Patient should start sitz baths as soon as possible. Sitz baths should be taken three or four times a day for 20 minutes at a time in warm but not hot water. Packing gauze can be removed in 48 hours if it has not yet fallen out.
Acetaminophen or ibuprofen should be prescribed for pain control. Avoid opiate analgesics because of constipating and, thus, stool-hardening effects. If opiates are felt necessary, stool softeners and/or laxatives must be used in conjunction. Antibiotics are not essential. The patient should remain well hydrated and take a stool softener to avoid traumatic passage of feces. This should be continued for 2-4 weeks.