If you are coming into hospital for bowel (colorectal) surgery you may be placed on our enhanced recovery programme. This programme has multidisciplinary input and aids post operative recovery, reducing your hospital stay to a minimum.

Before your admission you will be seen in the pre-operative assessment clinic. The nurse will ask you questions regarding your medical history and general health. Blood will be taken for a routine check.

If you are prescribed Warfarin, aspirin, anti-platelet drugs the oral contraceptive pill or hormone replacement therapy, you may need to stop these before the procedure; please speak to the surgeon or nurses in pre admission clinic or the ward you are attending. However, it is very important that you think about other contraceptive methods and your general practitioner will be able to advise you about this.

Your body needs plenty of nutrients to recover from an operation. Although you will not be allowed solid food from six hours before your operation, you will be given carbohydrate rich drinks to have the day before your operation and the morning of surgery.

Carbohydrate drink information - Vitajoule is a nutritious drink that we want you to take prior to your surgery. This is to provide you with extra calories to make up for you not eating. Below are instructions on how to take Vitajoule.

The night before your admission mix two sachets of 50g Vitajoule supplement with 800ml of water and then drink. You must have nothing to eat from midnight but can drink any fluids until 4am.

On the morning of your surgery mix one sachet of 50g Vitajoule supplement with 400ml of water and then drink before 7am. If you have any questions, please contact the colorectal nurse specialist:

Telephone: (0191) 233 6161 and ask for extension 37665.

You will be asked to come in either the day before, or on the morning of, your operation. Please bring with you any medicines you are taking and show them to the doctor. You will be shown to your bed area by a nurse who will note your personal details.

The anaesthetist will visit you before the operation; they will discuss the types of anaesthetic available and will discuss any previous problems you have encountered with anaesthesia.

Prior to surgery, or the evening after surgery, you may be given a small injection. This will be given in the top of your arm and is used to prevent any clots forming in your legs (also known as DVT).

Please be aware if you are arriving on the day of your surgery you may be admitted before your surgery to a special pre operative area. After your operation you will be admitted to a ward area specific to your needs.

You will be transferred to theatre on your bed or a trolley, after the operation you will be transferred to a recovery area prior to returning to the ward.

You may be given an enema to clear the contents of your bowel before your operation.

Your body needs plenty of nutrients to recover from an operation. Although you will not be allowed solid food from six hours before your operation, you will be given carbohydrate rich drinks to have the day before your operation and the morning of surgery. This is to provide you with the extra calories to make up for not eating.

You will be given surgical stockings to wear. These reduce the risk of a blood clot forming in your leg veins. When you are in theatre you will also be given an injection of Tinzaparin. This is a medicine which thins the blood and helps to prevent clots.

Once you are awake from your anaesthetic, you will go back to the surgical ward.  You may have a small tube (catheter) in your back for the next few days to provide you with continuous pain relieving medicine (epidural). You will have a tube (catheter) in your bladder. This is so that we can monitor how well your kidneys are working and how much urine you are making.  

You will be given extra oxygen to breath via a mask and you will have a drip in your arm giving you fluid.

A few hours after your operation you will be able to start to drink. You will be given two nutritious drinks on the evening after your operation. This is to provide you with the nutrients necessary for healing.  The nursing staff will help you to sit up out of your bed.

If you have any pain you can be given additional painkillers so please tell the nursing staff if you are uncomfortable. It is very common to feel sick after an operation. You can be given an anti-sickness medication to help with this.

It is important to do deep breathing exercises. The physiotherapist will explain how to do this. It is important that you do these exercises at least twice an hour when you are awake to reduce the risk of a chest infection.

You will be able to eat and drink today. You will also be given four nutritious drinks as extra supplements throughout the day.

The nurses will help you out of bed and you should spend at least eight hours out of bed today. The physiotherapist will help you to walk and you should aim to walk the length of the ward four times. Being upright out of bed and walking around is good for your recovery. It helps prevent chest infections and encourages your bowels to return to normal function.

Day 2 onwards

You will be started on oral painkillers. The dose will be adjusted to give you optimal pain relief. It is important to continue with your deep breathing exercises.

Your catheter will be removed on day 2-3. If you are managing to drink enough, the drip will be stopped. You can eat and drink as usual and will have extra nutritious drinks as supplements.

You should spend at least eight hours out of bed and aim to walk a little further each day.

Discharge

You should be able to leave hospital about four days after your operation. We will not discharge you from hospital until we are sure that you are ready. This means that we will make sure your pain is well controlled, you are able to eat and drink, your bowels are functioning and there is someone at home to help you.

This provides information about your discharge from our enhanced recovery programme following your colorectal surgery. If you have any further questions please ask a member of staff.

What if I feel unwell?

Complications do not happen very often, but it is important for you to know what to look out for should you feel unwell. If you are concerned about anything in this leaflet, contact details are given at the end.

Bowel Function

Your bowel habit may change after part of your bowel is removed. Your motions may become loose or you may be constipated. Make sure that you eat regular meals and drink plenty of fluids. If you are concerned about your bowel function you can contact us for advice.

Abdominal Pain

You may suffer from some stomach pains during the first week following your operation.

This pain usually lasts for a few minutes but goes away between spasms. If you have severe pain lasting more than 1-2 hours or have a fever and feel generally unwell, you should contact us on the given numbers.

Urinary Function

After bowel surgery you may get a feeling that your bladder is not emptying fully, this usually resolves with time. If you have excessive stinging or burning when passing urine please contact us or your GP as you may have a water infection.

Wound Care

For the first 1-2 weeks following your operation your wound may be slightly red and uncomfortable. If your wound is inflamed, painful, swollen or discharging fluid please contact the surgical team on the numbers provided.

Diet

Make sure that you eat regular meals. You may find some food cause looseness of the bowels. If this happens you should avoid these foods in the first few weeks after your surgery. If you do have diarrhoea it is important to replace the fluid loss by drinking extra liquid.

Hobbies / Activities

You can return to hobbies and activities soon after your surgery. This will help your recovery.

Gradually increase your exercise during the four weeks after your operation until you are back to your normal level of activity.

Do not undertake heavy lifting until six weeks following your surgery.

Once your wound is pain free you can return to your usual activities.

Contact Details

• Main hospital switchboard 0191 233 6161
• Colorectal Nurse Specialist (08:00 - 17:00) - Ask for extension 37665
• On-call Surgical Senior House Officer (SHO) (17:00 onwards and weekends) -  Ask for extension 48600