RETURNING HOME FOLLOWING BOWEL SURGERY

RETURNING HOME
FOLLOWING BOWEL
SURGERY
Information Leaflet
Your Health. Our Priority.
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When will I be discharged home?
If your bowel surgery has been performed as an emergency the length of time it takes to
recover in hospital may vary, most patients are discharged home between 5 to 10 days after
their surgery. Patients who have elective surgery can be discharged between 4 to 10 days. You
will not be discharged until your pain is managed comfortably with oral pain killers, you are
managing to eat and drink and you have passed flatus (or wind). You may be discharged home
before your bowels have opened. You will also be assessed to make sure your mobility is back
to the level it was prior to your hospital admission.
If you have a stoma:
Whether you have a permanent or temporary stoma, you will need to be managing this
independently before you are discharged. The Stoma Nurse Specialist will visit you at regular
intervals throughout your stay to give you support and help you manage your stoma care. The
ward nurses are also there to help and support you caring for your stoma. This is to enable you
to feel confident and ready to manage it independently at home.
What happens when I return home?
Complications do not happen very often, but it is important that you know what to look out for.
During the first two weeks after surgery, if you are worried about any of the following, please
phone the telephone numbers at the end of this leaflet. If you cannot contact the people listed,
then ring your GP.
Abdominal pain
It is not unusual to experience griping pains (colic) during the first week or two following major
bowel surgery. The pain usually lasts for a few minutes and will come and go away in spasms.
If the pain becomes severe and lasts for several hours it may indicate a problem such as a
leakage of fluid from the area where the bowel was joined together. This can be a serious
complication that can occur within the first two weeks after surgery. This happens only very
rarely (3-5% of all major bowel operations). This risk can be higher in patients with other
conditions such as, diabetes, pre-existing heart disease and those with inflammatory bowel
disease for instance, Crohns disease. Should this occur, it may be accompanied by a fever and
sweating. You should contact us on the telephone numbers provided.
Passing urine
Sometimes after bowel surgery you may experience a feeling that your bladder is not emptying
fully, especially after the catheter is removed after the operation. This usually improves with
time. If it does not, or if you have excessive stinging when passing urine, please contact us or
you GP as you may have an infection.
Wound care/infections
Depending on the surgical approach, the wounds on the abdomen are closed differently. For
open surgery the wound is often large and runs down the middle of the abdomen, this is
generally closed with clips which are removed approximately 10 days after surgery. For
laparoscopic surgery, keyhole sites and/or smaller wounds running down the middle of the
abdomen are often closed using ‘skin glue’. In this instance the skin glue dries and falls off
naturally over time. In either situation stitches maybe used, some are dissolvable and some
require removal approximately 10 days following surgery.
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If you are discharged prior to the clips/sutures being removed or in some cases, your wound
may have partially broken down and is being managed with dressings only, the ward nursing
staff will assess the wound, advise on the type of clips/stitches and dressings which have been
used and depending on your individual situation refer you to the district nurses, either at home
or your GP surgery, to remove these on their first visit or provide daily dressing changes.
It is not unusual for your wounds to be slightly uncomfortable during the first one to two weeks.
Please let us know if your wound becomes inflamed, painful or swollen, or starts to discharge
fluid. If your wounds have healed continue to shower and bath as normal and pat dry your
wounds.
Bowel habit
Your bowel habit may change after the removal of part of the bowel and may become loose or
constipated or alternate in bouts from one to another, particularly in the first few weeks after
surgery. The effect of your surgery on your bowel function will be dependent on the type of
surgery you have had. The advice in this leaflet is general so please contact your Colorectal
Nurse Specialist and they can provide you with a leaflet tailored to your specific health needs.
Right Sided Surgery one of the functions on the large bowel or colon is to absorb the liquid or
water from the stools. It can take time for the body to readjust to a section of the bowel being
removed and you may find you initially have loose stools. If this is more than three to four times
a day then we may advise taking medication such as Loperamide or Codeine Phosphate.
Please contact us for advice and guidance.

Reduced colon length to absorb water – can cause loose stools/diarrhoea
As we are removing a length of colon and rectum, so we will reduce the amount
of colon that can pull water out of the liquid stool to bulk it up. This means that
you may find your stool is very loose or watery. This can sometimes lead to
leakage of stool from your bottom (incontinence).
Left Sided Surgery If you have had surgery on the left side of your bowel then it may take a
while for your bowel habit to settle down to a more established ‘new normal’ pattern. However, it
is likely that your bowel habit long term will never quite be as it was before your surgery.
Or
Total Colectomy A small number of patient may have had all their colon removed and may
only have their rectum remaining. These patients will have altered bowel function and specialist
advice and information leaflets tailored to their need are available from the Colorectal Nurse
Specialists.
The surgery to remove your tumour can alter a number of things:

Reduced storage capacity of rectum - can cause urgency to go and
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frequency of visits
The storage capacity of your rectum may be less and not able to hold as much
stool as it did before the surgery. This may cause a feeling or urgency (when
you have to rush, as you cannot hold on for long) and may mean that you need to
go more often. This can sometimes lead to leakage of stool from your bottom
(incontinence).
We have joined the remaining rectum with the colon with extremely strong staples
and this may cause a feeling of something being ‘stuck’ inside your rectum or you
may have the feeling that you are not completely empty when you have opened
your bowels. This will usually improve over time.
You may also, at the beginning, find it difficult to distinguish between stool and
wind being in the rectum and may have some difficulty in holding onto wind. This
will also usually improve over time.
It is important to remember that the changes to your bowel function after surgery
are normal and should improve over the 12 week period following your discharge
from hospital. if you feel that you are not coping or managing these changes please contact
your Colorectal Nurses for help and advice.
Is there any special diet I should have?
After having an operation on your bowel there are no dietary restrictions on what you can eat
and drink including alcohol in moderation. However, it is important to continue to eat a wellbalanced, varied diet of fruit, vegetables and whole wheat cereals and bread. Introducing more
protein such as, meat, chicken, fish and dairy products, will help your recovery and aid tissue
repair following surgery.
If you are finding it difficult to eat you may benefit from taking high calorie drinks such as Build
up or Complan (available in supermarkets and chemists) to supplement your food. If you are
suffering from diarrhoea then it is important to replace the fluid loss and to drink extra fluids. The
non-fizzy sports drinks such as Lucozade Sport are very useful in these circumstances.
Can I exercise?
We encourage activity from day one following surgery. You should plan to undertake regular
exercise several times a day and gradually increase during the four weeks following your
surgery until you are back to your normal level of activity. The main restriction we would place
on exercise is that you do not undertake heavy lifting until six weeks following your surgery as it
usually takes this amount of time for the deeper muscle layers of the wound to heal. This
includes carrying heavy shopping, doing housework like vacuuming. In addition, if you are
planning to restart a routine exercise such as jogging or swimming that you wait until at least
four weeks after discharge and start gradually. It is recognised that you are likely to have times
when you feel tired and need to rest; it is advised to rest on your bed free from distractions.
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Common sense will guide your exercise and rehabilitation. In general, if the wound is still
uncomfortable, modify your exercise. Once the wounds are pain free you can normally
undertake most activities.
When can I return to work?
Many people are able to return to work within four to six weeks following their operation. If your
job is a heavy manual job then take advice from the medical staff about when to return to work.
If your surgery has been performed for cancer then further treatment such as chemotherapy
may be required, if this is so please contact the Colorectal Nurse Specialist team for advice
regarding return to work. Contact number available at the end of this leaflet.
If you are in any doubt about returning to work please discuss it with your surgeon or GP.
Sick notes can be obtained from the ward nursing staff to cover your stay in hospital and from
your GP for the rest of your time off work.
When can I drive again?
You should not drive until you are confident that you can drive safely. Once you have got back
to most of your normal activities you should be able to drive. However, we recommend that
before you drive for the first time, sit in the driver’s seat and hit the brake pedal hard as if you
are performing an emergency stop. If you get any abdominal pain when performing this then do
not drive. It is important that any pain has resolved sufficiently to enable you to perform an
emergency stop and turn the wheel quickly in an emergency. You may also find it helpful to
drive short distances to start with and to have a companion with you when you first go driving
again. It is advisable to contact your insurance company before you start driving again.
For patients who have had a stoma (colostomy/ileostomy) formed:
Having a stoma does not exempt you from wearing a seat belt. You are strongly advised to
continue wearing a seat belt to prevent injury.
When can I begin sexual relations again?
Feeling tired and weak after an operation or illness naturally affects your sex drive. As you
gradually start to feel well again and your energy levels return to normal so should your sex
drive. It is important for you and your partner to discuss your feelings openly.
Sexual intercourse can be resumed as soon as you feel comfortable, generally about 2 - 4
weeks after surgery. Occasionally, following surgery or radiotherapy to the rectum or lower
colon, nerve and blood vessel damage can occur. In men this may cause ejaculatory problems
or result in difficulty in maintaining an erection. In women, discomfort or vaginal dryness may
occur. If you have a perineal wound it may take longer to feel more comfortable.
These problems are usually temporary, due to inflammation and swelling after surgery, but in
some instances may be permanent. If you do experience any problems of this nature please
discuss this with your Surgeon or Colorectal Nurse Specialist as specialist help is available.
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When can I go on holiday?
There is no reason why you should not go on holiday but wait until you have your post-operative
appointment, which is approximately 6 weeks after you go home. Patients that need to have
additional treatment, for instance chemotherapy, please seek advice from your Colorectal Nurse
Specialist.
Follow up
An appointment for follow up clinic will be arranged for you. You will be notified by post and this
usually takes place 6 weeks post operatively. However, if you are awaiting results then an
earlier appointment (a minimum of 2 weeks) will be given to you and you will be informed of this
usually by telephone and/or via mail.
For patients who have had a stoma formed:
The Stoma Care Sister will also arrange to visit you approximately 24 – 48 hours after you leave
the hospital (this does not include weekends) to see how you are coping and to give advice
and support. We hope that after your operation you will not have any problems.
Contact us
After you go home from hospital you may continue to feel tired but you should feel progressively
better every day. This means that your appetite should improve, your pain level should go down
and you should be able to slowly increase your daily activity.
If you are not making progress towards what is normal for you, or you feel unwell or
anxious, please do not hesitate to contact the ward where you were an in-patient. Other
numbers provided below can be used for advice and support.
In an emergency you may be asked to come to the Surgical Admissions Unit for assessment.
Ward B6
0161 419 5942 or 0161 419 5259
Ward B3
0161 419 5936 or 0161 419 5233
Ward C6
0161 419 5953 or 0161 419 3062
Colorectal
Cancer
Nurse Specialists
www.stockport.nhs.uk
Doreen Dooley, Jill Taylor, Rebecca Costello
24 hour answer phone:
0161 419 4088
Pager through switch:
0161 483 1010
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Stoma
Care Nurse
Specialist
Jean Sellars, Caroline Dowson, Janet Land
24 hour answer phone:
0161 419 5052
0161 419 5059
Contact via switchboard:
0161 483 1010
Consultant Surgeons
Mr M Saeed
Secretary:
0161 419 4267
Mr E Clark
Secretary:
0161 419 2028
Mr S Rai
Secretary:
0161 419 4268
Mr F Reid
Secretary:
0161 419 4275
Mr M Marsden
Secretary:
0161 419 4265
Dr Hasan
Secretary:
0161 419 4233
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If you would like this leaflet in a different format, for example, in large print, or on
audiotape, or for people with learning disabilities, please contact:
Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: 0161 419 5678.
Email: [email protected]
Our smoke free policy
Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free
NHS Premises' to find out more.
Leaflet number
Publication date
Review date
Department
Location
www.stockport.nhs.uk
SUR24
March 2015
March 2017
Surgery and Critical Care
Stepping Hill Hospital
Surgery and Critical Care | Stepping Hill Hospital