A Patient's Guide to Colorectal Cancer
The following information may be helpful for patients of the Colorectal Cancer Center at Cedars-Sinai.
Bowel Resection Patient Care
The Colorectal Cancer Center at Cedars-Sinai wants patients to be well informed about bowel resection surgery, from preparing for the procedure to recovery and follow-up care.
Education
The nurse will explain the recovery process and goals for today. Items you will have during your recovery:
- IV. You will have an IV placed in your hand or arm to give you fluids and medication. It will remain in place until you are able to drink liquids.
- Catheter. A catheter will be inserted into your bladder during surgery, to drain urine. It will be removed when you are able to walk to the bathroom.
- Leg sleeves. These will be on while you are in bed. The leg sleeves are to help with circulation and prevent blood clots.
Items you may or may not have, depending on your physician:
- Tri-flow. This is an instrument used for breathing exercises. The nurse will show you how to use it. You will use it during your entire stay.
- NG tube. The NG tube assists with relieving abdominal discomfort.
- Patient-controlled analgesia (PCA) machine. It is one way to give you pain medication. The nurse will show you how to use it.
Diagnostic Tests
Blood pressure and temperature will be checked frequently. A nurse will check your abdomen for sounds, swelling and pain.
Medication
You will receive pain medication via a PCA machine or shots. Tell your nurse if your pain score is greater than 4 (scale 0-10) or if you:
- Cannot sleep
- Are nauseous
- Feel itchy
- Feel restless or nervous
Nutrition
No food or drink today. The IV will deliver nutrition to your body.
Treatments
You will be assisted with changing your position every few hours to provide comfort and to prevent skin problems. If a tri-flow has been ordered, use it 10 times every hour.
Activities
Today you will:
- Stay in bed and rest
- Wiggle your toes and move your feet and legs 10 times every hour
- Do deep breathing and coughing exercises 10 times every hour
- Daily Goals
- We hope that by the end of the day:
- Your pain is under control
- You have no nausea
Education
Today the nurse will review instructions about:
- Getting out of bed
- Doing breathing activities
- Controlling pain
- Taking medications
- Eating and nutrition
The more you walk, the better you will feel. Walking helps decrease gas pain and stimulate the return to normal bowel function. You should be as active as you can and walk.
The catheter will be removed if you can walk to the bathroom. If your catheter is removed, use the collection hat in the bathroom so the nurse can measure your fluid output.
The nurse will begin discharge planning with other healthcare team members. Together they will plan for your post-hospital needs. Be prepared to answer questions, such as:
- Do you live by yourself?
- Is help available?
- What do you usually eat at home?
Diagnostic Tests
Your blood pressure and temperature will be checked three times today. The nurse will check your abdomen for sounds, swelling and pain. Your doctor may or may not order blood tests.
Medication
Tell your nurse if your pain score is greater than 4 (scale 0-10) or if you:
- Cannot sleep
- Are nauseous
- Feel itchy
- Feel restless or nervous
Nutrition
No nausea is a good sign. Your doctor may start you on sips of water and allow you to drink liquids. No straws will be allowed if you have had a laparoscopic bowel procedure done. The IV will stay in place until you are able to drink fluids easily.
Treatments
Keep turning every two hours, and ask a staff member if you need assistance. Leg sleeves will be on while in bed. If a tri-flow is ordered, use it 10 times every hour.
Activities
Today you will:
- Sit in a chair for 30 minutes (or more) at least three times
- Walk in the hallway with staff assistance at least three times
- Continue deep breathing and coughing exercises 10 times every hour
- Comb your hair, brush your teeth and shave with assistance or by yourself
Daily Goals
- Pain score of less than 4
- Sit in chair for 30 minutes three times
- Walk in hallway with assistance three times
- Raise three balls in the tri-flow
- Start sips of clear liquids
Education
Today the nurse will talk to you about:
- Doing activities
- Controlling pain
- Taking medications
- Drinking fluids
You may go home in 24 to 48 hours if you are progressing and meeting your daily goals.
The catheter will be removed if you can walk to the bathroom. If your catheter is removed, use the collection hat in the bathroom so the nurse can measure your fluid output.
Tell your nurse if you pass gas or have a bowel movement.
A dietitian may visit you today to discuss your diet if requested by you or your physician.
If your procedure involved the creation of a colostomy or an ileostomy, a nurse specialist will visit you to discuss the appliance and its care.
A social worker is available to help plan for post-hospital care.
Diagnostic Tests
Your blood pressure and temperature will be checked three times today. The nurse will check your abdomen for sounds, swelling and pain. Your doctor may or may not order blood tests.
Medication
Tell your nurse if you:
- Have pain
- Cannot sleep
- Are nauseous
- Feel itchy
- Feel restless or nervous
Nutrition
No nausea is a good sign. Your doctor may start you on sips of water and allow you to drink liquids. No straws! The IV will stay in place until you are able to drink fluids easily.
Treatments
Keep turning every two hours, and ask a staff member if you need assistance. Leg sleeves will be on while in bed. Tri-flow:Use it 10 times every hour.
Activities
Today you will:
- Sit in a chair for 45 minutes (or more) at least three times
- Walk in the hallway with staff assistance, or by yourself, at least 4 timesat least four times
- Comb your hair, brush your teeth and shave. Ask staff if you need assistance
Daily Goals
We hope that by the end of the day:
- Your pain is under control
- You are able to sit in chair for 45 minutes three times
- You are able to walk in hallway four times
- You are able to drink fluids without problems
- Your catheter is removed and you are able to use bathroom
- You raise three balls in the tri-flow
- Your leg sleeves removed
- You receive a visit from nurse specialist regarding colostomy or ileostomy appliance (if applicable)
- You are able to open/close colostomy or ileostomy appliance clamp and empty contents (if applicable)
- You will have a ride to take you home
Need to Know:
- Your doctor may let you go home today!
- Discharge can occur as early as 10 a.m.
The nurse will review instructions about:
- Diet
- Medications
- Activity and Exercise
Do you know when to call your doctor? Call immediately if you:
- Feel nauseated
- Feel bloated or have stopped passing gas
- Have chills or fever
- There is redness or burning at incision site
Medication
Your doctor will write a list of medications you are to continue taking at home.
Nutrition
Your doctor will select your diet.Your doctor may send you home with either liquid or solid food.
Activities
Today, you will:
- Continue to do as much as you can independently.
- Ask staff if you need assistance.
Daily Goals
Today:
- You are ready to go home!
- You are able to take pain pills without problems.
- You are able to walk independently.
- You are able to drink fluids easily.
- You are able to comb hair, brush teeth, shave, and get dressed with little or no assistance.
- You are aware of the danger signals to watch for at home.
- You know when to call the doctor.
- You are able to care for your colostomy or ileostomy appliance without guidance.
Frequently Asked Questions
The exact causes of colorectal cancer are not known. However, studies show that the following risk factors increase a person's chances of developing colorectal cancer:
- Age. Colorectal cancer is more likely to occur, as people get older. This disease is more common in people over the age of 50. However, colorectal cancer can occur at younger ages, even, in rare cases, in the teens.
- Diet. Colorectal cancer seems to be associated with diets that are high in fat and calories and low in fiber. Researchers are exploring how these and other dietary factors play a role in the development of colorectal cancer.
- Polyps. Polyps are benign growths on the inner wall of the colon and rectum. They are fairly common in people over age 50. Some types of polyps increase a person's risk of developing colorectal cancer. A rare, inherited condition, called familial polyposis, causes hundreds of polyps to form in the colon and rectum. Unless this condition is treated, familial polyposis is almost certain to lead to colorectal cancer.
- Personal medical history. Research shows that women with a history of cancer of the ovary, uterus, or breast have a somewhat increased chance of developing colorectal cancer. Also, a person who has already had colorectal cancer may develop this disease a second time.
- Family medical history. First-degree relatives (parents, siblings, children) of a person who has had colorectal cancer are somewhat more likely to develop this type of cancer themselves, especially if the relative had the cancer at a young age. If many family members have had colorectal cancer, the chances increase even more.
- Ulcerative colitis. Ulcerative colitis is a condition in which the lining of the colon becomes inflamed. Having this condition increases a person's chance of developing colorectal cancer.
- A change in bowel habits
- Diarrhea, constipation or feeling that the bowel does not empty completely
- Blood (either bright red or very dark) in the stool
- Stools that are narrower than usual
- General abdominal discomfort: frequent gas pains, bloating, fullness or cramps
- Weight loss with no known reason
- Constant tiredness
- Vomiting
Early screening is the best method of reducing risks. Almost all cancers of the colon and rectum start as a polyp. A polyp is a small benign or non-cancerous growth that occurs in the inner lining of the large intestine. Some of these polyps can slowly grow and transorm into cancer.
This process typically takes eight to 10 years. Many polyps and early cancers do not show any signs or symptoms. The goal of screening is either to remove any polyps that may be found in order to reduce the chance of them turning into a cancer or early detection of cancer. Some people use alternative and complementary therapies to help reduce their risks.
Simply call 1-800-CEDARS-1 (1-800-233-2771) 7 days a week, 6 am - 9 pm PT.
Have Questions or Need Help?
Call us or send a message to the Colorectal Cancer team. You can also have us call you back at your convenience.