Discharge advice after colorectal surgery

This information sheet has been provided to help answer some of the questions you, your family and friends may have about what to expect after your colorectal surgery.

Will I need to visit the hospital again?

Yes, for a check-up at the clinic in Outpatients 2, six weeks after your discharge home. We will either give you an appointment before you leave or post one to you. Your doctor will give you the results of your operation at this appointment, make plans with you for any further treatment and answer any questions you may have.

You may also need an appointment with an oncologist (cancer specialist) to discuss whether or not you would benefit from any further treatment such as chemotherapy.

When can I get back to normal?

Diet

You should aim to eat regular meals three or more times a day. If you are finding it difficult to eat, you may find it helpful to supplement your diet with nourishing drinks. It is very important to obtain an adequate intake of protein and calories.

Bowel function

It can take a while for bowel function to return to a manageable pattern. Your nurse specialist will discuss this with you as it will depend on the type of surgery you had and experiences vary for individual patients.

Your stools may become loose or you may become constipated. If you are passing loose stools more than four times a day for more than four days, we advise taking medication such as loperamide, which you can buy from pharmacies without a prescription.

Prescription medicines and some painkillers can cause constipation. If you are not back to your normal bowel routine within two weeks, ask your GP for a stool softener, such as lactulose or contact the nurse specialist.

Driving

Unless your doctor advises you otherwise, do not drive until you have had your check-up in the Outpatient Clinic. Your strength and speed of movement must be back to normal, as you must be able to perform an emergency stop. It is important that you inform your insurance company that you have had an operation to ensure that you are covered in the event of an accident.

Exercise and general activities

It is fairly common to feel weak and tired immediately after discharge home from hospital and you should aim to increase your level of activity gradually. Start by going for short walks every day, gradually increasing the distance you walk.

Most patients are able to get back to normal (including participating in sport or exercise) approximately 6–8 weeks after they go home.

You should not go swimming until your wound is completely healed.

You should not lift anything heavier than 4.5 kg (10 lb) for the first six weeks, but this can be increased gradually. If lifting anything causes pain or discomfort, stop and put it down.

Sexual activity

In most cases, sexual intercourse can be resumed once you have recovered from your operation and your wound is fully healed.

Men can sometimes experience difficulties achieving an erection because of bruising around the nerves in the pelvis. This is normally temporary and can be treated with medication by your GP.

Some women find the shape of the vagina feels different and that it feels dry. Experimenting with different positions and using lubricants (such as K-Y Jelly) may help. It is normal to be a little anxious at first, but try to be patient. If difficulties persist, please do discuss them with your doctor or nurse specialist, who will be able to help and advise you.

Work

Patients with ‘light’ occupations (such as office work) may be able to return to work approximately three weeks after surgery. However, if your work is physically demanding, you may need to stay off for 4–6 weeks. If you had surgery for cancer, there are booklets available for patients to give to their employers which will help both the employee and the employer to agree a return to work programme.

Check with your surgeon and your employer if you are not sure. Please note that you may continue to feel very tired for some weeks after your operation.

Looking after your wound at home

It is safe to get your wound wet, unless the doctor has told you otherwise. Please do not use antiseptic, bubble bath or anything else in the bathwater until the wound has healed, unless instructed by your doctor.

Wash over your wound gently using soap and water, then rinse thoroughly. Pat your wound dry with a clean towel.

If stitches were used to close your wound, these will dissolve about six weeks after your operation and will not need to be removed. If your wound was closed with staples, these will need to be removed. The nurse on the ward will advise you about this before you are discharged home.

Steristrips are small pieces of tape sometimes used to hold wounds together. If there were used in your case, you can remove them once they start to peel off your wound. If they are still in place ten days after your operation, you should remove them yourself in the bath or shower.

Is there anything I need to watch out for at home?

Sometimes after bowel surgery you experience a feeling that your bladder is not emptying completely. This usually resolves within 2–3 weeks. However, if it does not, or if you have excessive stinging when passing urine, please contact us as you may have an infection.

You may feel different sensations in your wound, such as tingling, itching or numbness. This is normal and is part of the healing process.

Please contact your GP or your nurse specialist if you experience any of the following:

• Persistent nausea (feeling sick) or vomiting (being sick)
• Persistent bleeding from the rectum (back passage)
• Fever or a high temperature (37.5°C/101.5°F or above)
• Pus or increasing redness around the wound
• Increasing pain
• Increasing diarrhoea

If you have any queries or concerns, please contact the ward where you had your operation or the colorectal nurse specialists.

Contact information

Colorectal Nurse Specialists

Chelsea and Westminster Hospital
T: 020 3315 8354

West Middlesex University Hospital
T: 020 8321 5892