Large bowel resection - discharge

What to Expect at Home

You may have these problems after you return home from the hospital after having large bowel surgery:

• Pain when you cough, sneeze, and make sudden movements. This may last 1 to 5 days.
• Hard stools, or you may not be able to have a bowel movement at all.
• You may have problems with diarrhea.
• You may have problems with your colostomy.

Self-care

Activity:

• Do not lift anything heavier than a gallon of milk (about 10 pounds) for the first 6 weeks.
• Short walks and going up and down stairs are okay.
• Don't push yourself too hard. Increase your exercise slowly.

Your doctor will give you pain medicines to take at home.

• If you are taking pain pills 3 or 4 times a day, take them at the same time each day for 3 to 4 days. They may control pain better this way. 
• Do not drive or use other heavy machines if you are taking narcotic pain medicines. These medicines may slow your reaction time.
• Try getting up and moving around if you are having some pain in your belly.

Press a pillow over your incision when you need to cough or sneeze. This may lessen the pain. Ask your doctor when you should start taking the medicines you stopped before surgery. 

Wound Care

If your staples have been removed, you will probably have Steri-Strips (small pieces of tape) placed across your incision. These pieces of tape will fall off on their own.

Take sponge baths for the first 2 days after your staples are removed. You may shower after that. Ask your doctor or nurse when you can soak in a bathtub.

• It is okay if the Steri-Strips get wet. But, do not soak or scrub them or let the shower beat directly on them.
• Keep your wound dry at all other times.
• The Steri-Strips will fall off on their own after a week.

Your doctor will tell you how often to change your dressing and when you may stop using one.

• Your doctor will tell you when to start cleaning your wound daily with soap and water. Look carefully for any changes to the wound as you do this.
• Pat your wound dry. Do not rub it dry.
• Ask your doctor before putting any lotion, cream, or herbal remedy on your wound.

Do not wear tight clothing that rubs against your wound while it is healing. Use a thin gauze pad over it to protect it if needed.

If you have a colostomy, follow care instructions from your doctor or nurse. Sitting on a pillow may make you more comfortable if the surgery was in your rectum.

Diet

Eat small amounts of food 5 to 8 times a day. Do not eat 3 big meals.

• Space out your small meals. Wait the same amount of time between each one.
• Add new foods back into your diet slowly--one or two at a time.
• Try to eat plenty of protein.

Some foods may cause gas, loose stools, or constipation as you recover. Avoid foods that cause problems.

If you become sick to your stomach or have diarrhea, avoid solid foods and drink only clear fluids for a little while. Call your doctor.

If you have hard stools:

• Try to get up and walk around more. Being more active can help.
• If you can, take less of the pain medicines your doctor gave you. They can make you constipated.
• You may use stool softeners if your doctor tells you it is okay.
• Ask your doctor if you can take milk of magnesia or magnesium citrate. Do not take other laxatives without asking your doctor first.
• Ask the doctor if it is okay to eat foods that contain a lot of fiber or take psyllium (Metamucil).

Returning to Work

Return to work only when you feel ready to. These tips may help:

• You may be ready when you can be active around the house for 8 hours and still feel okay when you wake up the next morning.
• You may want to start back part-time and on light duty at first.
• Your doctor can write a letter to limit your work activities if you do heavy labor.

When to Call the Doctor

Call your doctor if:

• You have a fever over 101 °F or a fever that does not go away with acetaminophen (Tylenol).
• Your belly is swollen.
• You feel sick to your stomach or you are throwing up a lot. Or, you cannot keep food down.
• You have not had a bowel movement 4 days after leaving the hospital.
• You have been having bowel movements and they suddenly stop.
• You have black or tarry stools, or there is blood in your stools.
• You are having belly pain that is getting worse, and pain medicines are not helping to ease your pain.
• You are short of breath or are having chest pain.
• Your legs are swelling.
• There are changes in your wound from the surgery:
  • The edges are pulling apart.
  • Green or yellow drainage is coming from it.
  • It is redder, warm, swelling, or more painful.
  • Your bandage is soaked with blood.

Alternate Names

Ascending colectomy - discharge; Descending colectomy - discharge; Transverse colectomy - discharge; Right hemicolectomy - discharge; Left hemicolectomy - discharge; Hand assisted bowel surgery - discharge; Low anterior resection - discharge; Sigmoid colectomy - discharge; Subtotal colectomy - discharge; Proctocolectomy - discharge; Colon resection - discharge; Laparoscopic colectomy - discharge; Colectomy - partial - discharge; Abdominal perineal resection - discharge

References

Fry RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Coln and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 50.

Update Date: 12/10/2012

Updated by: Robert A. Cowles, MD, Associate Professor of Surgery, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.