As you prepare to leave hospital you may need to get certain things organised. To help you with your planning, make sure you get the answers to these three questions:
For further information please speak to the staff looking after you.
The Enhanced Recovery Nurses will discuss your discharge date with you.
Complications should 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 bottom of this page. You should be able to reach a member of staff on the ward at anytime. If you cannot contact the people listed, you will need to contact your GP or the NHS 111 service.
It is not unusual to suffer gripping pains (colic) during the first week following removal of a portion of bowel. The pain usually lasts for a few minutes and will go away completely in between spasms.
Severe pain that lasts for several hours may indicate a leakage of fluid from the area where the bowel has been joined together. This can be a serious complication, which fortunately, happens only rarely. Should this occur, it may be accompanied by a fever. On occasion leakage may occur which makes you feel generally unwell, causes a fever but is without pain.
If you have severe abdominal pain lasting more than 1-2 hours and/or have a fever and feel generally unwell, you should contact us on the telephone numbers provided immediately.
Occasionally after surgery you can experience some nausea which is not unusual. Persistent nausea and vomiting however is not to be expected as this could be a sign of obstruction. If this happens to you it could be a sign of obstruction which needs to be treated.
If you experience severe nausea and vomiting please contact us immediately on the telephone numbers provided.
The ward nurses will check your wound dressing before discharging you home.
If you have had key hole surgery you might have paper stitches (steristrips) which may be left directly on the wounds. You can continue to bathe or shower and you can pull these off after 7 days during a soak in the bath. You shouldn’t need further dressings after this.
For other wounds it is possible that either dissolvable stitches or a special adhesive will be used and again you may continue to take light showers or baths. If you require a dressing for a longer period of time then the nursing staff will advise you.
It is not unusual for your wounds to be slightly red and tender during the first 1-2 weeks. You may also notice bruising.
Please let us know if your wound:
As this may indicate an infection. You may also wish to contact your GP or practice nurse at your surgery for advice.
In the early stages following surgery to remove part of your bowel, your bowel habit may change and may either become loose or constipated. This can continue for up to 2-3 weeks.
Try to eat regular meals three or more times per day, drink adequate amounts, and take regular walks during the first two weeks after your operation. This will help improve bowel function.
Please note that if you have an ileostomy it is normal to pass loose stools more frequently than 3 times per day into the Stoma bag. The stoma nurse specialists will discuss this with you.
Please seek advice from the Enhanced Recovery Nurses, your GP or by contacting one of the telephone numbers at the bottom of this page if you are experiencing any of the following:
Sometimes after bowel surgery you may experience the feeling of a full bladder.
This usually resolves, however if you experience ANY of the following problems please ring for advice:
A balanced, varied diet is recommended and particularly eating 3 or more times a day. You may find that some foods upset you and cause loose bowel motions. If that is the case you should avoid those foods for the first few weeks following your surgery. You may find a low residue diet will help in the first two weeks after your operation.
If you are finding it difficult to eat it is still important to obtain an adequate amount of protein and calories to help your body heal. You may benefit from having three to four high protein, high calorie drinks such as Build-up or Complan (available in supermarkets and chemists) to supplement your food, or continue with the Fortisip or Fortijuce drinks which can be prescribed by your GP.
It is important to drink plenty of water. If you are suffering from diarrhoea then it is important to replace the fluid loss and to drink extra fluid.
If you are losing weight without trying or are struggling to eat enough you may benefit from a consultation with the dietitian, please contact any of the numbers provided below and someone will be able to help you, or ask your GP or consultant to refer you.
Try to include high calorie and high protein foods at each mealtime.
Fatty and sugary foods such as:
Try these snack ideas which are high in energy or protein:
Milky drinks are high in energy and protein. Choose from the following:
If you dislike milk, try these high energy alternatives:
The following suggestions may help to add extra energy and protein to everyday foods if you have lost weight or are not eating much:
We encourage activity from day one following surgery. You should plan to undertake regular exercise several times a day and gradually increase during the 4 weeks following your operation 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 4 - 6 weeks following your surgery. In addition, if you are planning to restart a routine exercise such as jogging or swimming that you wait until 2 weeks after surgery and start gradually.
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 undertake most activities.
Many people are able to return to work within 2 - 4 weeks following their surgery. If it involves a heavy manual job then we would not advise heavy work until 6 weeks following surgery.
It is advised that you do not drive until you are confident that you can drive safely. Usually this is when you are doing most of your normal activities. In general this will be after 4 weeks of surgery. It is important that any pain has resolved sufficiently to enable you to perform an emergency stop. You should contact your insurance company to check their terms or you may not be fully insured.
In general it is advised that you take up your hobbies and activities as soon as possible again after surgery. It enables you to maintain your activity and will benefit your convalescence.
We would not advise restricting these unless they cause significant pain or involve heavy lifting within the first 6 weeks following surgery.
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 two to four 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 and/or maintaining an erection. In women, discomfort or vaginal dryness may occur.
These problems are usually temporary, due to inflammation and swelling after surgery, but in some instances may be permanent. If you do experience problems of this nature, please discuss it with your surgeon or colorectal nurse specialist, as specialist help is available.
You may continue with your normal medicines unless directed to stop by your doctor. You will be given a new supply of these if you do not have enough at home. You will also be given pain killers and any other medicines required, to take home.
It is a good idea to have a supply of non-prescription pain killers, such as Paracetamol, at home as a back up.
If you are required to continue with the ‘Clexane’ injections at home, you will be given enough pre-filled syringes to complete the course (usually for four weeks after your operation) and a ‘sharps bin’ to put the used syringes into. Your GP or local chemist will be able to advise you on how to dispose of the bin in your area.
If you are under the care of one of the colorectal nurse specialists, your follow up appointment will be arranged by them. They will discuss this with you as soon as the biopsy results are available. This will usually be approximately two weeks after discharge home. Otherwise an appointment will be sent through the post as directed by the consultant.
Follow up appointments allows the team to see how you are and talk through any further treatment. Please do not hesitate to contact any of us on the numbers provided below if you need any help or advice following surgery.
If your surgery was planned (not an emergency) the enhanced recovery nurse will phone you at home each day for approximately four to five days to check on your progress. In between times, if you have any concerns, you can contact them on the number provided, or out of hours contact the ward.
If you experience any of the following please seek urgent advice by contacting us on the numbers below.
www.nhs.uk/conditions/enhanced-recovery
www.gov.uk/government/organisations/department-of-health-and-social-care
Telephone: 0117 414 3610
Telephone: 0117 414 3611
Telephone: 0117 414 0514
Telephone: 0117 414 0270
Gate 32B Brunel building
Southmead Hospital
Bristol
BS10 5NB
Telephone: 0117 414 3233
Telephone: 0117 414 3234