Transanal Resection HF#4754



 

Bowel Prep

 

A few days before your surgery, go to the drugstore and buy

 

1 bottle of magnesium citrate (10 oz).

2 sodium phosphate enemas.

 

The Day before Surgery

Water

Broth

Juice without pulp (apple, grape)

Popsicles

Hard candy

Clear Jell-O® (no fruit, etc. in it)

Sparkling water or soda

Weak coffee or tea, no creamer

Gatorade®

Special K2O® protein water

 

After lunch, do not eat or drink solid foods, juice with pulp, dairy products, or alcohol.

 

_____ At 2:00 pm drink magnesium citrate 10 oz. (1 bottle).  It is best to drink it chilled.

 

Do Not Eat after lunch but you may have clear liquids until 4 hours before surgery starts.

 

The Day of Surgery

 

_____  Give yourself the first enema 1½ hours before you leave home.  Give yourself the second enema ½ hour later.  Shower.  If your surgery is later in the day you do not need to wait to do the enemas, do them when you wake up.

 

After Surgery

 

Rectal Care

 

• Take a sitz bath at least three to four times a day and after each bowel movement for the first 2 days and then as needed.  A sitz bath is sitting in warm water to soothe your rectum.  You can use a plastic device that fits on your toilet or sit in the bathtub.  This helps healing and lessens pain and rectal spasms.  Sit in the water for at least 10-20 minutes.

 

• For the first few days, clean the rectum after a bowel movement by spraying it with warm water.  You may want to use baby wipes to gently clean the rectum.

 

• You may have yellowish-red drainage from the rectum for 7 -14 days.  Sanitary pads in your underwear can prevent soiling.  The drainage will become less and become lighter in color over time.  You can expect more bloody drainage after a bowel movement, with increased activity, and about 10 days after surgery when the stitches begin to dissolve.

 

Activities

 

• Do not lift more than 20 pounds until it is okayed by your doctor.
• Avoid standing or sitting for more than an hour at a time for a few days.
• Do not drive while taking narcotic pain pills.  
• Sexual activity may be resumed when okayed by your doctor.
• Check with your doctor before you return to work.  The time you may be off work may be longer if your job involves heavy labor or sitting for long periods of time.

 

Pain

 

It is normal to have pressure rather than pain after surgery.  Or you may feel like you need to quickly get to the bathroom.  This will improve as you heal.  You will have pain pills to take if needed.

 

Diet

 

You may be on a low fiber diet for the first few weeks with stool softeners (docusate sodium) as needed.  This will avoid bulky stool stretching the incision.  After 2 – 3 weeks, you may increase the amount of fiber in your diet.  This may include a bulk fiber laxative like Metamucil^®.  Your doctor will talk to you about your diet.

 

Be sure to drink at least 8-10 (8 oz.) glasses of fluid a day.  Fluids with caffeine do not count. 

 

When to Call the Doctor

 

• If you do not have a bowel movement within 1-2 days, you may need a laxative.
• Unable to control bowel movements.
• Large amounts of bright red blood from the rectum that does not stop with applied pressure to the rectum for 10 minutes.
• Temperature greater than 100.4° F., take your temperature once a day for 1 week.
• Foul-smelling drainage from rectum.
• Excess swelling in or around the rectum.
• Pain not controlled by pain pills.
• Problems passing urine.

 

Phone Numbers

 

Digestive Health Center: (608) 890-5000.

 

After hours, weekends or holidays this number will be answered by the paging operator.  Ask for the doctor on call or ask for Dr. Harms, Heise, Kennedy, or Foley.  Leave your name and phone number with area code. The doctor will call you back.

 

If you live out of the area, call (855) 342-9900.
 

 

Low Fiber Diet

 

Food Group	Foods Recommended	Foods to Avoid
Breads, Grains, Pastas, Rice	White breads, rolls, biscuits, muffins, and crackers without seeds and nuts White Rice White Pasta	Any bread product or pasta made with whole grains or bran. Any product made with seeds, dried fruit, coconut, or nuts. Brown rice Wild rice. Check food labels and avoid any products with more than 2 grams of fiber per serving.
Cereals	Check labels on cereal boxes and choose cereals with less than 1 grams of fiber per serving, such as corn flakes or rice krispies. Refined cooked cereals limited to ½ cup servings, e.g. cream of wheat, farina, and quick cooking oatmeal.	Whole grain or bran cereals All cereal with more than 1 gram fiber per serving. Granola Cereal bars
Fruits – fresh, frozen, or canned - limit to  ½ cup servings	Apples, peeled Apricots, peeled Avocado, ripe Banana (1/2 ), ripe Cherries, sweet Mandarin oranges Melons Peaches, peeled	Dried fruits All other fruits that are high in fiber such as all berries, dates, figs, pears, whole oranges, prunes.
Vegetables – fresh, frozen, or canned - limit to ½  cup servings	Asparagus tips, cooked Carrots, cooked Cucumber, peeled and seeded Lettuce, tender leaf lettuce Potatoes, peeled and cooked Sweet potatoes, cooked Winter squash, cooked Zucchini, peeled and seeded	All others
Beans and Lentils		All dried beans such as kidney, garbanzo, black, navy, and pinto beans. Soy beans Lentils
Meats, Poultry, Fish	Tender meats, poultry and fish that are cooked.	Meat, poultry, or fish that are fried with a crisp crust. Tough meats or meats with gristle. Meat products made with whole grains, nuts, or seeds such as some sausages or lunch meats. Soy meat substitutes such as Boca burgers.
Eggs	Eggs, cooked in any way
Dairy	Milk, cheese, yogurt, sour cream, and any dairy products as tolerated.	Dairy products with added nuts, seeds, or fruits.
Beverages	Coffee and tea Cocoa Carbonated beverages Fruit juices without pulp (except prune juice)	Prune juice Smoothies made with fruits or grains
Fats	Butter and margarine  Vegetable oil Olive oil Salad dressings made without fruits, nuts, or seeds Meat gravies	Any fats or salad dressings with added fruits, dried fruits, seeds, or nuts.
Desserts and Sweets	Sugar, honey, molasses, corn syrup. Jelly Sherbet, frozen yogurt, ice cream, and popsicles made without fruits, seeds, or nuts. Cookies, pastries, pies, puddings, custards, and candy made without fruit, seeds, or nuts.	Jams, preserves, and marmalade. Any made with fruit, dried fruit, nuts, seeds, or coconut.
Miscellaneous	Salt, pepper, ketchup, mustard, vinegar, herbs, and other spices as tolerated. Cream sauces Smooth peanut butter and nut butters, limited to 1 tablespoon per serving.	Nuts and seeds Olives Pickles Soups, casseroles, and other mixed dishes made with high fiber fruits, vegetables, or grains.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 04/25/2013

Copyright © 04/09/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4754

Print Health Fact For You