When to Call Your Doctor

When to Call Your Doctor

Removal of a portion of the colon, small bowel or rectum is a major operation. After a period of hospitalization that varies depending greatly on emergency or elective circumstances, and the presence or absence of complications, you will be ready for discharge to home or to an alternative care facility.

Discharge from the hospital requires adequate nutritional intake (usually orally), adequate demonstration of normalization (bowel movements per anus or stoma), and ability to tolerate oral pain medications (as pertains to wound discomfort). There is a tremendous variability of "normal" in all of these areas. Hospital stays from 4 days, which is very short, to 14 days, which is a little on the long side, are in the "range." The average, however, generally is about 7 days.

The most common postoperative "problems" associated with small bowel, colonic or rectal resections relate to:

1. Wound or incisional problems (increased pain, discolorations or concerns regarding infection).
2. Control of bowel function—after removal of a small or extended portion of the bowel, regaining of normal bowel function varies with the individual. We try to control functions and prevent either constipation or diarrhea.
3. Dietary considerations ("What can I eat?," is a very common post-discharge question.) Normalization of the diet and bowel movements may take up to several weeks postoperatively. As necessary, dietary restrictions will be discussed by your doctor prior to your discharge from the hospital.
4. Abdominal distress (nausea, vomiting, bloating, gas cramps and hiccoughs) Increase in any of these symptoms to the point of pain, particularly if it is worsening as time goes on, is cause for concern, and your colon and rectal surgeon should be consulted.
5. What medications will I take home from the hospital? When may I resume my "regular" medicines? Medications and supplies upon discharge generally center around pain control, bowel function regulation (anti-diarrheal agents or stool softeners), prednisone where applicable, antacids, antibiotics, supplies concerned with wound care, gauze dressings, occasional drainage tubes or irrigating supplies.
6. Activity constraints such as walking, climbing stairs, driving a car, sexual activities, running, golfing, and "When can I go back to work?," where applicable.
7. Unusual bleeding from wound, rectum, stoma or other.
8. When to see you back in the office: Any further follow-up tests anticipated in near or distant future such as scans or endoscopy procedures, blood tests or x-rays. Your physician should cover all of these areas with you prior to your discharge. If this has not been done or you are uncertain about any of these items, call your physician to get updated information soon after you are discharged to home. If you are concerned about any possible complications, please call your physician immediately.

If your own doctor is unavailable, the on-call doctor is available 24 hours a day, every day of the year, including holidays. You may reach Stanford’s colorectal cancer surgeons by calling the Stanford Cancer Center at 650-498-6000. After hours and on weekends call the Stanford page operator at 650-723-6661 and they will locate the doctor on call. In an emergency try to contact your colorectal surgeon for advice before you go to the hospital. A telephone call may save you a lot of time, discomfort, and expense.