PATIENT INFORMATION POST DISCHARGE FOLLOWING MAJOR
BOWEL SURGERY – OPEN OR LAPAROSCOPIC
The following information is designed to assist you at home with your ongoing recovery. There will be
adjustments for you, don’t be surprised at how tired you can still become. You may find that you
experience some “ups and downs” emotionally, you have after all, had some recent health challenges so don’t be too hard on yourself.
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Pain relief A person’s pain tolerance is very individual – you may infact have no need for further
pain relief. If required at the time of discharge you will be on oral analgesics / pain killers ie
paracetamol (Panamax or Panadol) or Endone. Taken regularly these tablets are very effective. If
you do require relief, you may find taking them as directed first thing in the morning (ie before
warm shower), during the afternoon and before retiring, most useful. Pain / discomfort will
continue to diminish with time. If abdominal pain were to increase then please contact you doctor.

Activity – gradually increase your activity, as you feel able, avoid thinking you feel so good that
you could run a mile and then suffer for the next few days. Be sensible. It is important to allow
yourself to rest ie afternoons have a lie down. Walk around the house every hour initially and then
extend and vary this. Visitors can also be tiring, so again be sensible. If your night sleeping pattern
is interrupted try some old-fashioned remedies ie hot milk with pain relief a half hour before a
warm shower and then retire with a book. After an extended stay in ICU / HDU or hospital in
general, to re-establish sleeping for longer periods a mild sleeping tablet may be warranted for the
first few days at home. Just being home in your own bed is often all that you need.

Wound care - before discharge or soon after - at your doctor’s rooms or with home nurses, your
stitches or staples will be removed from your “wound”. Some wounds may have dissolving sutures
requiring no removal. There may be some “Hypafix” (cloth like tape) over the wound, or even
some thin strips of tape. These are in place to give a little more support to the skin edges, and can
stay on until they “fall” off. You can shower with them on and just dry them gently. Or, you may go
home with a clear film over your wound this usually comes off at a week, or when you have been
instructed. It may look “mucky” underneath – this is mostly congealed blood. The best place to
take off the dressing is under the shower, give the wound a gentle wash and you’ll be surprised at
just how healthy it looks.
Sometimes a wound may become hard and reddened, even split a little (eg at the bottom end)
and weep, usually a straw coloured fluid. While this is naturally alarming for you, more often than
not it is a short-term delay in wound healing. Should you be concerned or if you feel unwell,
develop a fever, the wound area (or wound drain site) becomes very hot, swollen or starts to weep
please don’t hesitate to ring your surgeon or speak to the nurse at his rooms.

The white stockings that you have been wearing in hospital are designed to help reduce the risk
of clot formation in your legs. Continue to wear these until you are fully mobile. (Don’t throw them
away as you may find them useful if you fly or take long trips and are sitting for extended times.
They are actually quite expensive to buy.) Wear shoes / slippers on hard floors – stockings can
be slippery.

Bowel function.
Following large bowel surgery, your toileting habits can be erratic or
unpredictable. This will settle with time – try and be patient. Bowel function is at its worse
immediately after surgery and will continue to improve for anything up to a year or two. There are
some strategies to help if;
 You have more frequent, “gassy” and softer bowel actions – even very loose motions.
 You feel as if you don’t completely “evacuate” your bowels.
 You have some urgency, even incontinence.
 Constipation is an issue.
Diet can play an important role in helping the above.
By the time you are discharged from hospital – unless specifically directed by your surgeon, you
will be able to eat a normal diet.
Here are some pointers. Remember - just as you are an individual, so is your bowel.
You need to choose from a well balanced diet – which meets your needs and tolerances.

Your body needs nourishment to promote healing and provide energy.
It
still has a lot of work to do.


Include foods from the 5 food groups.
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Breads and cereals
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Vegetables
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Fruits
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Milk and dairy products
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Meat, chicken and fish
While you continue to recover you may not be interested in facing a 3 course meal.
Try:

Six small meals a day

Serve foods on a bread & butter plate – easier to
appreciate

Space drinks between meals and snacks

Find your mother’s old cook book – there are some
tried and true recipes that may just be the right thing.

Gradually build back to standard serves.

Avoid foods that you know from past experience cause problems ie loose bowel
motions, odour or cramps, retry them when your appetite is on course and you are
feeling confident.

It is not unusual to find you have lost interest in some foods and drinks, ie tea or
coffee. The taste just doesn’t seem the same. Water may need a twist of lemon or a
dash of other flavour.

It is very important that you drink
at least 1.5 – 2 litres of fluid a day.
Not only for your general body
needs but also to assist
bowel and bladder function.
FOODS THAT MAKE BOWEL MOTIONS LOOSER & MORE FREQUENT
Fruits (especially stone fruits)
Alcohol – beer and red wine

Fresh
High fibre cereal, bran and bread

Canned
Highly spiced foods – chilly and curry

Dried
Greasy foods
Vegetables especially
Orange, prune or grape juice

red capsicum, peas, corn
Chocolate

cabbage, onions and spinach Caffeine – in cola, tea and coffee

Dried or stringed beans

Brussel sprouts & broccoli
FOODS THAT THICKEN BOWEL MOTIONS
Bananas
Applesauce
Milk arrowroot biscuits
Boiled white rice
Cheese
Yogurt
White bread – not high fibre
Tapioca
Creamy peanut butter
Potatoes and pumpkin
Pasta - white
Pretzels
White marshmallows
FOODS THAT CAUSE FLATUS/GAS
Beans, spinach and onion
Beer
Nuts
Carbonated beverages
Cucumber
Corn
Cabbage family vegetables Radishes
Dairy products
FOODS THAT CAUSE ODOUR
Fish
Turnips
Asparagus
Eggs
Beans
Garlic and some spices
The above is meant as a guide only, we certainly don’t want you to think eating is a chore or
difficult for you – on the contrary, eating should be enjoyable. There may be instances when
referral to a dietician is indicated.
Medications may be prescribed by your doctor to try and slow down the bowel and “dry” out the
bowel motion, for example loperamide and lomotil. Use only as directed and only after being
prescribed by your doctor.
There are of course medications which can cause diarrhoea or make it worse. Most common are
antibiotics and non steroidal anti-inflammatory drugs. Anti-depressant medications can cause either
diarrhoea or constipation. Analgesics / pain killers such as Panadeine which contain codeine can
cause constipation. If you feel that the medications you take are causing problems contact your
doctor to discuss them.
When constipation is a problem are you;

drinking enough fluid?

increasing you activity?

eating a regular and balanced diet?

using pain relief tablets that are constipating?
A mild laxative may be necessary and will be recommended by your doctor if necessary.

Driving – if you can not drive comfortably, responsibly or safely (ie couldn’t brake in an
emergency) you should not be driving. There is no reason why a seat belt can not be worn
following abdominal surgery, the risk of injury due to an accident would far out weigh possible
discomfort experienced from the belt.

Sexual activity after bowel surgery may be resumed once you feel comfortable. However if your
surgery has involved the vagina or you have any other concerns please discuss them with your
surgeon.

Continue the leg, breathing and coughing exercises you were taught and encouraged with in
hospital. Until you have returned to normal activities these exercises will help maintain optimal
breathing/lung function and circulation throughout your body. Naturally not smoking will also aid in
all areas of your recovery – including wound healing.

Follow-up with your surgeon – an appointment is usually made before you are discharged from
hospital. Generally your surgeon would want to review your progress 4 – 6 weeks after the
operation. (Sooner if thought necessary.)
Please contact your surgeon or the nurse at his rooms if you are concerned about
your recovery OR if troubled by any of the following:
 Nausea or vomiting.
 Increasing abdominal pain & or distension.
 Temperature / fever / night sweats.
 Problems passing your urine eg stinging, burning, loin pain.
 Your wound is becoming increasingly red, or swollen, there is bleeding or
discharge.
 Ongoing problems with reestablishment of bowel function ie continuing diarrhoea
or constipation.
Rooms phone number 8267 3355 all hours
IN A MEDICAL EMERGENCY PLEASE GO TO YOUR NEAREST HOSPITAL WHICH
HAS AN EMERGENCY DEPARTMENT FOR ATTENTION.
21.11.10 ajh/dt