Questions about small bowel surgery

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sfgirl

sfgirl

Joined
Nov 1, 2013
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I am going to have to have a small bowel resection soon and I am very nervous about it. I don't know what to expect except what I have read online. Will I be out of work long? Will I have be in lots of pain? Will I have to stay in the hospital long? Any help or advice would be great. Please.:confused2:
 
Hi sfgirl. I've been through lots of surgery. Typically you are in 5-7 days (they want you eating before you're released). It hurts but the doctors want your pain well managed so you can get up and walk. Don't suck it up or it will take longer to heal. You'll need to take it easy for 6-8 weeks. I usually start feeling normal 10 weeks out. If your nervous prior to going into the OR tell the doc. They have wonderful meds to help you relax.
Hope all goes well.
 
I will definitely need relaxation meds. I've had surgeries before but usually just perirectal abscesses & fistulas but every time I need relaxing meds because I can't stop crying. This is my first time having something major though. Will he just do small cuts or one huge one?
 
Hi. I'm not sure. Check with the surgeon. Mine have all been big but the last one was done through the stoma to get rid of a stricture.
 
I'm waiting very impatiently for him to call back :). Mine is a strictures as well I believe. I'm just so nervous I can barely even focus at work today. Thanks for all your help.
 
Hello

You've already had good advice. I wanted to add my advice too. Firstly, the amount of time out of work will depend on what you do, it normally takes 6-8 week's, but can be longer for open surgery, and you should listen to your own body. You will be in pain after your operation, but you'll probably have a pain killer pump, which is attached to an IV, you press a button and get a dose of pain meds. Do this as soon as you feel any pain, don't let it get bad before you press it. Make sure you let your doctors know if you are in excessive pain.

Make sure that you get up and walking a little as much as you can once you are ready, it does hurt at first, but the more you do it, the easier it will get .

The length of your hospital stay will depend on what type of surgery you have (key hole or open) . For my surgery, I had one cut that was about 2 inches and then 3 others that were really tiny. Key hole surgery is becoming more common these days as it has less infection risk, quicker recovery, less pain, less scaring, less time in hospital etc, but it is not every surgeon's choice and is a very individual thing. I went into hospital on a Monday, had the op on the Tuesday and came home on the Saturday, pretty standard here.

It's natural to be nervous, just remember that these surgeons do this all the time, they are highly skilled and will take good care of you. We will be here to support you as much as we can. Just make sure you give yourself time to recover and try not to get too stressed.
 
Thank you so much for your advice. I am so grateful for both of your help. I definitely need to remember not to let my pain get too bad because even now I wait until the last minute to do anything about my pain. I always try to tough it out.

I keep telling myself not to be nervous and just let the doctors do what is best but I just really hate the unknown. It drives me crazy to not now what is going on and google only makes things worse lol.
 
Hi and :welcome:

DJW said:
...(they want you eating before you're released). .
Click to expand...

And probably also having a BM. These days they get you up and moving around as soon as possible (even before YOU think that it is possible) and that helps with getting your gut moving, too.
 
Yes, as Susan mentioned. Your bowel needs to wake up before eating. First step is rumbling in your gut followed by passing gas. Everything will be working again before you're released.
 
DJW said:
Your bowel needs to wake up before eating. First step is rumbling in your gut followed by passing gas. Everything will be working again before you're released.
Click to expand...

So pretty much after the surgery my bowel will need to learn to work again slowly?
 
No. It just goes quiet from the surgery/anesthetic. It takes a few days to start working again. Once it starts working you go on clear fluid, then full fluid and then food.
 
When I had surgery, I started eating before my bowel woke up, my surgeon pointed out that if I didn't eat I'd have nothing to pass... So it's not always the same order for everyone.

I was actually allowed to drink water the day of operation (once out of recovery), and then I was allowed soup the next day.. Different surgeons will have different ways of doing things, but I was encouraged to take sips of water as often as I could the night after the op and after I kept the soup down, I was even told my parents could bring me a few things. Although I am gluten intolerant (severe coeliac) and the food the hospital was providing was useless, so my surgeon recommended that so I could get some decent food in me.
 
I see. I can't wait to go see my surgeon so I can know his specifics. I'm not quite as afraid now after hearing from all you guys.

Hopefully I will start finally to feel much better after this.
 
Whether you can have laparoscopic surgery depends whether you have had open surgery in the past. I have always had open surgery unfortunately. They don't generally give premeds any longer. You need to ask surgeon. I was told I could have a premed before my last surgery and my surgeon said I could if I wasn't first up. Unfortunately on the day of the op, the anaesthesiologist refused until my blood sugar dropped. Reluctantly gave me a tablet which I threw up. So make sure you sort things out before your op. My last resection I was in six days. My advice to you is to walk, walk, walk, as soon as you can. Movement gets the bowel working. Good luck. I know it is scary, but you will be fine. Hold onto the fact that you will be so much better afterwards.
 
Well I've never had open surgery. I've never had this type of surgery at all only rectal surgeries for abscess removals.

I'm definitely going to keep holding on to hope that this will help. Its been a long 6 years of this and I'm ready for remission.
 
I know that this seems scary but surgery has been the one thing to bring out remission in me. Hold onto that thought. I hope that it will do it for you. I was back at work after six weeks after my last operation. I hope like me you will feel better than you have in years. It will be worth it.
 
In your situation as a general rule they will start with laparoscopic and only change to open if they run into complications, unless the surgeon otherwise stipulates.

Both of my kids have had small bowel but theirs was open due to existing complications. Ignore the yearly time frames as the post I lifted this from is about 2.5 years old…

Sarah:
had a right hemicolectomy 5 years ago and has been in remission since that time. Her surgery was an emergency, she was undiagnosed, and so was performed as an open procedure. This is an outline of her post op recovery...

Surgery day - She was in theatre for approx 4 hours. When she returned to recovery she had oxygen, two IV's, two drains, an NG tube and an IDC (urinary catheter). She was in ICU overnight. She asked to go back to the ward the next morning. I think the surgeon wanted her to stay another day but she couldn't get out fast enough! Oxygen therapy ceased.

Day 1 post op - Moved to the ward and spent the day on bedrest. IDC removed. NG tube on free drainage and morphine IV remained on PCA (patient controlled analgesia).

Day 2 post op - No change with drains and tubes. Physiotherapy commenced. Up out of bed and gentle ambulation commenced twice a day. Although Roo refused to use a pan so started walking to the toilet that day.
Started eating ice chips.

Day 3 post op - One IV removed and condensed IV morphine and fluids into one. NG tube removed. Increasing mobilisation. Ice chips.

Day 4 - Bowels open. Commenced on clear fluids. Mobilising.

Day 5 - Tolerated fluids from previous day and throughout this day so commenced on light diet at tea time. Both drains removed and IV removed. Oral analgesia and antibiotics commenced.

Day 6 - Discharged home.

I don't know if being paediatric made a difference but each day she was visted by the surgical team twice, the physiotherapist twice, the pain management team once and the dietician once.

Sarah was in very poor condition prior to surgery so I felt that she didn't truly recover for a number of months. I would say she was running on about 80% for the first few months and reached full recovery after about 6 months. She returned to school 3 weeks after the operation and has now been in remission for 5 1/2 years.

Matt:
had a right hemicolectomy in April. It was planned surgery that was required due to an existing fistula and abscess. He had a pigtail drain in for 3 months prior to surgery.

Surgery day - He was in theatre for about 4 hours and recovery for 2 hours. When he arrived back on the ward he had one IV that consisted of the PCA (patient controlled analgaesia) and other IV fluids for hydration and IV medication. He also had one wound drain, a urinary catheter and oxygen.

Day 1 post op - No change with IV's or tubes and drains. Started mobilising and about an hour sitting in the chair.

Day 2 post op - Still no change with the tubes and lines. Commenced on clear fluids and continued with gentle mobilisation.

Day 3 post op - Urinary catheter removed, still on clear fluids, mobilising well.

Day 4 post op - PCA removed and started on oral analgaesia, remains on clear fluids, started farting, only one IV now left.

Day 5 post op - Last IV removed, commenced on free fluids, bowels open.

Day 6 post op - Commenced of light diet.

Day 7 post op - Commenced on full diet, drain out.

Day 8 post op - Discharged!

Matt had no issues post op and I feel that the start of week 4 post op was the real turn around in his recovery. It was at this point that he really started to move freely and shades of his old self started to appear. His recovery has been much quicker than Sarah's. He returned to school 3 weeks after surgery, was allowed to drive short distances after 3 weeks and long distances after 6 weeks but he was driving longer distances at 5 weeks. Started soccer training at about 5 weeks as well. He is also in remission.

The life savers in hospital for them were...TV, mobile phone, iPod, laptop with DVD's, ear plugs, comfortable loose fitting pyjamas/clothes, footwear that is easy to slip on an off, like slippers, magazines/books and short visits from friends when they were up to it.

They have both been on maintenance meds (Imuran) following surgery.
Click to expand...

They are both still in remission. :)
 
I'm not feeling too bad djw. A bit of pain off and on but nothing I can't handle. :)

Managua I'm still in a waiting game. More test results pending.
 
DustyKay that was 2.5 years ago & they're both still in remission?! I really hope this gets me in remission. I was diagnosed in 2008 & it's been active the entire time. :(
 
@sfgirl

Sarah’s surgery was nearly 8 years ago (July 2006) and Matt’s was 3 years ago (April 2011). They both continue to be in remission. :)
 
Tomorrow marks 3 weeks since my resection. I have been working half time for about a week.

If I can offer any advice, it would be to take everything as easy as you can. Keep your expectations realistic. I've struggled with this and it still helps me to hear other people tell me the same.

Good luck with your surgery!
 
Thank you. Where do you work? I work in a daycare so I doubt I will be able to go back that fast.

I just heard back from the doctor a few minutes ago and they made me an appointment to see the surgeon on Monday to set up dates. I also have to have a Seton removed and something else put in so I hope he will do it all while I'm out.
 
I teach trombone lessons. So, you're right, you will be out longer than me. I have. 4 year old son, and even he alone was more than I could handle when I got home from the hospital.

A big factor is going to be whether or not they can do your surgery laparoscopically. Mine was supposed to be. But, once they started, they realized they couldn't because my intestines were all matted together. So, I got the full incision, which makes it take longer to fully recover.

I suggest going in to your appointment with your surgeon with a list of questions. It's their job to answer them. Plus, they want you as comfortable as possible going into it. My surgery happened as an emergency. I was freaked out and the doctor took his time when he talked to me.
 
I am so sorry to hear that. I just had a colonoscopy last week so I don't believe they're matted or anything. Did you know you had crohns before the emergency surgery?

I have a whole list of questions that I've been writing down. He's usually pretty good at explaining but I've never had anything major like this.
 
I've had Crohn's since I was 16, a little over 20 years. I've known I was going to need surgery for a few years and was slated to get it in June when work slows down a little. My Crohn's isn't active right now, so the surgery was to remove scarred intestine from a previous surgery. But, the night before Easter, I had a big meal and everything got blocked up. After surgery, they told me that the section they removed only had a 1mm pathway for my food to get through. They couldn't believe I survived that long like that. Crazy!

It sounds like you're in good hands. The whole experience is fresh on my mind, so feel free to pick my brain about anything.
 
Wow that's a long time! I'm not sure how narrow mine is all I know is that my gi couldn't fit a pediatric scope through during my colonoscopy.

How long did your surgery take? What I read online says 1 to 4 hours depending on what happens once they get in there.
 
You know I have had seven resections and I have never asked how long it took. My last one, I think I went into theatre at about lunch time and was back on the ward about 5, but I don't know how long I was in recovery as I think I was hallucinating, I remember being in a huge ward with hundreds of people, obviously a delusion. I never ask for details, I let my surgeon do his business and concentrate on getting better. I am always so grateful to wake up after surgery, that I don't take everything in
 
They said mine was easy. It took an hour and a half. They said they were looking to keep things interesting and decided to make the old incision look nicer.
 
Lol I ask lots of questions but my mom wanted to know how long. As far as I'm concerned the hour wait is what gets me because I have too much time to panic.

A hour & a half doesn't sound too bad. A lot better than 4.
 
You should be able to have an epidural for pain management instead of the PCA. I refused it but only because I am frightened of paralysis having spent time in ICU after my first op and waking unable to move anything. But it is certainly worth considering
 
I will have to look into that. I will write it on my question list. Paralysis sounds pretty scary though.
 
My surgery has been scheduled for June 6th. I went in pretty well informed thanks to all of you and I'm pretty sure things will be great in the end. I am definitely afraid of going in all over again now that I have an actual date however. :)
 
I had a resection on my large intestine in February to remove a stricture. Surgery lasted about 4 hours including the recovery room. I was in the hospital for 6 days and then had to go back in for another 7 days due to a post-surgical obstruction. The pain from the surgery was nothing compared to the obstruction and was less than the pain from dealing with the stricture.

I had the PCA pump and not the epidural. If you get the PCA, just make sure to push the button enough.

Edit - I was off work from February 20 (surgery day) until just after Easter.
 
stay ahead of the pain. if you get a pain epidural - keep it in until day 2, possibly day 3 post surgery. if you don't need it, don't press the button, but don't have them remove it until day 2 or 3.

try to walk - and walk a lot.

for me, the first bm after surgery was scary - i was just scared - there wasn't any reason to be - but I was really scared. (again - no reason to be - i am just probably the biggest baby ever when it comes to ... everything really) :)

best of luck to you
 
I will definitely stay ahead of the pain. I was afraid to have a bm after my Seton so I'm pretty sure this one will be scary. I'm also a baby but I have to act brave around my mom and sisters so they'll be less nervous.
 
Hi Sfgirl.
Thought I would tell you about my recent experience. Im just coming up 4 weeks post surgery now. I was admitted at 7am and was first on the list that day so i was taken into theater at 10. My surgery lasted a little over six hours, this was due to the fact i needed open surgery and they did a lot of work. I had 5 small strictureplastys two 5-7 cm sections of small bowel removed, the last 40cm of the small bowel and first 10 of the large bowel removed along with all the inbetween ( ileum etc).
I was given an epidural and when I woke up one press of the button and everything below my ribs was numb it was wonderful I woke up only mildly sore which was nice after my previous surgery to remove a perianal abscess, that was really painful.
The first day after surgery the physiotherapist was with me bright and early and I was straight up and taking baby steps to spend a while sat in my chair.
I had to have the epidural switched for the PCA that afternoon as the epidural worked too well and my left leg went so numb i couldnt walk on it. But of the two i would choose the epidural it worked better for me than PCA but im sure there are plenty of people who are the opposite!
By day 4 I was eating very soft foods and started getting very bloated and uncomfortable as my bowel did not want to wake up. Cant stress enough how much walking helps. In the end a suppositorie sorted me out and after being terrified that the first BM would be all blood and pain was v happy to find there was nothing to it. The only painful bit was the walk to the loo!
I was discharged day 7 due to a small infection in the incision. Since then im now back to eating a lot more food and have gained a bit of weight. There is hardly any discomfort left ( I roll and try to sleep on my belly - still a bit sore).
So four weeks on and tbh im starting to feel good again. I was terrified of surgery but now I know that I was worried over every little thing needlessly. Im hoping this puts me into my first remission since DX 7 years ago.
If you got any questions just ask! And im sure this amazing community will support you when or if you need it!
Good luck and all the best!
 
Hey sfgirl,

I had a small bowel & colon resection on April 18th. I'm exactly at my 5 week point post operation. They took around 14 inches of small bowel and 1-2inches of colon. I stayed in the hospital for 12 days post operation - being discharged on the 30th of April.

Here's what happened, and what you might expect:

1) You will most likely have an NG tube sucking contents out of your stomach for a week.

2) You will not be eating/drinking anything for 1-2 weeks. You will be getting IV drips to keep you hydrated. They will feed you ice chips and possibly some sips of water to keep you psychologically satisfied.

3) You will not be in a lot of pain, just uncomfortable. The pain button should keep you satisfied. Don't use it too much, it can make you nauseous from over use. (what i did, lol)

4) If you get a stoma(ileostomy or colostomy) you will have to be emptying your ostomy bag quite frequently. Tell your nurse if you are having a lot of out put to give you a urine bag so you don't have to empty it every 20 minutes..believe me you are going to want to do it, because it will tire you to constantly have that pouch on your mind.

5) Stay positive - your mind will go to negative places..Know that there is always an opposite side to having a thought. You can choose to think what you want. Don't let fear control your mind.

Much Love & Luck,

- Skully
 
Thanks iggy... I'm trying to decide between epidural & PCA the surgeon wants me to choose. I'm so glad to hear your feeling good I'm getting more & more nervous the closer it gets.

Hey there skully87
 
Sorry skully I got cut off. My mind definitely keeps going to negative places. And it doesn't help that I just had 2 family members die back to back. I'm more afraid of being put under & not waking up.
 
Sfgirl - You will defiantly wake up. They tried to keep me asleep..I was supposed to be asleep for 2 days but i woke up the 10 hours later. They put me on the Michael Jackson drug (prophyphal? sp), and the surgeon was shocked that I woke up. They were waiting to close me up because i was so inflamed. Don't worry - Think happy thoughts. :)

-Skully
 
With regards to the epidural and PCA In my opinion I would go for the epi first! I had mine put in just before getting put to sleep. I was terrified of this thought of a needle going in to my spine but they put a tiny bit of local anaesthetic in first and I didnt feel a thing! You have to curl over a pillow to increase the gaps between vertebrae. Now after surgery that would have been impossible for me. I had to choose also but as my doctors said if the epidural dosent work for you there is no problem changing for PCA but I wouldnt like to try and get the epidural in post surgery.
Its your choice and again in sure other peoples experiences are different to mine. Have a long talk with your Doctors about the options they should explain everything.
Saw my GI today fpr the first time and looking at my bloods it looks like I may finally be in my first remission! So really if this lasts the surgery was well worth it!
Wishing you all the best.
 
Thank you both. I am trying to keep happy thoughts in my head and not focus too hard on the surgery. I'm reading about the epidural now to get some more info.
 
I've had one bowel resection surgery with the PCA pump.....the 5 others with the epidural! The epidural was superior for me in controlling the post op pain! I was able to get out of bed without pain and move around comfortably. Hopefully I don't need any further surgery but if I do I would certainly choose the epidural!!! Think positive thoughts and it will all be over and you'll be on the road to health!!!:):):)
 
Everything I've been reading about the epidural is good too so I'm sure I will be taking you guys advice! :D I'm doing my best to remain positive and remember its all to make me feel better.
 
Hi sfgirl, Thank you for posting this question, and thank you to everyone who responded! I am having surgery just a few days before you on June 4th. I am having part of my colon and small intestine removed. This is my first surgery and I was wondering what to expect, everyones comments really help a lot! Good luck to you, I hope everything goes well!
 
This is the worst pain I've ever experienced and my tummy won't wake up. I can't even make myself eat food. Help please :(
 
I'm sorry to hear you are struggling :( how many days post opp are you?

The pain can be agonising if it's not controlled properly, what pain relief are you getting? Are the staff aware you are in so much discomfort?
 
sfgirl said:
This is the worst pain I've ever experienced and my tummy won't wake up. I can't even make myself eat food. Help please :(
Click to expand...

As you know I went into surgery Wednesday I hope I can put your mind at ease a little in knowing I went from extreme pain from nausea and gas to feeling much better in a matter of hours this morning. It can turn around very quickly. I will keep you in my prayers that this will happen to you too soon! Stay positive and remember how much better we will feel when this is all over!
 
Sorry ur having such a tough time of it all sfgirl! It took a good 6-7 days for my Bowel to wake up when I had surgery!!! One day @ a time.....keep hopeful and it can change for the better very quickly!!! I remember being starved and couldn't wait to eat a solid meal! Each time I craved turkey dinner for some reason!!! Lol good luck!!!!:):):)
 
sfgirl said:
This is the worst pain I've ever experienced and my tummy won't wake up. I can't even make myself eat food. Help please :(
Click to expand...

It takes time. My advice to you is to walk, walk, walk. Trust me the only way for the pain to shift is to get it working again. I was in horrible pain for a long while after the last op, but the more active I was the better. I found slow release morphine, a small dose, helped it without bunging me up. Make sure you don't leave hospital until the pain is controlled. I went home with tramadol and ended up at my doctors two days later where they prescribed the morphine. :ghug:
 
Thanks you all for your replies. I'm 3 days post op now and my tummy is still asleep but my pain is a little better. Apparently I just needed a different nurse who would actually listen to me. They're giving me colace to get my belly moving and norco and dilaudid for the pain. I walked 3x yesterday but not very far at all. I got really out of breath.
 
Jenafer I'm so glad to hear things changed for you so quickly. I've definitely had the nausea but I quickly asked for meds because if coughing hurts this bad I don't even wanna know how bad vomiting will hurt.
 
I'm starting to feel better by the day. im moving around a bit better. I keep having a burning pain in my tummy I'm not sure if that's normal.
 
sfgirl said:
I'm starting to feel better by the day. im moving around a bit better. I keep having a burning pain in my tummy I'm not sure if that's normal.
Click to expand...

Very early days. I was in agony for about two months after my last one. I was on slow release morphine for a while.
 
They have me alternating Vicodin and tramadol. I feel like I'm on autopilot but when I tried taking myself down the pain got bad again. I really had no idea recovery would be this hard.
 
It is hard. Keep the pain meds up. Trust me one day you wake up and feel so much better. Takes about three months to recover fully.
 
Definitely stay ahead of the pain by taking your meds. Continue to walk to both build back up endurance as well as help relieve gas pain. I was lucky with my first resection and only needed pain meds the first 24 hours. I have a high tolerance for pain and walked and walked. I had more pain from my foley cath and NG tube than I did from the surgical site. Hoping I get similar results from my upcoming surgery.
 
I will keep up with the pain meds better. I just hate the autopilot feeling. I've just been walking in circles around my living room to get my walking in. Passing gas has definitely helped with pain relief also having a bm helped. Harvintx good luck on your procedure I hope its justice as smooth.
 
sfgirl said:
I'm starting to feel better by the day. im moving around a bit better. I keep having a burning pain in my tummy I'm not sure if that's normal.
Click to expand...

I still have burning in my abdomin. Mostly when I am walking and exerting myself. I'm getting my staples taken out tomorrow I am going to ask the dr. about this.
 
I remember that burning pain, I was told its normal and its nothing to worry about. I'm sorry you've had such a rough time, just remember it does get better, You're still very much in the early days so its no surprise that you aren't feeling top notch at the moment. Remember to make sure you rest enough and don't push yourself to go back to work too soon etc. Baby steps is the key :).
 
I won't be rushing back to work anytime soon. I figure with the amount of germs and heavy lifting there I should wait my whole 6 weeks. Thanks for wishing me well I am starting to feel better and better.
 
I remember having incredible pain, too. I kept my thumb on the pain pump for a week.

I passed my first gas 3 days after surgery and had my first bm 6 days after surgery.

If I could offer any advice, it would be to do the deep breathing as much as possible. Just know that you will recover well. Looking back, it send like recovery took forever for me. But, 8 weeks later, I am doing pretty well.

Hang in there!
 
Thank you. I'm hanging in. My nurse at the hospital had her colon taken out so she was very supportive and has called to see if I'm doing any better or have questions.
 

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