Patient education: Colectomy – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

What is a colectomy? — A colectomy is surgery in which a doctor removes part or all of the large intestine (figure 1). The large intestine is also called the colon.

Doctors might do a colectomy to treat problems such as:

●Colon cancer

●Digestive tract disorders, such as severe diverticulitis or inflammatory bowel disease

●Blockage in the colon

●Injury to the colon

There are 2 main ways doctors can do a colectomy:

●Open surgery – During open surgery, the doctor makes a cut, or "incision," in the belly. Then, they remove some or all of the colon.

●Minimally invasive surgery – During minimally invasive surgery, the doctor makes a few smaller cuts in the belly. Then, they insert long, thin tools through the cuts to do the surgery.

How long it takes for you to recover, and what you need to do, depends on which type of surgery you had. If you had minimally invasive surgery, you might be able to return to your normal activities sooner. With open surgery, it usually takes longer to recover.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

You should also:

●Make sure that you know how to care for the colostomy or ileostomy, if you have one. You also need to know how and when to empty or change the ostomy bag.

●Take all of your medicines as instructed.

●Take care of your incision – You might have stitches, skin staples, surgical glue, or a special skin tape on your incision. If you had minimally invasive surgery, you might have more than 1 incision.

•Keep your incision dry and covered with a bandage for the first 1 to 2 days after surgery. Your doctor or nurse will tell you exactly how long to keep your incision dry.

•Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. Do not put your incision underwater, such as in a bath, pool, or lake. This can slow healing and raise your chance of getting an infection.

•After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on the incision. They will also tell you if you need to cover your incision with a bandage or gauze.

•Always wash your hands before and after you touch your incision or bandage.

●Increase your activity slowly – Start with short walks around your home, and walk a little more each day.

•Keep coughing and doing deep breathing exercises for 7 to 10 days after you go home. This will help prevent lung infections. When you cough, sneeze, or do deep breathing exercises, press a pillow across your incision to support the wound and ease pain. You can also use an abdominal binder to help support your incision.

•Avoid heavy lifting, sports, and swimming for at least 2 to 3 weeks. (Your doctor or nurse will tell you exactly how long to avoid these or other activities.)

●Eat when you are hungry. If you got specific instructions about what to eat or avoid, follow them.

●Drink plenty of fluids, unless your doctor told you otherwise. This is especially important if you have an ileostomy.

●Use a stool softener to help prevent constipation, if needed. This is a common problem if you take opioid pain medicines. Follow all instructions for taking your pain medicines.

●Take non-prescription medicines to relieve pain instead of opioids if you want, such as acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), or naproxen (sample brand name: Aleve).

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress and talk about further treatment. Go to these appointments.

If you have stitches or staples, you will need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or skin tape, it will fall off on its own. Do not pick at it or try to remove it yourself.

When should I call the doctor? — Call for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have redness or swelling around your incisions.

●You have nausea or vomiting, or cannot eat.

●You have very bad belly pain, or your belly feels swollen or bloated.

●You have new bad shoulder pain.

●You are constipated or have many episodes of diarrhea in a day.

●Your bowel movements are bloody, black, or tar colored.

More on this topic

Patient education: Colectomy (The Basics)
Patient education: Colon and rectal cancer (The Basics)
Patient education: Diverticulitis (The Basics)
Patient education: Crohn disease in adults (The Basics)
Patient education: Crohn disease in children (The Basics)
Patient education: Ulcerative colitis in adults (The Basics)
Patient education: Ulcerative colitis in children (The Basics)
Patient education: Living with a colostomy (The Basics)
Patient education: Living with an ileostomy (The Basics)

Patient education: Colon and rectal cancer (Beyond the Basics)
Patient education: Diverticular disease (Beyond the Basics)
Patient education: Crohn disease (Beyond the Basics)
Patient education: Ulcerative colitis (Beyond the Basics)