• Dizziness, light-headedness, or fainting — these can indicate significant blood loss.
• Inability to pass urine for more than 6–8 hours after the procedure.
• Severe or escalating pain not controlled by paracetamol and ibuprofen.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• Pain: Significant perianal pain is expected and often worsens over the first 3–5 days before settling — this is normal and not a sign that something has gone wrong. Take paracetamol (1 g every 6 hours) regularly — do not wait for pain to become severe. Add ibuprofen (400 mg with food) if tolerated and not contraindicated. Stronger analgesia, topical agents, ice packs, and sitz baths are covered under Medications below.
• Bleeding: A small amount of fresh red blood on the dressing, on toilet paper, or in the bowl is normal in the early period. Light pink or watery discharge from the wound is expected and can continue for 1–2 weeks. Heavy bleeding, passing clots, or feeling dizzy requires urgent assessment.
• Swelling and bruising: Perianal swelling, bruising, and firmness around the wound are normal and will gradually settle over 2–4 weeks.
• Urinary retention: Difficulty passing urine is a known early complication, particularly in men. If you have not passed urine for more than 6–8 hours after the procedure and your bladder feels full, present to your nearest emergency department for assessment.
• Rest: Rest at home for the remainder of the day after surgery. Light walking from the next day is encouraged.

• A gauze pad or sanitary pad held in place by close-fitting underwear is practical for managing wound discharge.
• Keep the wound area clean. After each bowel motion, gently clean with moist wipes or a sitz bath — do not scrub.
• Sitz baths (sitting in a shallow bath of warm water for 10–15 minutes) 2–3 times daily and after each bowel movement provide good pain relief, keep the wound clean, and promote healing. Begin from the day after surgery.
• The wound heals from the inside out (by secondary intention) and may take 4–6 weeks to fully close. A small persistent opening or some weeping during this time is normal and expected.
• Do not apply antiseptic creams (such as Betadine) to the wound unless specifically instructed, as these can slow healing.

• The first bowel movement after haemorrhoidectomy is often dreaded — and yes, it is uncomfortable. Doing the preparation properly makes a real difference.
• Start a stool softener (e.g. Movicol, lactulose, or Coloxyl) from the day of surgery and continue for 2–4 weeks. Adjust the dose to keep stools soft and easy to pass.
• Maintain a high-fibre diet — fruit, vegetables, wholegrain bread, oats, legumes — and drink at least 8 glasses of water daily. Adequate hydration is the single most important factor in maintaining soft stools. A fibre supplement (Metamucil, Benefibre) can help if needed.
• Do not delay going to the toilet when you feel the urge — waiting leads to harder stools and more painful bowel movements.
• Do not strain at stool. If you cannot open your bowels comfortably after a few minutes, get up and try again later. Increase the stool softener dose as needed.
• Taking pain relief 30–60 minutes before an anticipated bowel motion makes a real difference.
• If you have not opened your bowels by day 3, take an extra dose of softener or a gentle laxative — and contact our rooms if there is still nothing by day 4.

You may resume sexual intercourse when you feel comfortable — most patients find 2–4 weeks is a reasonable guide. Avoid anal intercourse until the wound is fully healed.

• Paracetamol 1 g every 6 hours, regularly — not just when you feel pain. Set an alarm.
• Ibuprofen 400 mg three times daily with food (if tolerated and not contraindicated by stomach ulcer disease, kidney disease, or certain blood thinners).
• Stronger pain relief (e.g. oxycodone, tapentadol) will usually be prescribed for the first week — take as directed.
• Topical agents (e.g. nifedipine ointment, GTN ointment, lignocaine gel) may be prescribed to relax the anal sphincter and ease pain — apply as directed.
• Ice packs (wrapped in a cloth or towel) applied for 15 minutes every hour can help reduce swelling and ease pain, particularly in the first few days.
• Continue your usual regular medications unless specifically told to stop.
• If you were prescribed antibiotics at the time of surgery, complete the full course even if you feel well.
• If pain is escalating rather than settling, or feels uncontrolled despite these measures, contact our rooms.

A follow-up review is arranged in person approximately 4–6 weeks after your operation to check the wound is healing well and answer any questions. Our rooms will contact you to organise the appointment, and this follow-up review is at no charge. You are welcome to call us at any time to book or to discuss any concerns in the meantime.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Heavy or persistent bleeding, passing clots, or feeling dizzy or light-headed. A larger one-off bleed around days 7–14 is uncommon but recognised, and almost always settles without treatment — but should be assessed if it does not stop within 1–2 hours.
• Inability to pass urine for more than 6–8 hours, particularly with a feeling of bladder fullness — a known early complication.
• Severe or escalating pain not controlled by your prescribed analgesia.
• Increasing redness, warmth, swelling, or pus-like discharge from the wound — possible infection.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Persistent nausea or vomiting, or inability to tolerate fluids.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• Pain: After LIS, mild to moderate discomfort at the sphincterotomy site is expected and usually improves significantly within a few days. After Botox, post-procedure pain is often minimal — the existing fissure pain typically settles over the following 1–2 weeks as the sphincter relaxes. Take paracetamol (1 g every 6 hours) regularly and add ibuprofen (400 mg with food) if tolerated.
• Bleeding: A small amount of fresh red blood on toilet paper, on the stool, or in the bowl is normal in the first few days — particularly with bowel motions. Heavy bleeding requires urgent assessment.
• Altered sensation: Mild numbness or altered sensation around the anus is occasionally noted after Botox and almost always settles. Some patients report minor wind leakage or mild incontinence to wind in the early weeks after either procedure — this is usually transient.
• Rest: Rest at home for the remainder of the day of your procedure. Light walking from the next day is encouraged.

• The LIS wound is small and usually closed with dissolvable sutures — these do not need to be removed.
• There is no significant wound after Botox — only the injection sites.
• You can shower straight away. Pat the area dry afterwards — do not rub.
• Sitz baths (sitting in a shallow bath of warm water for 10–15 minutes) 2–3 times daily and after bowel motions are helpful — they ease discomfort, keep the area clean, and relax the sphincter. Begin the day after your procedure.
• Avoid baths, swimming pools, and spas until any wound is fully healed — typically 1–2 weeks.
• Do not apply antiseptic creams (e.g. Betadine) unless specifically instructed.

• Keeping stools soft is the single most important factor in healing — hard stools tear the fissure open again.
• Start a stool softener (e.g. Movicol, lactulose, or Coloxyl) from the day of your procedure and continue for at least 2–4 weeks.
• Drink at least 8 glasses of water daily and eat a high-fibre diet — fruit, vegetables, wholegrains, oats. Add a fibre supplement (Metamucil, Benefibre) if needed.
• Do not delay going to the toilet when you feel the urge, and do not strain.
• The first few bowel motions may sting briefly — this is expected and improves quickly.

You may resume sexual intercourse when you feel comfortable. Most patients are comfortable within 1–2 weeks. Avoid anal intercourse for 4–6 weeks after LIS to allow the wound to heal fully.

• Paracetamol 1 g every 6 hours, regularly for the first few days.
• Ibuprofen 400 mg three times daily with food (if tolerated and not contraindicated by stomach ulcer disease, kidney disease, or certain blood thinners).
• Stool softener from the day of your procedure for at least 2–4 weeks.
• Topical agents (e.g. nifedipine ointment, GTN ointment, lignocaine gel) may be continued or prescribed to keep the sphincter relaxed during healing — apply as directed.
• Continue your usual regular medications unless specifically told to stop.
• If pain is escalating rather than settling, or feels uncontrolled despite these measures, contact our rooms.

A follow-up review is arranged approximately 4–6 weeks after your procedure to check that the fissure has healed and to discuss whether any further treatment is needed. After Botox, the full effect develops over 1–2 weeks and lasts 3–4 months — the fissure usually heals during this time. This follow-up review is at no charge. Our rooms will contact you to organise the appointment; you are welcome to call us at any time in the meantime.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Heavy or persistent bleeding, passing clots, or feeling dizzy or light-headed.
• Severe or escalating pain not controlled by your prescribed analgesia.
• Significant incontinence — to liquid stool or solid stool (mild wind leakage is common and transient; loss of control of stool is not expected and warrants review).
• Increasing redness, warmth, swelling, or pus-like discharge — possible infection.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Inability to pass urine for more than 6–8 hours.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• Pain: Significant discomfort in the anal region is expected for the first few days. Take paracetamol (1 g every 6 hours) regularly — do not wait for pain to become severe. Add ibuprofen (400 mg with food) if tolerated and not contraindicated. Your surgeon may prescribe stronger analgesia — take as directed.
• Bleeding: A small amount of fresh blood staining on the wound dressing is normal. Light pinkish discharge is expected, particularly in the first 1–2 weeks. Heavy bleeding that soaks through dressings requires urgent assessment.
• Swelling and bruising: Perianal swelling, bruising, and firmness around the wound are normal and will gradually settle over 2–4 weeks.
• Rest: Rest at home for the remainder of the day after surgery. Light walking from the next day is encouraged.

• A wound dressing or gauze pad will be placed at surgery. Change this daily or when soiled.
• A simple gauze pad or a women's sanitary pad held in place by close-fitting underwear is practical for managing wound discharge.
• Keep the wound area clean. After each bowel movement, gently pat the area clean with moist wipes or toilet paper — do not scrub.
• Sitz baths (sitting in a shallow bath of warm water for 10–15 minutes) 2–3 times daily and after each bowel movement provide good pain relief, keep the wound clean, and promote healing. Begin from the day after surgery.
• The wound heals from the inside out (by secondary intention) — it may take several weeks. A small persistent opening is normal and expected during this time.
• Do not apply antiseptic creams (such as Betadine) to the wound unless specifically instructed, as these can slow healing.

• The first bowel movement after anal surgery can be uncomfortable — this is normal.
• Take a stool softener (e.g. Movicol, lactulose, or Coloxyl) from the day of surgery to keep stools soft and easy to pass. Continue for at least 2–3 weeks.
• Maintain a high-fibre diet and drink at least 8 glasses of water daily. Adequate hydration is the single most important factor in maintaining soft stools.
• Do not delay going to the toilet when you feel the urge — waiting leads to harder stools and more painful bowel movements.
• Do not strain at stool. If you are unable to open your bowels comfortably, increase your stool softener dose or contact our rooms.

If you have a seton, additional activity restrictions apply until reviewed at your follow-up.

You may resume sexual intercourse when you feel comfortable. There is no strict restriction, but avoid activity that causes significant perianal discomfort. Most patients are comfortable to resume within 2–4 weeks depending on the nature of the procedure. If you are unsure, discuss this at your follow-up review.

• Continue your usual regular medications unless specifically told to stop.
• If you were prescribed antibiotics at the time of surgery, complete the full course even if you feel well.
• Avoid anti-inflammatory medications (ibuprofen, naproxen) if you have a history of stomach ulcers or kidney disease — use paracetamol instead.

A wound check appointment will be arranged for approximately 2–4 weeks after surgery. If you have a seton, regular review appointments are essential — these will be scheduled at your follow-up. Please do not miss these appointments, as seton management requires ongoing assessment.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Heavy or persistent bleeding, passing clots, or bleeding that soaks through multiple pads.
• Severe or escalating pain not controlled by your prescribed analgesia, or pain and swelling that worsen rather than improve after the first few days.
• Increasing redness, warmth, swelling, or pus-like discharge from the wound, or redness spreading beyond the wound area — possible infection.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Inability to pass urine for more than 6–8 hours.
• Persistent nausea or vomiting, or inability to keep fluids down.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• Pain: Significant perianal pain is expected in the first few days. You may be admitted to hospital overnight or for a couple of days for pain control. Take paracetamol (1 g every 6 hours) regularly. Stronger analgesia and topical agents are covered under Medications below.
• Bleeding: A small amount of fresh red blood on the dressing, on toilet paper, or in the bowl is normal. Heavy bleeding requires urgent assessment.
• Swelling and bruising: Perianal swelling, bruising, and firmness around the wound are normal and will gradually settle over 2–4 weeks.
• Urinary retention: Difficulty passing urine is a recognised complication after perineal surgery, particularly with strong analgesia. If you have not passed urine for more than 6–8 hours and your bladder feels full, present to the emergency department.
• Rest: Rest at home (or in hospital) for the first 24–48 hours. Light walking from the next day is encouraged.

• A gauze pad or sanitary pad held in close-fitting underwear is practical for managing discharge.
• After each bowel motion, clean gently with moist wipes or a sitz bath — do not scrub.
• Sitz baths (sitting in a shallow bath of warm water for 10–15 minutes) 2–3 times daily and after each bowel motion give good pain relief, keep the area clean, and help healing. Begin from the day after surgery.
• Light pink or watery discharge from the wound is expected for 1–2 weeks.
• Do not apply antiseptic creams (e.g. Betadine) unless specifically instructed.

• Start a stool softener (e.g. Movicol, lactulose, or Coloxyl) from the day of surgery and continue for at least 4–6 weeks. Adjust the dose to keep stools soft and easy to pass — never hard.
• Drink at least 8 glasses of water a day.
• Maintain a high-fibre diet — fruit, vegetables, wholegrain bread, oats, legumes. A fibre supplement (Metamucil, Benefibre) can help.
• Some patients are advised to follow a low-residue diet for the first 1–2 weeks. Follow the specific advice given to you.
• Do not strain. If you cannot open your bowels comfortably after a few minutes, get up and try again later. Increase the stool softener.
• Do not delay going to the toilet when you feel the urge.
• Take pain relief 30–60 minutes before an anticipated bowel motion if needed.
• If you have not opened your bowels by day 3, take an extra dose of softener or a gentle laxative — and contact our rooms if there is still nothing by day 4.

You may resume sexual intercourse when you feel comfortable — most patients find 3–4 weeks is a reasonable guide. Avoid anal intercourse for at least 6 weeks, or until cleared at your follow-up review.

• Paracetamol 1 g every 6 hours, regularly — not just when you feel pain.
• Ibuprofen 400 mg three times daily with food (if tolerated and not contraindicated).
• Stronger pain relief (e.g. oxycodone, tapentadol) will usually be prescribed for the first 1–2 weeks — take as directed. Be aware these commonly cause constipation; the stool softener regimen above addresses this.
• Topical agents (e.g. nifedipine ointment, GTN ointment, lignocaine gel) may be prescribed to relax the sphincter and ease pain — apply as directed.
• Antibiotics may be prescribed, particularly after a flap procedure — complete the full course even if you feel well.
• Continue your usual regular medications unless specifically told to stop.
• If pain is escalating rather than settling, or feels uncontrolled despite these measures, contact our rooms.

A follow-up review is arranged in person at approximately 2 weeks for an early wound check, and again at 6 weeks to assess healing of the repair. Further reviews may be arranged depending on progress. These follow-up reviews are at no charge. Our rooms will contact you to organise the appointments; you are welcome to call us at any time to book or to discuss any concerns.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Heavy or persistent bleeding, passing clots, or feeling dizzy or light-headed.
• Severe or escalating pain not controlled by your prescribed analgesia.
• New or significant incontinence — to liquid stool or solid stool. (Some mild wind leakage in the early weeks is common.)
• Increasing redness, warmth, swelling, or pus-like discharge — possible infection or breakdown of the repair.
• A sudden gush of fluid or stool from the wound — possible breakdown of the repair.
• Inability to pass urine for more than 6–8 hours.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Persistent nausea or vomiting, or inability to tolerate fluids.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• Discharge is normal and expected. A seton is designed to keep the fistula draining — you will notice a persistent discharge of fluid around the seton. This is a sign that the seton is doing its job. Use a gauze pad or sanitary pad held in close-fitting underwear to manage this.
• Mild discomfort is common, particularly in the days immediately following insertion. This usually settles to a low-level awareness rather than significant pain.
• The seton loop will remain visible at the skin surface — it should feel like a firm cord or thread passing through the perianal area.

• Do this once or twice daily, ideally during or after your sitz bath when the tissue is soft and relaxed.
• Use clean hands. Gently grasp the visible loop and slide it back and forth through the tract — a movement of a centimetre or two is sufficient.
• Some resistance and mild discomfort when moving the seton is normal. You should not need to force it.
• If moving the seton causes significant pain or you notice the seton feels very tight, stop and contact our rooms — do not attempt to force it through.

• Sitz baths (sitting in a shallow bath of warm water for 10–15 minutes) are strongly recommended 2–3 times daily and after each bowel movement. They keep the area clean, reduce discomfort, and make moving the seton easier.
• After each sitz bath, gently pat the area dry — do not rub.
• After bowel movements, clean gently with moist wipes or damp toilet paper. Do not scrub around the seton.
• Do not apply antiseptic creams (such as Betadine) to the wound unless specifically instructed.

• Do not attempt to remove the seton yourself — even if it feels loose. It must be removed or adjusted by your surgeon.
• Do not tighten, cut, or tie a knot in the seton.
• Do not ignore a seton that has clearly come out, fallen out, or appears broken — contact our rooms.

Most setons remain in place for several months. The timing depends on the type of seton, the nature of your fistula, and your overall treatment plan — which may include a staged procedure such as a mucosal advancement flap or ligation of intersphincteric fistula tract (LIFT) at a later date. Your seton will be reviewed and managed at each outpatient appointment. Do not miss these reviews, as seton management requires ongoing assessment.

• The seton feels significantly tighter or more painful than usual (beyond the expected mild awareness).
• Inability to move the seton despite it being in the correct position.
• Increasing redness, swelling, or warmth spreading beyond the wound area — possible infection.
• Heavy bleeding from the wound or surrounding area.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• The seton has clearly come out, fallen out, or appears broken.

After hours: present to your nearest emergency department. For the Austin Hospital Emergency: (03) 9496 5000. For emergencies, call 000.

• The lead exits your skin in the upper buttock area and is secured with a dressing. An external programmer (small device) connects to the lead.
• Keep the dressing clean, dry, and intact for the entire test period — no showering over the dressing. Sponge bathe and protect the dressing with a waterproof cover if needed.
• Avoid bending, twisting, lifting, or stretching activities that may pull on the lead.
• No baths, swimming, or spas during the test period.
• Keep a diary of symptoms — bowel movements, incontinence episodes, urgency — as instructed. This information is essential for deciding whether to proceed to a permanent implant.
• If your symptoms do not improve, contact our rooms — adjustments to the programming can sometimes help.
• If the lead becomes dislodged, the dressing comes off, or you develop redness or pain at the site, contact our rooms.

The permanent implant has two small wounds: the lead site near the sacrum (lower back) and the IPG (battery) site on the upper buttock. Both are usually closed with dissolvable sutures.

• The first 24–48 hours: Some bruising and discomfort around both wound sites is expected. Take regular paracetamol and ibuprofen as needed.
• Most dressings can be left intact for one week or longer — they are designed to stay in place. Only remove if irritating your skin, lifting off, or frankly soiled.
• You can shower straight away — the dressings are waterproof. Pat dry afterwards.
• No baths, swimming, or spas for 2 weeks after the permanent implant.
• Mild stimulation (tingling or tapping sensation) from the device is normal — you may be aware of it, particularly when changing position.

• No lifting more than 5 kg for 6 weeks.
• Avoid activities that stretch the lower back (yoga, Pilates, gardening, rolling onto your back from your side too quickly).
• Sleep on your side or back. Avoid sleeping on your stomach for the first few weeks.
• Light walking is encouraged from the day after surgery.
• Return to desk work is typically possible within a few days. Manual work requires 4–6 weeks off — discuss at your follow-up.
• Cycling, horse-riding, vigorous gym, and contact sports — discuss at follow-up before resuming.

• Patient programmer: You will be given a handheld controller to turn the device on/off and adjust stimulation intensity within set limits. Your stoma/incontinence nurse or the device representative will demonstrate this in detail.
• MRI scans: Modern devices are generally "MR conditional" — meaning MRI is possible under specific conditions. Always tell any doctor or imaging facility that you have a sacral neuromodulation device. Carry your device identification card with you.
• Airport security: Show your device identification card and request a hand search rather than walking through metal detectors. Modern body scanners may briefly affect stimulation but cause no harm.
• Theft-detection gates (in shops, libraries): walk through normally but do not linger.
• Future surgery: Inform any surgeon you have an implanted device. Specific precautions are needed around diathermy/electrocautery, which can damage the device.
• Dental treatment: Generally safe. Inform your dentist.
• Mobile phones and household appliances: No restrictions, with the exception of induction cooktops and welding equipment, which should be avoided.

• Paracetamol 1 g every 6 hours, regularly for the first few days.
• Ibuprofen 400 mg three times daily with food (if tolerated and not contraindicated).
• Continue your usual regular medications unless specifically told to stop.
• If you were prescribed antibiotics at the time of surgery, complete the full course even if you feel well — infection around an implanted device is serious and antibiotics are routinely given.

Programming visits with the device representative and your surgeon will be arranged in the weeks after your implant to fine-tune the stimulation settings. The first review is typically around 2–4 weeks after the permanent implant, with further reviews as needed. These follow-up reviews are at no charge. Our rooms will coordinate the appointments; you are welcome to call us if you have concerns in the meantime.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Increasing redness, warmth, swelling, or pus-like discharge from either wound site — possible infection. Infection around an implanted device is serious and needs prompt review.
• Sudden change in stimulation — loss of the usual sensation, painful or shocking stimulation, or stimulation in a new area — possible lead displacement.
• Return of your incontinence symptoms after they had improved — possible lead displacement or device problem.
• Severe or escalating pain at either site.
• The lead or device feeling like it is protruding through the skin.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000. Always tell ED staff that you have a sacral neuromodulation device.

• Pain: Some discomfort around the wound is expected and typically improves significantly over the first week. Some tightness or pulling sensation around the closure is normal as healing progresses. Take paracetamol (1 g every 6 hours) regularly — do not wait for pain to become severe. Add ibuprofen (400 mg with food) if tolerated and not contraindicated. Stronger analgesia is covered under Medications below.
• Bleeding and discharge: A small amount of clear or slightly blood-tinged ooze around the dressing edges is normal in the first few days.
• Dressing: The Dermabond Prineo dressing is in place and waterproof — see Wound and dressing care below for full details. Leave it alone.
• Rest: Rest at home for the remainder of the day after surgery. Light walking from the next day is encouraged — it reduces the risk of clots in the legs and helps recovery.

Your wound has been closed with a specialised tissue adhesive and mesh dressing called Dermabond Prineo. This is a skin-coloured dressing that bonds directly to the wound edges and holds the closure securely while healing occurs beneath it.

• Leave the dressing completely undisturbed. Do not pick at, lift, or attempt to remove it — it is designed to fall off on its own.
• The dressing will naturally peel away and fall off after approximately 3–4 weeks as the skin beneath heals. This is normal and expected.
• Do not apply any creams, ointments, tape, or additional dressings over the Dermabond Prineo unless specifically instructed by your surgeon.
• There is no need to change or replace the dressing.
• You can shower straight away — the Dermabond Prineo is waterproof and can get wet. Allow warm water to run over the area gently; do not scrub, rub, or use a flannel or loofah over the dressing. Avoid applying soap directly to the dressing.
• After showering, pat dry — do not rub.
• Avoid baths, swimming pools, spas, and the ocean until the wound is fully healed and the dressing has fallen off — typically 4–6 weeks after surgery.

Try to minimise excessive movement of the natal cleft area in the early weeks — avoid vigorous bending, twisting, or stretching of the buttocks where possible.

• Paracetamol 1 g every 6 hours, regularly — not just when you feel pain.
• Ibuprofen 400 mg three times daily with food (if tolerated and not contraindicated by stomach ulcer disease, kidney disease, or certain blood thinners).
• Stronger pain relief may be prescribed for the first few days — take only as directed.
• Continue your usual regular medications unless specifically told to stop.
• If you were prescribed antibiotics at the time of surgery, complete the full course even if you feel well.
• If pain is escalating rather than settling, or feels uncontrolled despite these measures, contact our rooms.

Routine hair removal in the natal cleft is not recommended as a standard first step after surgery. Whether hair removal is appropriate depends on your individual situation — and for many people who have had a single episode, it is not needed at all.

• For patients whose pilonidal disease keeps coming back, or whose individual circumstances make it appropriate, hair removal may be advised at follow-up.
• When hair removal is recommended, laser hair removal is preferred over regular shaving — it is more effective and avoids the irritation that ongoing shaving can cause.
• Whether hair removal is appropriate for you will be discussed at your follow-up appointment.

A wound check will be arranged for approximately 3–4 weeks after surgery, around the time the dressing naturally falls off. Healing will be assessed and you will be advised on return to full activity and hair removal. This follow-up review is at no charge. Our rooms will contact you to book the appointment; you are welcome to call us at any time to book or to discuss any concerns in the meantime.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Increasing pain (rather than improving) after the first few days.
• Spreading redness, warmth, or swelling around the wound, or pus-like discharge — possible infection.
• Wound edges separating or gaping open, or the dressing lifting off in the first week.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Persistent nausea or vomiting, or inability to tolerate fluids.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• Pain: Some discomfort around the wound is expected and typically settles steadily over the first 1–2 weeks. Take paracetamol (1 g every 6 hours) regularly — do not wait for pain to become severe. Add ibuprofen (400 mg with food) if tolerated and not contraindicated. Stronger analgesia and ice packs are covered under Medications below.
• Bending and hip movement (inguinal repair): Bending forwards or flexing your hips tends to be uncomfortable for the first few days after inguinal hernia surgery. This settles within a week. Stand up slowly, use your hands to push out of chairs, and sleep on your back or whichever side you find comfortable.
• Bruising and swelling: Some bruising and swelling around the wound is normal and will gradually settle over 1–2 weeks. For inguinal repair: blood from the operation can track downwards into the scrotum, causing bruising along the groin and scrotum that turns black and blue, then green or bronze as it fades. This can look dramatic but is harmless and does not need treatment.
• Testicular tenderness (inguinal repair): Mild testicular tenderness or sensitivity is common after inguinal hernia repair and typically settles over 4–6 weeks. Marked swelling, hardness, or severe testicular pain should be reviewed.
• Rest: Rest at home for the remainder of the day after surgery. Light walking around the house from the same evening, and outside walking from the next day, is encouraged — it reduces the risk of clots in the legs and helps recovery.

• Most dressings can be left intact for one week or longer — they are designed to stay in place.
• Only remove the dressing if it is irritating your skin, lifting off, or frankly soiled. If you remove it, you may replace it with a clean dressing, or leave the wound uncovered if it is dry.
• You can shower straight away. The dressings used are waterproof and can get wet in the shower without needing to be changed. Afterwards, simply pat dry — do not rub.
• Avoid baths, swimming pools, and spas until the wound is fully healed.
• Most skin sutures are dissolvable and do not need to be removed. If you have non-dissolvable sutures or staples, you will be told when to have them removed.
• For inguinal repair: supportive close-fitting underwear (briefs rather than boxers) for the first 1–2 weeks can make movement more comfortable and reduce dragging on the wound.

• Avoid straining at stool — straining, coughing, and sneezing all put pressure on the repair. If a sneeze or cough is coming, brace the wound gently with your hand to support it.
• If you become constipated — particularly common while taking stronger opioid pain relief — use a stool softener (e.g. Movicol, lactulose, or Coloxyl) and increase your fibre and water intake.
• Maintain a high-fibre diet and drink at least 8 glasses of water daily.

You may resume sexual intercourse when you feel comfortable and pain allows — generally from 2–3 weeks after hernia repair. There is no strict medical restriction, but avoid positions that cause discomfort or place strain on the wound. If you have had a large or complex repair, discuss any specifics at your follow-up review.

• Paracetamol 1 g every 6 hours, regularly — not just when you feel pain.
• Ibuprofen 400 mg three times daily with food (if tolerated and not contraindicated by stomach ulcer disease, kidney disease, or certain blood thinners).
• Stronger pain relief (e.g. oxycodone, tapentadol) may be prescribed for the first few days — take only as directed. Be aware these commonly cause constipation; pair with a stool softener if needed.
• Ice packs (wrapped in a cloth or towel) applied for 15–20 minutes several times a day can help reduce swelling and ease pain, particularly in the first few days.
• Continue your usual regular medications unless specifically told to stop.
• If you were prescribed antibiotics at the time of surgery, complete the full course even if you feel well.
• If pain is escalating rather than settling, or feels uncontrolled despite these measures, contact our rooms.

A follow-up review is arranged in person approximately 2–6 weeks after your operation to check the wound and answer any questions. Our rooms will contact you to organise the appointment, and this follow-up review is at no charge. You are welcome to call us at any time to book or to discuss any concerns in the meantime.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Increasing redness, warmth, swelling, or pus-like discharge from the wound — possible infection.
• Severe or escalating pain not controlled by your prescribed analgesia.
• Inability to pass urine for more than 6–8 hours, particularly with a feeling of bladder fullness — a recognised early complication after groin surgery.
• Marked scrotal swelling or hardness, or severe testicular pain (inguinal repair) — distinct from the expected bruising and mild tenderness described above.
• A new lump or bulge at or near the operation site that does not reduce when you lie down — possible early recurrence.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Persistent nausea or vomiting, or inability to tolerate fluids.
• Calf pain or swelling, or sudden shortness of breath or chest pain — call 000 immediately.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• Pain: Managed in hospital with a combination of regular paracetamol, anti-inflammatories, and stronger agents — sometimes with an epidural, regional block, or patient-controlled analgesia (PCA) in the early period.
• Drains: One or more drains are usually placed at the time of surgery and removed once the output is low enough (typically over several days to 1–2 weeks). Some drains may go home with you — instructions will be given.
• Abdominal binder: A binder will be fitted before you go home and worn for several weeks — see the Abdominal binder section below.
• Mobilising: Getting out of bed and walking from the day after surgery is important to reduce the risk of clots in the legs and chest infections, and to help bowel function return.
• Diet: You will start with sips, progress to clear fluids, then a light diet as your bowels recover. Most patients are eating a light diet within 2–3 days.
• Length of stay: Typically 3–7 days, depending on the size and complexity of the repair and your individual recovery.

• An abdominal binder supports the repair, reduces pain, and reduces the risk of seroma (fluid collection) and bulging.
• Wear the binder continuously for the first 4–6 weeks, including overnight, removing only for showering. Specific advice may differ — follow what you are told.
• It should be snug but comfortable. If it is too tight or causes skin irritation, contact our rooms.
• From 6 weeks onwards, you may begin to wear it only during physical activity, gradually weaning off over the following 4–6 weeks.

• You will usually have a large midline or transverse abdominal wound. Smaller wounds may also be present where drains exit.
• Most dressings can be left intact for one week or longer. Only remove if irritating your skin, lifting off, or frankly soiled.
• You can shower straight away. The dressings used are waterproof. Afterwards, pat dry — do not rub.
• Avoid baths, swimming pools, and spas until the wound is fully healed and any drains are out — typically 4–6 weeks.
• Most skin sutures are dissolvable. Staples, if used, will be removed at 10–14 days.
• Some bruising, firmness, and a sensation of tightness across the abdomen is normal for weeks to months as the repair settles.

• It is normal for the bowel to take a few days to return to normal function after major abdominal surgery.
• Avoid straining — straining, coughing, and sneezing all put pressure on the repair. If a sneeze or cough is coming, brace the wound gently with your hand (or a pillow) to support it.
• If you become constipated — common with opioid pain relief — use a stool softener (Movicol, lactulose, Coloxyl) and stimulant laxative as needed (Senokot, Dulcolax). See the General post-op care guide for the full constipation plan.
• Drink at least 8 glasses of water a day and maintain a high-fibre diet.

You may resume sexual intercourse when you feel comfortable and pain allows — generally from 3–4 weeks. Avoid positions that place strain on the repair. Discuss any concerns at your follow-up review.

• Paracetamol 1 g every 6 hours, regularly.
• Ibuprofen 400 mg three times daily with food (if tolerated and not contraindicated).
• Stronger pain relief (e.g. oxycodone, tapentadol) will usually be prescribed for the first 1–2 weeks — take as directed. Pair with a stool softener.
• Continue all regular medications unless specifically told to stop. Pay particular attention to blood pressure, heart, diabetic, and thyroid medications.
• Blood-thinning medications (warfarin, apixaban, rivaroxaban, clopidogrel, aspirin) are withheld around surgery and restarted as directed.
• If antibiotics were prescribed, complete the full course.
• Many patients are sent home on a short course of injectable blood thinner (e.g. enoxaparin/Clexane) for clot prevention — specific instructions will be given.

A follow-up review is arranged in person at approximately 2 weeks for an early wound and drain check, and again at 6 weeks to assess healing and discuss return to activity. Further reviews are arranged as needed. These follow-up reviews are at no charge. Our rooms will contact you to organise the appointments; you are welcome to call us at any time to book or to discuss any concerns.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Increasing redness, warmth, swelling, or pus-like discharge from the wound — possible infection. Mesh infection is a recognised serious complication.
• Severe or escalating abdominal pain not controlled by your prescribed analgesia.
• A new bulge or swelling appearing under or near the wound — possible seroma (fluid collection) or, less commonly, an early recurrence.
• Sudden change in drain output — particularly a large increase, or output becoming cloudy, blood-stained, or feculent.
• Inability to pass urine for more than 6–8 hours.
• Inability to pass wind or open your bowels for more than 3–4 days — possible ileus or, rarely, obstruction.
• Persistent nausea or vomiting, or inability to tolerate fluids.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Calf pain or swelling, or sudden shortness of breath or chest pain — call 000 immediately.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• Pain: Pain will be managed in hospital with a combination of regular paracetamol, anti-inflammatory medication, and stronger agents as required. Epidural or patient-controlled analgesia (PCA) may be used initially. As you recover, oral medications will gradually replace these.
• Enhanced recovery: An Enhanced Recovery After Surgery (ERAS) protocol is followed. This means early mobilisation (getting out of bed the day after surgery), early introduction of oral fluids and diet, and removal of drains and urinary catheters as soon as it is safe to do so.
• Diet: You will typically start with clear fluids and progress to light foods as your bowel function returns. Most patients are eating a light diet within 2–3 days of surgery.
• Bowel function: Return of bowel function (passing wind, then a bowel motion) is an important milestone. It usually occurs within 2–5 days depending on the extent of surgery. Temporary changes in bowel frequency and consistency are normal.

• Keyhole (laparoscopic) wounds are small and typically heal quickly. Open wounds are larger and may take longer.
• Most dressings can be left intact for one week or longer — they are designed to stay in place. Only remove if irritating your skin, lifting off, or frankly soiled.
• You can shower straight away. The dressings used are waterproof, so they can get wet without needing to be changed. Afterwards, pat dry — do not rub.
• Dissolvable sutures are commonly used — these dissolve on their own and do not require removal. Staples, if used, will be removed at your wound check appointment.
• A small amount of clear or slightly blood-tinged ooze from the wound is normal in the first few days. Change dressings as directed.
• Do not apply antiseptic creams or powders to wounds unless specifically instructed.
• Avoid baths, swimming pools, and spas until wounds are fully healed — usually 4–6 weeks.

• You can resume your normal pre-operative diet on discharge unless your surgeon has specifically advised otherwise. There is no need to follow a low-residue or restricted diet by default.
• Drink at least 8 glasses of water daily — adequate hydration is essential for recovery and bowel function.
• In some cases you may be commenced on early fibre supplementation (e.g. Metamucil, psyllium husk) — this helps bulk and regulate stool consistency after surgery. Take as directed.
• Some patients experience a temporary increase in bowel frequency, looser stools, or urgency after bowel surgery. This usually improves over weeks to months as the bowel adjusts.
• If you develop persistent diarrhoea, constipation, nausea, or vomiting after discharge, contact our rooms.

Recovery timelines vary depending on the extent of surgery, whether keyhole or open, and individual factors. Specific advice is given at your follow-up appointment.

You may resume sexual intercourse when you feel comfortable and pain allows — generally from 2–4 weeks after bowel surgery, longer after major or open surgery. There is no strict medical restriction, but avoid positions that place strain on the abdominal wound. If you have had pelvic or rectal surgery and have concerns about specific changes (e.g. erectile function, sensation), please discuss any concerns at your follow-up.

• Continue all regular medications unless specifically told to stop — in particular blood pressure, heart, thyroid, and diabetic medications.
• Blood thinning medications (warfarin, apixaban, rivaroxaban, clopidogrel, aspirin) will be withheld around surgery and restarted as directed. Follow specific guidance given at discharge.
• A stool softener (e.g. Movicol, lactulose) is commonly recommended in the first few weeks — take as prescribed.
• Iron supplements may be prescribed if you were anaemic before surgery — take with food to reduce nausea.

A follow-up appointment is usually arranged for 2–4 weeks after discharge. The wound is checked in person and there is time to answer any questions. This follow-up review is at no charge. Our rooms will contact you to book the appointment; you are also welcome to call us at any time to book or to discuss any concerns in the meantime.

If your surgery was for cancer, your pathology results will be discussed at this appointment and at a multidisciplinary team (MDT) meeting. What the results mean and whether further treatment — such as chemotherapy or radiotherapy — is recommended will be explained at this appointment. Please ensure you attend this appointment.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Increasing abdominal pain, particularly if sudden or severe.
• Increasing redness, warmth, swelling, or pus-like discharge from the wound — possible infection.
• Significant rectal bleeding, passing clots, or feeling dizzy or light-headed.
• Not passing wind or bowel motions for more than 3–4 days after discharge — possible ileus or obstruction.
• Persistent nausea or vomiting, or inability to keep fluids down.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Calf pain or swelling, or sudden shortness of breath or chest pain — call 000 immediately.
• Any other concern that something is wrong — it is always better to ask.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

A stoma is a surgically created opening in your abdomen through which bowel contents are diverted into a bag (appliance) worn on the skin. A colostomy diverts the colon and typically produces a formed or semi-formed stool. An ileostomy diverts the small bowel and produces a higher volume of liquid output. Some stomas are permanent; others are temporary, with the bowel joined up again at a later operation.

• A healthy stoma is pink to red and moist, similar in colour to the inside of your cheek. Some swelling immediately after surgery is normal — the stoma will shrink to its permanent size over 6–8 weeks.
• Light bleeding from the stoma surface when cleaning is normal — the tissue is fragile and has a good blood supply.
• Contact our rooms or your stoma nurse if the stoma appears very dark (purple or black), dry, or sunken — this may indicate a problem with blood supply.

• Change your bag regularly — typically every 2–3 days for a two-piece system, or when the bag is one-third to half full of output.
• Best time to change: first thing in the morning, before eating or drinking, when output is usually at its lowest.
• Gather all your supplies before starting: new bag/flange, scissors, warm water, soft cloths or dry wipes, a disposal bag.
• Gently remove the old flange by pressing the skin away rather than pulling the flange off. Remove slowly to avoid skin trauma.
• Clean the skin around the stoma with warm water and a soft cloth — avoid soap with moisturisers, oils, or creams as these can prevent the flange from sticking. Pat dry thoroughly before applying the new flange.
• Cut or mould the flange opening to fit snugly around the stoma (allowing 2–3 mm clearance). A poor fit allows output to leak onto the skin and cause irritation.
• Press the new flange firmly onto the skin for 30–60 seconds, using your body warmth to improve adhesion.

• Keeping the peristomal skin (skin around the stoma) healthy is one of the most important aspects of stoma care.
• Skin should be clean, dry, and free from output before applying a new flange. Output that sits on the skin — particularly ileostomy output — causes rapid skin breakdown.
• Use a barrier wipe or barrier ring (provided by your stoma nurse) to protect the skin under the flange edge.
• If the skin becomes red, sore, or broken, contact your stomal therapy nurse — do not simply apply creams and hope it settles, as skin breakdown can escalate quickly.
• Avoid zinc oxide creams, talcum powder, or household skin creams around the stoma unless specifically recommended by your stoma nurse.

• Some patients are advised to eat smaller, lower-fibre meals for the first few weeks while the stoma settles — your stoma nurse will give you tailored guidance. After that, gradually reintroduce foods one at a time to see how your stoma responds.
• Ileostomy: Output will be liquid to semi-liquid. Aim to drink at least 2–3 litres of fluid daily to prevent dehydration. Monitor for signs of dehydration: dark urine, headache, fatigue, cramps.
• Colostomy: Output should become more predictable and formed over time. Some patients with a sigmoid colostomy can learn to irrigate (flush) the stoma to regulate output — ask your stoma nurse if this is appropriate for you.
• Foods that may increase output or cause odour include onions, garlic, spicy foods, brassicas (cabbage, broccoli, cauliflower), and beans. These do not need to be avoided permanently — experiment gradually.
• Foods that can thicken ileostomy output include white rice, banana, white bread, boiled potato, and marshmallows.
• Chew food thoroughly and eat slowly to reduce wind and blockage risk.

• You may shower with your bag on or off — the stoma itself is not harmed by water.
• Swimming is possible once your wound is healed (usually 4–6 weeks). Waterproof flanges and smaller "swim covers" are available — ask your stoma nurse.
• Avoid very hot baths, as heat can loosen the flange adhesive.

• Most clothing worn before surgery can be continued — loose, comfortable waistbands are most comfortable initially.
• High-waisted underwear or stoma support garments can help keep the bag secure and discreet.
• You may return to work, socialise, travel, and exercise normally once you are physically recovered. Stomas need not prevent any of these activities.
• You are entitled to a Continence Aids Payment Scheme (CAPS) subsidy through the Australian Government to help cover the cost of stoma products — your stoma nurse or the Australian Council of Stoma Associations (ACSA) can assist with registration.

• No output from the stoma for more than 4–6 hours, especially with abdominal pain and nausea — possible blockage.
• Stoma appears very dark, purple, or black, or dry — possible problem with blood supply.
• Stoma appears to be retracting below the skin surface, or prolapsing outward significantly.
• High-volume watery output (more than 1.5–2 litres per day from an ileostomy) — risk of dehydration.
• Signs of dehydration: very dark urine, dizziness, little or no urine output.
• Severe skin breakdown around the stoma that is not settling with standard care.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• Stomal Therapy Nurse: Your stoma nurse is your primary point of contact for all practical stoma management questions. Their contact details will be provided at discharge.
• Ostomy Australia / ACSA: acsa.org.au — provides information on product subsidies, support groups, and local stoma associations.
• Continence Foundation of Australia: continence.org.au — Australian resource for continence and bowel health, including the National Continence Helpline.

• Pain: Some discomfort at the port-site wounds (usually 3–4 small incisions on the abdomen) is expected and typically settles steadily over the first week. Take paracetamol (1 g every 6 hours) regularly — do not wait for pain to become severe. Add ibuprofen (400 mg with food) if tolerated and not contraindicated. Stronger analgesia is covered under Medications below.
• Shoulder-tip pain is very common after laparoscopic surgery and can be surprising. It is caused by the CO2 gas used to inflate the abdomen during the operation irritating the diaphragm, which refers pain to the shoulder (usually the right). It typically settles within 2–3 days. Walking, gentle movement, and simple analgesia all help.
• Wound discomfort and minor bruising around the port sites is normal and will settle over 1–2 weeks.
• Nausea may persist for 24 hours from the anaesthetic. Eat light foods first; resume normal diet as you feel able.
• Rest: Rest at home for the remainder of the day after surgery. Light walking from the next day is encouraged — it helps with the gas and reduces the risk of clots in the legs.

• Most dressings can be left intact for one week or longer — they are designed to stay in place. Only remove if irritating your skin, lifting off, or frankly soiled.
• You can shower straight away. The dressings used are waterproof, so they can get wet without needing to be changed. Afterwards, pat dry — do not rub.
• Avoid baths, swimming pools, and spas until the wounds are fully healed — usually 2–3 weeks.
• Most skin sutures are dissolvable and do not need to be removed.
• The umbilical (belly button) port is the largest of the keyhole wounds and may feel slightly tighter or more sore than the others — this is normal.

• Most patients can return to a normal diet within a few days.
• Some people find fatty or greasy foods cause loose stools, bloating, or mild abdominal discomfort in the first few weeks. This usually settles as the body adjusts. Reintroduce rich foods gradually.
• A small number of patients have ongoing looser or more frequent bowel motions long-term — usually mild, manageable, and improves over months.
• Drink plenty of water — at least 8 glasses daily.
• If you develop persistent diarrhoea, severe abdominal pain after eating, or jaundice (yellowing of the skin or eyes), contact our rooms.

You may resume sexual intercourse when you feel comfortable — most patients find 1–2 weeks is a reasonable guide. Avoid positions that place strain on the abdominal wounds until they are healed.

• Paracetamol 1 g every 6 hours, regularly — not just when you feel pain.
• Ibuprofen 400 mg three times daily with food (if tolerated and not contraindicated by stomach ulcer disease, kidney disease, or certain blood thinners).
• Stronger pain relief (e.g. oxycodone, tapentadol) may be prescribed for the first few days — take only as directed. Be aware these commonly cause constipation; pair with a stool softener if needed.
• Continue your usual regular medications unless specifically told to stop.
• If you were prescribed antibiotics at the time of surgery, complete the full course even if you feel well.
• If pain is escalating rather than settling, or feels uncontrolled despite these measures, contact our rooms.

A follow-up review is arranged in person approximately 2–4 weeks after your operation to check the wounds and discuss the pathology result from the gallbladder. Our rooms will contact you to organise the appointment, and this follow-up review is at no charge. You are welcome to call us at any time to book or to discuss any concerns in the meantime.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Jaundice — yellowing of the skin or whites of the eyes — or pale stools and dark urine.
• Severe or worsening abdominal pain, particularly if accompanied by fever or rigidity of the abdomen.
• Persistent nausea or vomiting, or inability to tolerate fluids.
• Increasing redness, warmth, swelling, or pus-like discharge from any of the wounds — possible infection.
• Heavy or persistent bleeding from a wound site.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Calf pain or swelling, or sudden shortness of breath or chest pain — call 000 immediately.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.

• Pain: Some discomfort at the port-site wounds (usually 3 small incisions on the abdomen) is expected and typically settles steadily over the first week. Take paracetamol (1 g every 6 hours) regularly — do not wait for pain to become severe. Add ibuprofen (400 mg with food) if tolerated and not contraindicated. Stronger analgesia is covered under Medications below.
• Shoulder-tip pain is very common after laparoscopic surgery, caused by CO2 gas irritating the diaphragm. It typically settles within 2–3 days. Walking, gentle movement, and simple analgesia all help.
• Wound discomfort and minor bruising around the port sites is normal and will settle over 1–2 weeks.
• Nausea may persist for 24 hours from the anaesthetic. Eat light foods first; resume normal diet as you feel able.
• Bowel function: Some patients have a temporary slowdown in bowel function in the first few days — passing wind is the first sign of return. Walking helps.
• Rest: Rest at home for the remainder of the day after discharge. Light walking from the day after surgery is encouraged.

• Most dressings can be left intact for one week or longer — they are designed to stay in place. Only remove if irritating your skin, lifting off, or frankly soiled.
• You can shower straight away. The dressings used are waterproof, so they can get wet without needing to be changed. Afterwards, pat dry — do not rub.
• Avoid baths, swimming pools, and spas until the wounds are fully healed — usually 2–3 weeks.
• Most skin sutures are dissolvable and do not need to be removed.
• The umbilical (belly button) port is usually the largest of the keyhole wounds and may feel slightly tighter or more sore than the others — this is normal.

• Start with light foods (toast, soup, plain pasta) and progress to your normal diet as you feel able.
• Drink at least 8 glasses of water daily.
• It is normal for the first bowel motion to take 2–3 days to return after surgery. Walking and adequate hydration help.
• If you become constipated — particularly common while taking stronger opioid pain relief — use a stool softener (e.g. Movicol, lactulose, Coloxyl).

Recovery may be longer if your appendicitis was complicated (perforation, abscess) or if open surgery was required. Specific advice is given at your follow-up.

You may resume sexual intercourse when you feel comfortable — most patients find 1–2 weeks is a reasonable guide. Avoid positions that place strain on the abdominal wounds until they are healed.

• Paracetamol 1 g every 6 hours, regularly — not just when you feel pain.
• Ibuprofen 400 mg three times daily with food (if tolerated and not contraindicated by stomach ulcer disease, kidney disease, or certain blood thinners).
• Stronger pain relief (e.g. oxycodone, tapentadol) may be prescribed for the first few days — take only as directed. Be aware these commonly cause constipation; pair with a stool softener if needed.
• Continue your usual regular medications unless specifically told to stop.
• If you were prescribed antibiotics at the time of surgery (particularly if the appendix had perforated), complete the full course even if you feel well.
• If pain is escalating rather than settling, or feels uncontrolled despite these measures, contact our rooms.

A follow-up review is arranged approximately 2–4 weeks after your operation to check the wounds and discuss the pathology result from the appendix. Our rooms will contact you to organise the appointment, and this follow-up review is at no charge. You are welcome to call us at any time to book or to discuss any concerns in the meantime.

If you have not received an appointment, or if you have concerns before your scheduled review, please call our rooms on (03) 9816 3951.

• Severe or worsening abdominal pain, particularly if accompanied by fever or rigidity of the abdomen — possible collection or abscess (a recognised complication, especially after complicated appendicitis).
• Persistent nausea or vomiting, or inability to tolerate fluids.
• Abdominal distension and inability to pass wind or open your bowels for more than 3–4 days — possible ileus.
• Increasing redness, warmth, swelling, or pus-like discharge from any of the wounds — possible wound infection.
• Heavy or persistent bleeding from a wound site.
• Fever above 38.5 °C, shaking chills, or feeling generally unwell.
• Calf pain or swelling, or sudden shortness of breath or chest pain — call 000 immediately.

After hours: present to your nearest emergency department or call 000 for any emergency. For the Austin Hospital Emergency: (03) 9496 5000.