What to expect after bowel cancer surgery

Learn everything you need to know about bowel cancer surgeries, including the causes of bowel cancer and what to expect from the recovery process

Bowel cancer is one of the UK’s most common cancers and is the general term for cancer that starts in the large bowel. According to Cancer Research, there were over 40,000 new cases of bowel cancer on average per year between 2014 – 2016. Once a silent killer, bowel cancer survival rate has been improving and has more than doubled over the past 40 years. This could be due to increased awareness and screenings.

As with any cancer, early detection is the key so that treatment can be pursued as soon as possible. One of the main treatments for bowel cancer is surgery. While surgery can be an arduous process, it’s often the recovery process that people aren’t prepared for. However, with the right mentality and a good support network, you can overcome these challenges and return to your healthy life in no time at all.

In this guide, Better Healthcare details the causes of bowel cancer, what to expect after a bowel cancer surgery, and how you can overcome the challenges of the recovery process ahead.

Causes of bowel cancer

While it’s not exactly known what definitely causes bowel cancer, several definite risk factors contribute to its development. These risk factors are:

  • Age: Those over the age of 60 account for 9 out of every 10 cases of bowel cancer in the UK.
  • Diet: Those eating a diet high in processed foods and red meats have an increased risk of developing bowel cancer, as do those who are not consuming enough fibre.
  • Smoking: Smoking may increase the risk of bowel cancer.
  • Alcohol: Those who drink a large amount of alcohol regularly are at increased risk.
  • Family Medical History: Those with a parent or sibling who developed bowel cancer when under the age of 50 are more at risk.
  • Digestive Disorders: Those with long-term ulcerative colitis or Crohn’s disease are more at risk.
  • Obesity: Being overweight is linked to increased incidences of bowel cancer – especially in men.
  • Being Inactive: Those who are physically inactive increase their chances of developing bowel cancer.
  • Genetic Conditions: Those with hereditary non-polyposis colorectal cancer (HNPCC) or familial adenomatous polyposis (FAP) face an increased chance of developing bowel cancer.

Bowel cancer generally starts as a polyp (a small growth) on the lining of the bowel. As a quarter of all people will develop polyps during their lifetime, these growths are quite common and aren’t necessarily cancerous. However, they can become cancerous over time. If the polyps are spotted during a screening, a doctor will typically recommend that they are tested via a colonoscopy.

Symptoms of bowel cancer

A significant reason why bowel cancer can be deadly is that the signs and symptoms of the disease aren’t very noticeable or odd. They generally do not make the person feel ill. However, there are clear symptoms that almost everyone with bowel cancer reports. These are some of the most common signs:

  • Persistent blood in the stool: Haemorrhoids (piles) can cause blood to be found in your stools or on toilet paper. However, blood without any additional clear symptoms of haemorrhoids can indicate bowel cancer.
  • Changing bowel habits: If you are noticing that you are going to the toilet to relieve your bowels more often, that stools appear to be looser, and that you are experiencing abdominal pain, then this is a potential sign of bowel cancer.
  • Discomfort, abdominal pain, or bloating from eating: Feeling uncomfortable after eating and a reduced appetite can be a sign of bowel cancer.

It’s important to note that even if all these symptoms are present, it doesn’t necessarily mean you have bowel cancer. This is part of the reason why bowel cancer can be hard to diagnose without proper screening – as the symptoms can look like a lot of temporary or chronic conditions. However, if any of these symptoms (even one) has persisted for longer than four weeks, you should discuss this with your GP.

Additionally, bowel cancer can sometimes stop waste from passing through the bowel properly – causing an obstruction. Symptoms of bowel obstruction are:

  • Persistent stomach swelling and abdominal pain
  • Unintended loss of weight with abdominal pain
  • Abdominal pain brought about by eating
  • Vomiting and abdominal swelling

If you suspect that you have a bowel obstruction, make an emergency appointment to see your GP. If that is not possible, and the symptoms persist or worsen, head to your nearest hospital’s A&E department.

Diagnosis of bowel cancer

If you go to your GP with symptoms of bowel cancer, they will first ask about your symptoms and if there’s a history of bowel cancer in your family. Then GP will likely perform a simple check of the rectum known as the digital rectal examination (DRE) and also examine your abdomen (stomach) to check for any lumps. While these checks may seem a little uncomfortable and intrusive, the examinations are relatively fast, usually lasting less than a minute.

A blood test will be taken to check for anaemia (iron deficiency) as a lack of iron can indicate bleeding caused by cancer.

Your doctor may refer you to a hospital to receive further testing via a flexible sigmoidoscopy. Two other tests used, which are more extensive, are a colonoscopy or a computerised tomography colonography (CT colonography). Those who head to A&E with emergency referrals like symptoms of a bowel obstruction will be given a CT scan.

If these tests determine the presence of bowel cancer, more tests will be performed to check and see if the cancer has spread to other areas of the body (known as stage 4 bowel cancer). Stages 1-3 relate to the cancer either still being in the bowel, having spread to the layers of muscles surrounding nearby organs, or having spread into the nearby lymph nodes respectively. An MRI scan and a CT scan of your chest and abdomen areas will determine whether the bowel cancer has spread or not. These tests will help doctors determine the best course of action to treat the disease.

As aforementioned, surgery is the primary treatment for bowel cancer. This can be performed alongside the secondary treatments of radiotherapy, chemotherapy or biological treatments. If caught early enough, treatment can stop the cancer and prevent it from coming back.

Bowel cancer surgery is called a colectomy, which is the removal of either part or all of the colon. There are three types of colectomy:

  • Open colectomy: Whereby an incision is made in the abdomen to remove the affected areas of your colon.
  • Keyhole (laparoscopic) colectomy: Whereby several small incisions are made in the abdomen before special instruments, guided by a camera, are used to remove the affected section of the colon.
  • Robotic surgery: A form of keyhole surgery whereby a surgeon’s instruments guide a robot to remove the cancer.

Robotic surgery can be performed remotely – meaning the patient can be at a different hospital from the surgeon. However, this is not offered in many UK hospitals as of right now.

As well as the colon, the nearby lymph nodes are removed too.

What to expect after bowel cancer surgery

While you will have the surgery explained to you by the consulting surgical team, as well as have time to ask questions about the colectomy, it is the bowel cancer recovery and rehabilitation process that can cause worry. However, the road to recovery from surgery can be a stress-free experience.

After you’ve had your operation, you’ll either spend a few hours in the recovery room, intensive care unit or high dependency unit before you are moved back to the ward. You will likely still be drowsy after the operation (which can be a little bit scary to some people), but this is completely normal.

When the drowsiness wears off, you will find that you are connected to a drip. This is to provide fluids to your body, as well as pain relief. Additionally, you will find a catheter inserted into your bladder to help with urine drainage and a tube called a wound drain to remove fluids that collect near the wound. You should also expect a nasogastric tube that enters through the nose and drains fluids from the stomach to prevent sickness. You may even awake to an oxygen mask. All of these things are completely normal and they will be removed, one by one, once you are back moving around, eating and drinking.

The nurses at the hospital will prompt you to get out of bed and move around as soon as possible – which will include breathing and leg exercises to help prevent any infections from occurring. Blood clots are prevented through injections of heparin to thin the blood as well as compression stockings.

Nurses will tend to your wound, clean it out and replace the dressing within the first few days. A nurse will instruct you on how to tend to the wound when you leave the hospital. You will be informed about how your stitches will come out, and who will remove them. Usually, this happens after ten days. However, you may have stitches that dissolve on their own.

Depending on the bowel cancer, you may have a stoma (an opening on the abdomen) and bag fitted over it. This will be connected to your bowels so waste can be diverted out of your body. A stoma can either be temporary or permanent and occurs if there is not enough bowel left after the operation. While surgery can correct this in some cases, in other cases, it will be a permanent fixture.

At first, it may be difficult to get used to your stoma, but a nurse will meet with you to discuss your concerns and tell you everything you need to know about living with a stoma.

You will begin drinking independently again within a day or two and eating some solids within a few days. You will also begin to walk independently within a few days of the operation, and you’ll start to feel better (physically and mentally) too. After around three to seven days (depending on your recovery speed), you’ll be discharged and allowed to go home.

Going home after bowel cancer removal surgery

Fatigue plays a huge role in the days, weeks and months after the surgery. This is normal, but it is also something that can be counteracted with a bit of planning and self-motivation. For example, you can set yourself goals of how much you should move around in a day or setting a rule on how long you allow yourself to sit down.

Of course, your overall fitness before the operation can play a role in your bowel cancer recovery – so keep this in mind so that you set yourself realistic goals.

You won’t be back to performing your usual activities, like shopping and cleaning until roughly six to eight weeks after surgery. As this is a fairly significant amount of time, a good approach is to prepare for your surgery by stocking up on household essentials.

Diet also plays a big role in your recovery, and you should receive consultation from a dietician on what you should or should not eat during your recovery. They should also offer advice on adapting your diet moving forward.

During the recovery period, you may feel restless or even depressed about the recovery and rehabilitation process. This is why it’s important to have a good support network around you. Having someone there to help you do the little things like cleaning up the home, cooking a healthy dinner and going to get your prescription can make a huge difference.

While a friend or family member is ideal, this may not always be possible for a number of reasons. One way around this is to secure the help of a carer. At Better Healthcare, we provide home care and live-in care workers to help people during their recovery from surgery.

Recover in comfort with Better Healthcare

When it comes to providing care for those who have received bowel cancer surgery, Better Healthcare Services’ team of healthcare professionals have the knowledge and experience to make the recovery process a less stressful experience.

Surgery can make the recipient feel physically drained of energy. However, having a home carer or live-in carer can remove a lot of the burden from everyday tasks – allowing vital time and energy to be spent on the recovery process. Better Healthcare’s team of carers can:

  • Help with personal care
  • Carry out light housekeeping
  • Go shopping, collect prescriptions and administer medication
  • Prepare healthy meals
  • Help maintain dietary and exercise goals

Additionally, our carers can provide you with the emotional support needed to recover as quickly as possible. However, as the client, you can decide on how much or how little support is needed to help you, or your loved one, in the bowel cancer recovery process.

For more information on how our carers can help in the recovery process, or to hire one of our carers, please call 0800 668 1234 and we will be happy to help with your enquiries. Alternatively, you can also contact us at one of our local offices.

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This post is not health advice and should not replace professional advice tailored to your specific circumstances. It is intended to provide information of general interest about current healthcare issues.

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