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Post-Operative Instructions for Colon,
Small Bowel and Excisions of the Rectum
Removal
of a portion of the colon, small bowel or rectum is a major operation.
After a period of hospitalization that varies depending greatly on emergency
or elective circumstances, and the presence or absence of complications,
you will be ready for discharge to home or to an alternative care facility.
Discharge from the hospital requires adequate nutritional intake (usually
orally), adequate demonstration of normalization (bowel movements per
anus or stoma), and ability to tolerate oral pain medications (as pertains
to wound discomfort). There is a tremendous variability of "normal" in
all of these areas. Hospital stays from 4 days, which is very short, to
14 days, which is a little on the long side, are in the "range." The average,
however, generally is about 7 days.
When to call your doctor
The most common post-operative "problems" associated
with small bowel, colonic or rectal resections relate to:
- Wound or incisional problems (increased pain, discolorations or concerns
regarding infection).
- Control of bowel function -- after removal of a small or extended
portion of the bowel, regaining of normal bowel function varies with
the individual. We try to control functions and prevent either constipation
or diarrhea.
- Dietary considerations ("What can I eat?," is a very common post-discharge
question.) Normalization of the diet and bowel movements may take up
to several weeks postoperatively. As necessary, dietary restrictions
will be discussed by your doctor prior to your discharge from the hospital.
- Abdominal distress (nausea, vomiting, bloating, gas cramps and hiccoughs)
Increase in any of these symptoms to the point of pain, particularly
if it is worsening as time goes on, is cause for concern, and your colon
and rectal surgeon should be consulted.
- What medications will I take home from the hospital? When may I resume
my "regular" medicines? Medications and supplies upon discharge generally
center around pain control, bowel function regulation (anti-diarrheal
agents or stool softeners), prednisone where applicable, antacids, antibiotics,
supplies concerned with wound care, gauze dressings, occasional drainage
tubes or irrigating supplies.
- Activity constraints such as walking, climbing stairs, driving a
car, sexual activities, running, golfing, and "When can I go back to
work?," where applicable.
- Unusual bleeding from wound, rectum, stoma or other.
- When to see you back in the office: Any further follow-up tests anticipated
in near or distant future such as scans or endoscopy procedures, blood
tests or x-rays. Your physician should cover all of these areas with
you prior to your discharge. If this has not been done or you are uncertain
about any of these items, call your physician to get updated information
soon after you are discharged to home. If you are concerned about any
possible complications, please call your physician immediately. If your
own doctor is unavailable, the oncall doctor is available 24 hours a
day, every day of the year, including holidays. If after hours, you
may reach any of our physicians by calling any of our offices. The answering
service will locate our doctors on call. In an emergency try to contact
your colon and rectal surgeon for advice before you go to the hospital.
A telephone call may save you a lot of time, discomfort and expense.
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