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Managing Bowel Function After Your Low Anterior Resection

This information describes the changes in bowel function that you may experience after your low anterior resection surgery.
 
After your surgery, your body will still have the ability to turn food into solid waste. However, you will have a new holding area for your stool. Your body will need time to adjust to this change.
 
If you have a temporary ileostomy or colostomy, do not follow the instructions in this resource until your doctor says it’s okay.
 

Changes in Bowel Movements

You can expect to have changes in your bowel movements for 6 to 12 months after your surgery. Your bowel movements may:
 
  • Be more frequent
  • Come in “clusters.” These are bowel movements that may occur several times an hour, several times a week
  • Occur every other day
  • Not feel complete; you may have the feeling that you still have to go
You also may:
 
  • Feel a strong sense of urgency to have a bowel movement
  • Have trouble telling the difference between having a bowel movement and passing gas

Diet

Foods may affect you differently than before your surgery. Certain foods may make you have bowel movements immediately after eating. You will need to test foods and see how you react to them. If you need help with your diet, call (212) 639-7312 to speak with a dietitian.
 
It is important that you drink a total of 6 to 8, 8-ounce glasses of noncaffeinated liquids a day. You can also drink tea, coffee, and other caffeinated liquids. However, these are extra liquids. Do not count them as part of your 6 to 8 glasses of liquids per day requirement.
 

Fiber supplements

Fiber supplements, such as Metamucil® or Citrucel®, will add bulk to solid waste. This helps stretch your new or remaining rectal space. Your doctor or nurse will suggest a fiber supplement. Take it with water or juice. Unless you are given other instructions, add 1 rounded teaspoon of the supplement to a single glass of liquid twice a day at the end of a meal.
 

Medication

If you are having many bowel movements, your doctor may prescribe medication to slow your bowel down. This may help decrease the feeling that you need to go right away, and may cut down on your number of bowel movements.
 
Take your medication before meals. Your doctor will tell you the dose and schedule. If you do not have a bowel movement for 2 days, contact your doctor or nurse.
 

Exercises

There are 2 exercises that may help you gain better control of the muscle in your anus. When you tighten this muscle, it holds in stool and gas. When you relax it, stool and gas can pass. Ask your doctor or nurse if you should do the exercises described below and when you should start.
 
  • Tighten the muscle as you would if you did not want to pass gas. Hold it for 15 seconds, and then relax. Do this 10 to 20 times each day.
  • When you feel the urge to have a bowel movement, see if you can hold it for a little while. Gradually increase the amount of time you wait before having a bowel movement.
Notes:

Skin Care

The area around your anus may be sore and irritated if you have multiple bowel movements. This can happen from frequent wiping.
To help with any discomfort:
 
  • Clean the area around your anus gently with warm water. Avoid soap or wipes because they can make your skin more irritated.
  • Sit in a warm tub of water 3 to 4 times a day.
  • Apply a thin layer of cream, such as Balmex® or Desitin®, to your anus as needed to prevent skin breakdown.