Major Bowel Surgery

What is major bowel surgery?

Major bowel surgery describes removal of some or all of the large intestine (made up of the colon and rectum). It is the main treatment for colorectal or bowel cancer. Other conditions such as diverticulitis, Crohn’s disease and ulcerative colitis may also be treated with surgery.

The cancerous or diseased section of bowel is removed together with some healthy tissue on either side of the affected area. The healthy ends are then joined together with stitches or staples.

If the bowel cannot be joined back together, your specialist bowel surgeon will create an opening (called a stoma) in the abdominal wall. She will then attach the bowel to the stoma so that waste can pass through into a bag. This may be temporary or permanent. Sometimes the colon is joined together, but in order to protect the join a loop of the small intestine is stitched to an opening in the skin of the abdomen (called an ileostomy). The bowel motion is diverted into a bag, allowing the join in the colon to rest and heal. An ileostomy can often be closed after a few months, allowing the bowel to return to working the usual way.

How do I prepare for major bowel surgery?

Your bowel surgery specialist will ask you about any medications you are taking. She will let you know if you need to make any changes to these before and after the surgery.

In the time before your surgery is scheduled, try to look after yourself with a healthy diet and regular gentle exercise. If you smoke, try to stop. Doing these things can help you get through the surgery and recover well.

If you are going to require a stoma (or if it’s a possibility), you will be seen by a specialist stoma care nurse who will take you through what to expect and what you need to do.

You may be admitted to hospital 1–2 days before your surgery so we can prepare your bowel. This usually involves not eating any solid food and drinking a powerful laxative.

What happens during major bowel surgery?

Major bowel surgery is done in a hospital under general anaesthesia. You will be asleep through the whole procedure and will not feel any pain.

Many bowel surgeries can be done laparoscopically.

There are several different types of major bowel surgeries. Your specialist bowel surgeon will talk to you about the procedure that will be best for your condition.

Generally, the diseased part of the bowel is removed together with some healthy tissue on either side. The healthy ends are either joined together or one end is attached to a stoma (and the other end is stitched closed).

What happens after major bowel surgery?

After surgery, you will be taken to the recovery ward. There you will be monitored until you are awake and can go back to your room. You will probably have several tubes attached to you.

You can expect to be in hospital for 7–10 days after major bowel surgery. During this time:

  • you will be given pain relief
  • you will be given fluids via a drip
  • you will be allowed to start eating once your bowel is working again
  • immediately after the operation you might have a tube in your nose that goes down the back of your throat and into your stomach to prevent nausea and vomiting
  • immediately after the operation you will probably have a urinary catheter in place so that you can empty your bladder without having to get out of bed.

Before you go home, you need to be eating and drinking okay and your bowels must be working.

It can take up to 3 months to recover from major bowel surgery. For the first month, you will probably feel weak and tired. It’s important to allow yourself to rest, but don’t stay in bed all of the time. Gentle exercise can help you recover better. Although you might not have much of an appetite at first, try to eat ‘little and often’.

For the first 6 weeks, avoid lifting anything heavy (including shopping, wet washing) or strenuous activity. Your bowel surgery specialist will advise you on when you can return to work.