Discharge Advice following Bowel Surgery
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Your colorectal team and nurses will discuss with you when is the right time for you to go home. This may be after a few days or longer. Even though you may be well enough to go home, many people are surprised at how long it can take to recover from an operation. Make sure you take time to rest when you are at home.
How to manage your pain
It is normal after bowel surgery to experience some abdominal discomfort. This may be from the wound or colic type discomfort from the bowel itself. This should continue to improve over several weeks. You should continue to take the pain relieving medication given to you on discharge from hospital. If you need more, please see your GP. A copy of the prescription is sent to the GP when you are discharged. You only need to take painkillers until you are able to carry out your normal activities without significant discomfort.
Your wound will either have been closed with staples or glue. It may have not fully healed by the time you go home. If you need to have further dressing changes the nurses on the ward can arrange this. This will be with either the district nurse or your practice nurse. You may have some bruising around your wound; this is normal and will disappear over time. Numbness, itching or tingling can be common as the wound heals. Scar tissue can feel hard and lumpy under the wound at first but this will soften over the following months. If your wound becomes red, inflamed or oozes pus
like fluid, this can indicate a wound infection. You should make an appointment with your GP or practice nurse as you may need antibiotics and dressing changes.
You may shower when you have gone home if the wound is healing well. Avoid soaking too long in the bath and carefully pat the wound dry afterwards with a clean towel.
Eating and drinking after bowel surgery
You will be encouraged to eat and drink after your surgery but it can take some time to get your appetite back. You may find it easier to try small frequent meals and snacks. Some foods can irritate the bowel giving you more wind or bloating. If this happens, you could try reducing the fibre in your diet. You can start to include fibre again slowly over a week or two. If you have an ileostomy, the stoma care nurses will give you detailed dietary advice before you are discharged. For further advice on diet please contact the colorectal nurses or enhanced recovery nurse.
Opening your bowels
Your bowel function may change after part of your bowel has been removed. It is quite normal for it to take several days for your bowel to open after surgery. You will begin by passing wind and then you will get the normal sensation of needing to open your bowels. It may be unpredictable to begin with and can be looser than usual. Some people experience constipation after surgery and you may be given a gentle laxative. You can help by walking regularly and drinking plenty of liquid.
Depending on the type of bowel surgery you have had, it can take several weeks or months for your bowel function to settle. Some people find that their bowel function never returns to its previous pattern but that they develop a new pattern. If you have had a stoma formed you will receive specialist advice from the stoma care nurses before and after you are discharged home.
Rest and exercise
It is normal to feel tired and weak for 2-3 months after your operation. It is important that you rest when you are tired but you must not spend long periods in bed during the day. Tiredness will improve and you will become stronger. Walking is a good form of exercise to begin with. You can increase the distance a small amount each day. To start with do not lift anything heavier than a full kettle for the first 2-4 weeks. You can then build up your activity levels according to how you feel.
Resuming sexual relations
The stress and anxiety caused by having surgery can reduce your sex drive. As you recover and your energy levels improve so should your sex drive. You can have sex as soon as you are feeling
comfortable. It is important that you and your partner make time to talk about your feelings so that you feel more relaxed when you feel ready to be intimate again. Sometimes after surgery or
radiotherapy to the rectum or pelvis you can get bruising to the nerves and blood vessels that control sexual function. In men this can cause ejaculatory problems or difficulty in getting/keeping an erection.
In women this may cause vaginal dryness or discomfort. This is usually temporary and will resolve as you recover from surgery. Depending on the surgery you have had, for a small number of patients, this can be a permanent problem. Your surgeon will have discussed this with you before your operation if you have a higher risk of this happening to you. You may speak to your consultant or nurse specialist if you continue to have concerns as additional help is available.
Driving and returning to work
If you have had laparoscopic (keyhole) surgery, you should wait at least 2 weeks before you start to drive. If you have had open surgery with a large incision, it will be 4 weeks. In both situations you would need to be able to perform an emergency stop without feeling discomfort. It is advisable to take at least 2-4 weeks off work. The type of surgery you have had and the nature of your work will determine this. You may find it helpful to return to work part time if you can until you become stronger. Your surgeon or colorectal nurse will be happy to discuss this with you.
Your follow up
If you have had your operation for a known or suspected cancer you will be called to come back to clinic approximately 3 weeks after your operation. The results of your operation any recommendations for further treatment will be discussed with you in clinic. If your operation was for a non-cancer condition your appointment will normally be 6-8 weeks after you go home. If you have any concerns, please don’t not wait for this appointment, please contact your GP or enhanced recovery nurse.
Enhanced Recovery Nurse (8am – 4pm) 01908 996540
Colorectal Cancer Nurses (8am – 4pm) 01908 996953
Stoma Care Nurses 01908 996951
Ward 20 01908 996444 (after 4pm, evenings and all-day weekends)
On call surgical registrar (at night and weekends) 01908 660033 – Bleep 1557