About Your Ileostomy Closure Surgery

This guide will help you get ready for your ileostomy closure surgery at Memorial Sloan Kettering (MSK). It will also help you understand what to expect during your recovery.

Read through this guide at least once before your surgery and use it as a reference in the days leading up to your surgery.

Bring this guide with you every time you come to MSK, including the day of your surgery. You and your healthcare team will refer to it throughout your care.

About Your Surgery

About Your Ileostomy

An ileostomy is the opening your surgeon made in your abdomen (belly) when you had surgery to remove a part of your colon or rectum. Your ileostomy was created from the part of your small intestine called the ileum. This allowed your bowel movements (poop) to pass out of your body and into a stoma bag. Your ileostomy was made so that your anastomosis (the place where your surgeon reconnected your bowel) can heal.

About Your Ileostomy Closure Surgery

An ileostomy closure surgery is done to reverse your ileostomy so that you can have bowel movements like you did before your surgery. Ileostomy closure surgery is usually done through your stoma (see Figure 1). Your surgeon may need to make an additional incision (surgical cut), but this is rare.

Figure 1. Your stoma

Figure 1. Your stoma

After your surgery, you will have a small wound where your ileostomy used to be. This wound will heal in about 4 to 6 weeks. You will need to change the bandage on this wound every day. While you’re in the hospital, your nurse will teach you how to change your bandage and give you the supplies you’ll need to do it at home.

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Before Your Surgery

The information in this section will help you get ready for your surgery. Read through this section when your surgery is scheduled and refer to it as your surgery date gets closer. It has important information about what you need to do before your surgery.

Write down your questions and be sure to ask your doctor or nurse.

Getting Ready for Your Surgery

You and your healthcare team will work together to get ready for your surgery.

Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you aren’t sure.

  • I take a blood thinner. Some examples are aspirin, heparin, warfarin (Coumadin®), clopidogrel (Plavix®), enoxaparin (Lovenox®), dabigatran (Pradaxa®), apixaban (Eliquis®), and rivaroxaban (Xarelto®). There are others, so be sure your healthcare provider knows all the medications you’re taking.
  • I take prescription medications (medications prescribed by a healthcare provider), including patches and creams.
  • I take over-the-counter medications (medications I buy without a prescription), including patches and creams.
  • I take dietary supplements, such as herbs, vitamins, minerals, or natural or home remedies.
  • I have a pacemaker, automatic implantable cardioverter-defibrillator (AICD), or other heart device.
  • I have sleep apnea.
  • I have had a problem with anesthesia (medication to make you sleep during surgery) in the past.
  • I am allergic to certain medication(s) or materials, including latex.
  • I am not willing to receive a blood transfusion.
  • I drink alcohol.
  • I smoke.
  • I use recreational drugs.

About Drinking Alcohol

The amount of alcohol you drink can affect you during and after your surgery. It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.

  • If you stop drinking alcohol suddenly, it can cause seizures, delirium, and death. If we know you’re at risk for these complications, we can prescribe medications to help keep them from happening.
  • If you drink alcohol regularly, you may be at risk for other complications during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.

Here are things you can do before your surgery to keep from having problems:

  • Be honest with your healthcare providers about how much alcohol you drink.
  • Try to stop drinking alcohol once your surgery is planned. If you develop a headache, nausea (feeling like you’re going to throw up), increased anxiety, or can’t sleep after you stop drinking, tell your healthcare provider right away. These are early signs of alcohol withdrawal and can be treated.
  • Tell your healthcare provider if you can’t stop drinking.
  • Ask your healthcare provider questions about drinking and surgery. As always, all of your medical information will be kept confidential.

About Smoking

If you smoke, you can have breathing problems when you have surgery. Stopping even for a few days before surgery can help. If you smoke, your nurse will refer you to our Tobacco Treatment Program. You can also reach the program by calling 212-610-0507.

About Sleep Apnea

Sleep apnea is a common breathing disorder that causes you to stop breathing for short periods of time while sleeping. The most common type is obstructive sleep apnea (OSA). With OSA, your airway becomes completely blocked during sleep. OSA can cause serious problems during and after surgery.

Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing machine (such as a CPAP machine) for sleep apnea, bring it with you the day of your surgery.

About Enhanced Recovery After Surgery (ERAS)

ERAS is a program to help you get better faster after your surgery. As part of the ERAS program, it’s important to do certain things before and after your surgery.

Before your surgery, make sure you’re ready by doing the following things:

  • Read this guide. It will help you know what to expect before, during, and after your surgery. If you have questions, write them down. You can ask your doctor or nurse at your next appointment, or you can call your doctor’s office.
  • Exercise and follow a healthy diet. This will help get your body ready for your surgery.

After your surgery, help yourself recover more quickly by doing the following things:

  • Read your recovery pathway. This is a written educational resource that your nurse will give you. It has goals for your recovery and will help you know what to do and expect on each day during your recovery.
  • Start moving around as soon as you can. The sooner you’re able to get out of bed and walk, the quicker you will be able to get back to your normal activities.

Within 30 Days of Your Surgery

Presurgical Testing (PST)

Before your surgery, you will have an appointment for presurgical testing (PST). The date, time, and location of your PST appointment will be printed on the appointment reminder from your surgeon’s office.

You can eat and take your usual medications the day of your PST appointment.

During your appointment, you will meet with a nurse practitioner (NP) who works closely with anesthesiology staff (doctors and specialized nurses who will give you anesthesia during your surgery). Your NP will review your medical and surgical history with you. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests needed to plan your care. Your NP may also recommend that you see other healthcare providers.

Your NP will talk with you about which medications you should take the morning of your surgery.

It’s very helpful to bring the following things to your PST appointment:

  • A list of all the medications you’re taking, including prescription and over-the-counter medications, patches, and creams.
  • Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
  • The name(s) and telephone number(s) of your doctor(s).

Identify Your Caregiver

Your caregiver plays an important role in your care. You and your caregiver will learn about your surgery from your healthcare provider. After your surgery, your caregiver should be with you when you’re given your discharge instructions so they’re able to help you care for yourself at home. Your caregiver will also need to take you home after you’re discharged from the hospital.

Complete a Health Care Proxy Form

If you haven’t already completed a Health Care Proxy form, we recommend you complete one now. A health care proxy is a legal document that identifies the person who will speak for you if you can’t communicate for yourself. The person you identify is called your health care agent. For more information about health care proxies and other advance directives, read the resource Advance Care Planning.

If you’re interested in completing a Health Care Proxy form, talk with your nurse. If you have completed one already, or if you have any other advance directives, bring them to your next appointment.

Exercise

Try to do aerobic exercise every day. Examples of aerobic exercise include walking at least 1 mile (1.6 kilometers), swimming, or biking. If it’s cold outside, use stairs in your home or go to a mall or shopping center. Exercising will help your body get into its best condition for your surgery and make your recovery faster and easier.

Follow a Healthy Diet

Follow a well-balanced, healthy diet before your surgery. If you need help with your diet, talk with your doctor or nurse about meeting with a clinical dietitian nutritionist.

10 Days Before Your Surgery

Stop Taking Vitamin E

If you take vitamin E, stop taking it 10 days before your surgery. Vitamin E can cause bleeding. For more information, read the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

7 Days Before Your Surgery

Stop Taking Certain Medications

If you take aspirin, ask your doctor if you should keep taking it. Aspirin and medications that contain aspirin can cause bleeding. For more information, read the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

Stop Taking Herbal Remedies and Other Dietary Supplements

Stop taking herbal remedies and other dietary supplements 7 days before your surgery. If you take a multivitamin, ask your doctor or nurse if you should keep taking it. For more information, read the resource Herbal Remedies and Cancer Treatment.

Watch a Virtual Tour

This video will give you an idea of what to expect when you come to Memorial Hospital (MSK’s main hospital) on the day of your surgery.

VIDEO

Buy Clear Liquids

You will need to follow a clear liquid diet before your surgery. Now is a good time to buy your supplies. For a list of clear liquids you can drink, read the section “Follow a Clear Liquid Diet.”

2 Days Before Your Surgery

Stop Taking Certain Medications

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®), 2 days before your surgery. These medications can cause bleeding. For more information, read the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

1 Day Before Your Surgery

Follow a Clear Liquid Diet

For People With Diabetes

If you have diabetes, ask the healthcare provider who manages your diabetes what you should do while you’re following a clear liquid diet.

  • If you take insulin or another medication for diabetes, ask if you need to change the dose.
  • Ask if you should drink sugar-free clear liquids.

While you’re following a clear liquid diet, make sure to check your blood sugar level often. If you have any questions, talk with your healthcare provider.

You will need to follow a clear liquid diet the day before your surgery. A clear liquid diet includes only liquids you can see through. Examples are listed in the “Clear Liquid Diet” table.

While you’re following this diet:

  • Don’t eat any solid foods.
  • Try to drink at least 1 (8-ounce) glass of clear liquid every hour while you’re awake.
  • Drink different types of clear liquids. Don’t just drink water, coffee, and tea.
  • Don’t drink sugar-free liquids unless you have diabetes and a member of your healthcare team tells you to do so.
Clear Liquid Diet
  Drink Do Not Drink
Soups
  • Clear broth, bouillon, or consommé
  • Any products with pieces of dried food or seasoning
Sweets
  • Gelatin (such as Jell-O®)
  • Flavored ices
  • Hard candies (such as Life Savers®)
  • All others
Drinks
  • Clear fruit juices (such as lemonade, apple, cranberry, and grape juices)
  • Soda (such as ginger ale, 7-Up®, Sprite®, and seltzer)
  • Sports drinks (such as Gatorade®)
  • Black coffee
  • Tea
  • Water
  • Juices with pulp
  • Nectars
  • Milk or cream
  • Alcoholic drinks

Note the Time of Your Surgery

A staff member from the Admitting Office will call you after 2:00 pm the day before your surgery. If your surgery is scheduled for a Monday, they will call you on the Friday before. If you don’t get a call by 7:00 pm, please call 212-639-5014.

The staff member will tell you what time to arrive at the hospital for your surgery. They will also remind you where to go. This will be the following location:

Presurgical Center (PSC) on the 6th floor
1275 York Avenue (between East 67th and East 68th Streets)
New York, NY 10065
B elevator to 6th floor

Sleep

Go to bed early and get a full night’s sleep.

 
Do not eat or drink after midnight.


 

The Morning of Your Surgery

  Two hours before your scheduled arrival time, drink the ClearFast PreOp® drink your nurse gave you.

After you finish the ClearFast, do not eat or drink anything else. This includes water, hard candy, and gum.


 

Take Your Medications

If your doctor or NP told you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take and the surgery you’re having, this may be all, some, or none of your usual morning medications.

Things to Remember

  • Wear something comfortable and loose-fitting.
  • If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
  • Don’t wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
  • Don’t put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
  • Leave valuable items (such as credit cards, jewelry, and your checkbook) at home.
  • Before you’re taken into the operating room, you will need to remove your hearing aids, dentures, prosthetic device(s), wig, and religious articles.

What to Bring

  • A pair of loose-fitting pants (such as sweat pants).
  • Sneakers that lace up. You may have some swelling in your feet. Lace-up sneakers can fit over this swelling.
  • Your breathing machine for sleep apnea (such as your CPAP machine), if you have one.
  • Your portable music player, if you choose. However, someone will need to hold it for you when you go into surgery.
  • Your Health Care Proxy form and other advance directives, if you have completed them.
  • Your cell phone and charger.
  • Only the money you may want for small purchases (such as a newspaper).
  • A case for your personal items (such as eyeglasses, hearing aid(s), dentures, prosthetic device(s), wig, and religious articles), if you have one.
  • This guide. Your healthcare team will use this guide to teach you how to care for yourself after your surgery.

Where to Park

MSK's parking garage

MSK’s parking garage is located on East 66th Street between York and First Avenues. If you have questions about prices, call 212-639-2338.

To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There’s a tunnel that you can walk through that connects the garage to the hospital.

There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Once You’re in the Hospital

When you get to the hospital, take the B elevator to the 6th floor and check in at the desk in the PSC waiting room.

You will be asked to say and spell your name and birth date many times. This is for your safety. People with the same or a similar name may be having surgery on the same day.

Get Dressed for Surgery

When it’s time to change for surgery, you will get a hospital gown, robe, and nonskid socks to wear.

Meet With Your Nurse

You will meet with your nurse before surgery. Tell them the dose of any medications (including patches and creams) you took after midnight and the time you took them.

Your nurse may place an intravenous (IV) line into one of your veins, usually in your arm or hand. If your nurse doesn’t place the IV, your anesthesiologist will do it later once you’re in the operating room.

Meet With Your Anesthesiologist

Your anesthesiologist will:

  • Review your medical history with you.
  • Ask you if you’ve had any problems with anesthesia in the past, including nausea or pain.
  • Talk with you about your comfort and safety during your surgery.
  • Talk with you about the kind of anesthesia you will have.
  • Answer your questions about your anesthesia.

Get Ready for Your Surgery

Once your nurse has seen you, 1 or 2 visitors can keep you company as you wait for your surgery to start. When it’s time for your surgery, your visitor(s) will be taken to the waiting area. Your visitors should read the resource Information for Family and Friends for the Day of Surgery.

You will either walk into the operating room or be taken in on a stretcher. A member of the operating room team will help you onto the operating bed. Compression boots will be placed on your lower legs. These gently inflate and deflate to help blood flow in your legs.

Once you’re comfortable, your anesthesiologist will give you anesthesia through your IV line and you will fall asleep. You will also get fluids through your IV line during and after your surgery.

During Your Surgery

After you’re fully asleep, a breathing tube will be placed through your mouth and into your windpipe to help you breathe. Your breathing tube is usually taken out while you’re still in the operating room after your surgery. Your wound will be covered with gauze and a dressing (bandage).

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After Your Surgery

The information in this section will tell you what to expect after your surgery, both during your hospital stay and after you leave the hospital. You will learn how to safely recover from your surgery.

Write down your questions and be sure to ask your doctor or nurse.

In the Post-Anesthesia Care Unit (PACU)

When you wake up after your surgery, you will be in the Post-Anesthesia Care Unit (PACU).

A nurse will be monitoring your body temperature, pulse, blood pressure, and oxygen levels. You may be getting oxygen through a thin tube that rests below your nose or a mask that covers your nose and mouth. You will also have compression boots on your lower legs.

Pain Medication

You will get medication to control your pain and keep you comfortable. There are different ways that pain medication can be given:

  • Nerve block: Some people get a nerve block before or during surgery. With a nerve block, your doctor injects medication into some of your nerves to reduce pain after surgery.
  • Intravenous (IV) medications: Some people get pain medication straight into a vein through their IV line.

You will have 1 or more of these after your surgery. They’re all effective methods to control your pain. Your doctor will talk with you before choosing the best one(s) for you.

Visitors

Your visitors can see you briefly in the PACU, usually within 90 minutes after you arrive there. A member of the nursing staff will explain the guidelines to them.

Moving to Your Hospital Room

You will stay in the PACU until you’re awake and your pain is under control. Most people are moved to their hospital room after a few hours in the PACU, but some people stay in the PACU overnight for observation. After your stay in the PACU, you will be taken to your hospital room.

In Your Hospital Room

The length of time you’re in the hospital after your surgery depends on your recovery and the exact surgery you had. Most people stay in the hospital for 2 days. Your healthcare team will tell you what to expect.

When you’re taken to your hospital room, you will meet one of the nurses who will care for you while you’re in the hospital. Soon after you arrive in your room, your nurse will help you out of bed and into your chair.

While you’re in the hospital, your nurses will teach you how to care for yourself while you’re recovering from your surgery. You can help yourself recover more quickly by doing the following things:

  • Read your recovery pathway. Your nurse will give you a pathway with goals for your recovery, if you don’t already have one. It will help you know what to do and expect on each day during your recovery.
  • Start moving around as soon as you can. The sooner you’re able to get out of bed and walk, the quicker you will be able to get back to your normal activities.

Read the resource Call! Don't Fall! to learn about what you can do to stay safe and keep from falling while you’re in the hospital.

Managing Your Pain

You will have some pain after your surgery. Your doctor and nurse will ask you about your pain often and give you medication as needed. If your pain isn’t relieved, tell your doctor or nurse. It’s important to control your pain so you can cough, breathe deeply, use your incentive spirometer, and move around. Controlling your pain will help you recover better.

Many people find their pain is controlled with over-the-counter medications alone. If you need stronger pain medication in the hospital, you will be given a prescription before you leave. Talk with your doctor or nurse about possible side effects and how to taper (slowly stop taking) your medication.

Moving Around and Walking

Moving around and walking will help lower your risk for blood clots and pneumonia. It will also help stimulate your bowels so you start passing gas and having bowel movements (pooping) again.

Read your recovery pathway to learn about your specific moving and walking goals. Your nurse, physical therapist, or occupational therapist will help you move around, if needed.

Exercising Your Lungs

It’s important to exercise your lungs so they expand fully. This helps prevent pneumonia.

  • Your nurse will give you an incentive spirometer. Use it 10 times every hour you’re awake. For more information, read the resource How to Use Your Incentive Spirometer.
  • Do coughing and deep breathing exercises. A member of your care team will teach you how to do these exercises.

Eating and Drinking

Right after your surgery, you won’t be able to eat solid foods. You will follow a clear liquid diet. After that, you will slowly start eating solid foods. This usually happens the day after your surgery.

A clinical dietitian nutritionist will give you more information about eating after surgery before you leave the hospital.

Caring for Your Wound

You will have a wound where your ileostomy used to be. It won’t be closed with sutures (stitches) or staples, and it will be very raw and red. This is normal.

Your nurse will pack (fill) your wound with gauze and change your bandage every day while you’re in the hospital. They will also teach you how to do it yourself. They will have you practice packing your wound and changing your dressing before you go home.

Your wound should close 4 to 6 weeks after your surgery.

Planning for Your Discharge

Your nurse will give you supplies so you can care for your wound at home. Most people also have a nurse visit them at home to help you as you heal. Your case manager (a member of your healthcare team who helps to plan and coordinate your services) will discuss this with you when planning your discharge.

Leaving the Hospital

By the time you’re ready to leave the hospital, your incision will have started to heal. Before you leave the hospital, look at your incisions with your nurse and caregiver. Knowing what your incisions look like will help you notice any changes later.

On the day of your discharge, you should plan to leave the hospital between 8:00 am and 10:00 am. Before you leave, a member of your care team will write your discharge order and prescriptions. You will also get written discharge instructions. Your nurse will review these instructions with you before you leave.

If your ride isn’t at the hospital when you’re ready to be discharged, you may be able to wait in the Patient Transition Lounge. A member of your healthcare team will give you more information.

At Home

Read the resource What You Can Do to Avoid Falling to learn about what you can do to stay safe and keep from falling at home and during your appointments at MSK.

Caring for Your Wound

Follow your healthcare team’s instructions for how often to change the gauze and bandage over your wound. Most people have a visiting nurse come to their home to help them. To prevent infection, clean your hands with soap and water or an alcohol-based hand sanitizer before you touch your wound.

Check your wound every day for any signs of infection until your doctor tells you it has healed. Call your doctor if you see any of the following signs of a wound infection:

  • A fever of 100.5 °F (38.0 °C) or higher
  • Swelling around your wound
  • Increased pain that doesn’t get better with medication
  • Drainage that looks like pus (thick and milky)

Managing Your Pain

People have pain or discomfort for different lengths of time. You may still have some pain when you go home and will probably be taking pain medication. Some people have soreness, tightness, or muscle aches around their incision for 6 months or longer. This doesn’t mean that something is wrong.

Follow the guidelines below to help manage your pain at home.

  • Take your medications as directed and as needed.
  • Call your doctor if the medication prescribed for you doesn’t ease your pain.
  • Don’t drive or drink alcohol while you’re taking prescription pain medication.
  • As your wound heals, you will have less pain and need less pain medication. An over-the-counter pain reliever such as acetaminophen (Tylenol®) or ibuprofen (Advil®) will ease aches and discomfort.
    • Follow your doctor or nurse’s instructions for stopping your prescription pain medication.
    • Don’t take more acetaminophen than the amount directed on the bottle or as instructed by your doctor or nurse. Taking too much acetaminophen can harm your liver.
  • Pain medication should help you resume your normal activities. Take enough medication to do your exercises comfortably. However, it’s normal for your pain to increase a little as you start to be more active.
  • Keep track of when you take your pain medication. It works best 30 to 45 minutes after you take it. Taking it when your pain first begins is better than waiting for the pain to get worse.

Managing Changes in Bowel Function

Your rectum is a storage tank for stool (poop). You had surgery to remove part of it, so now this tank is smaller. This means that it can’t hold as much stool. You may have a lot of small bowel movements because your rectum can’t hold a lot of stool. Over time, your rectum will stretch and be able to hold more stool. This process can take several months to years.

For the first few weeks after your surgery, you may have a lot of bowel movements. This is because the lower part of your colon hasn’t been used in a while. It will take time for your body to recover.

After your surgery, your bowel movements may:

  • Be more frequent.
  • Happen several times an hour, several times a week.
  • Happen every other day.
  • Not feel complete. After having a bowel movement, you may still feel like you 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.

If you also had radiation therapy, your rectum may be stiff. It won’t be able to stretch and hold stool as well as before your surgery. This is usually temporary.

Tips for Managing Frequent Bowel Movements

If you’re having multiple bowel movements a day, you may need to follow a bland diet for a few days. While you’re following a bland diet, avoid:

Dairy products, including milk, cheese and ice cream

  • Coffee
  • Chocolate
  • Spicy foods
  • Fried foods
  • Gravies and cream sauces
  • High-fat deli meats
  • Greasy meats, such as sausage and bacon
  • Fruit juices
  • Sugar-free foods

Following the BRAT diet can also help control frequent bowel movements. The BRAT diet is made up mostly of:

  • Bananas (B)
  • White rice (R)
  • Applesauce (A)
  • Toast (T)

Drinking black tea can also help.

Tips for Managing Soreness

You may have soreness around your anus from frequent bowel movements:

  • Soak in warm water 2 to 3 times a day.
  • Apply zinc oxide ointment (Desitin®) to the skin around your anus after every bowel movement. This helps prevent irritation.
  • Don’t use harsh toilet paper. You can use a nonalcohol wipe (such as a moistened flushable wipe) instead.
  • If your doctor prescribes medication, take it as directed.

Showering

Taking a warm shower is relaxing and can help decrease muscle aches.

Take your bandages off before you shower. When you shower, use soap to gently wash your wound. After your shower, pat your wound dry with a clean towel. Pack your wound with gauze and change your bandage.

Don’t take tub baths until you discuss it with your doctor at the first appointment after your surgery.

Eating and Drinking

Eat 5 to 6 small meals throughout the day. Remember to eat slowly and chew your food well. It’s important you try to maintain your weight. Drink 8 to 10 (8-ounce) glasses of liquids every day.

After your surgery, foods may affect you differently. Certain foods may make you have bowel movements right after you eat them. Certain foods may cause diarrhea (loose or watery bowel movements). You may need to change your diet after your surgery.

Every person is different, so there’s no way to know which foods will make this happen. During the first few months after your surgery, you will need to test foods and see how you react to them. It may be helpful to keep a food diary. This will help you keep track of which foods cause discomfort.

If you have questions about your diet, ask to see a clinical dietitian nutritionist.

Dietary Supplements and Medications

It may be helpful to take a dietary supplement or medication to help your bowel function after surgery. Don’t take these things without talking with your healthcare provider first.

Fiber

Your doctor may tell you to take a fiber supplement, such as Metamucil® or Citrucel®, starting about 4 weeks after your surgery. Fiber will help you by:

  • Increasing the bulk in your stool. This helps move waste out of your body.
  • Stretching your rectum by adding bulk to your stool. This stretching takes place over many months, but eventually your bowel movements should become less frequent and less urgent. This will combine all of the small pieces of stool together to create a larger bowel movement. These larger stools will also stretch out your rectum and you will be able to hold more stool. Your rectum squeezes better when it’s full.

Start by taking ½ to 1 teaspoon a day and take more of it as needed. Drink at least 8 (8-ounce) glasses (2 liters) of water or clear liquids each day because fiber can cause constipation if you’re not drinking enough. If you have bloating and gas, take simethicone (GasX®) as needed.

Probiotics

You may also need to take a probiotic supplement. Taking probiotics may help your bowels work better. Ask your healthcare provider for recommendations.

Other medications

If you’re 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. Your doctor will tell you how much to take and how often to take it.

If you don’t have a bowel movement for 2 days, contact your doctor or nurse.

Physical Activity and Exercise

For the first 6 to 8 weeks after your surgery:

  • Don’t lift, push, or pull anything heavier than 10 pounds (about 4.5 kilograms).
  • Don’t do any strenuous activities (such as jogging and tennis).
  • Don’t play any contact sports (such as football).

Doing aerobic exercise, such as walking and stair climbing, will help you gain strength and feel better. Walk at least 2 to 3 times a day for 15 to 20 minutes for the first 2 weeks after surgery. You can walk outside or indoors at your local mall or shopping center. Ask your doctor or nurse before starting more demanding exercises.

It’s normal to have less energy than usual after your surgery. Recovery time is different for each person. Increase your activities each day as much as you can. Always balance activity periods with rest periods. But, if you can’t sleep at night, it may be a sign that you’re resting too much during the day.

Kegel Exercises

You will need to do Kegel exercises to strengthen your pelvic floor muscles. This will help you hold in your bowel movements until you get to a toilet and prevent accidental stool leakage (incontinence) after your ileostomy is closed.

Ask your doctor when you should start doing Kegel exercises. Starting too soon after discharge can be painful.

You can do Kegel exercises while you’re sitting, standing, and walking. To do Kegel exercises:

  1. Tighten your pelvic floor muscles (the muscles you tighten when you’re trying to hold back a bowel movement).
  2. Hold this position for 5 to 10 seconds.
  3. Release and rest.

Repeat this exercise 10 times, 4 times a day.

Driving

You can start driving again 2 weeks after your surgery. Don’t drive while you’re taking pain medication that may make you drowsy. You can ride in a car as a passenger at any time after you leave the hospital.

Going Back to Work

Talk with your doctor or nurse about your job and when it may be safe for you to start working again. If your job involves lots of movement or heavy lifting, you may need to stay out a little longer than if you sit at a desk.

Follow-up Appointments

Your first appointment after your surgery will be 1 to 3 weeks after you leave the hospital. Call your surgeon’s office after you’re discharged from the hospital to schedule it.

It’s important that you go to all of your follow-up appointments after your surgery. You can call your doctor or nurse if you have any questions in between these appointments.

Managing Your Feelings

After surgery for a serious illness, you may have new and upsetting feelings. Many people say they felt weepy, sad, worried, nervous, irritable, and angry at one time or another. You may find that you can’t control some of these feelings. If this happens, it’s a good idea to seek emotional support.

The first step in coping is to talk about how you feel. Family and friends can help. Your nurse, doctor, and social worker can reassure, support, and guide you. It’s always a good idea to let these professionals know how you, your family, and your friends are feeling emotionally. Many resources are available to you and your family. Whether you’re in the hospital or at home, the nurses, doctors, and social workers are here to help you and your family and friends handle the emotional aspects of your illness.

Using MyMSK

MyMSK (my.mskcc.org) is your MSK patient portal account. You can use MyMSK to send and receive messages from your healthcare team, view your test results, see your appointment dates and times, and more.

If you don’t already have a MyMSK account, you can sign up by going to my.mskcc.org. For more information about signing up for a MyMSK account, watch our video How to Enroll in the Patient Portal: MyMSK. You can also contact the MyMSK Help Desk by emailing mymsk@mskcc.org or calling 800-248-0593.

Contact Your Doctor or Nurse If You Have:

  • A fever of 100.5 °F (38.0 °C) or higher
  • Pain, bloating, cramping, or tenderness in your abdomen
  • Nausea or vomiting
  • Trouble passing gas
  • Trouble having a bowel movement
  • Trouble urinating (peeing)
  • Swelling around your wound
  • Pain on your wound that doesn’t go away with medication
  • Bleeding from your rectum
  • Any of the following signs of dehydration (not having enough liquids):
    • Feeling very thirsty
    • Dry mouth or skin
    • Fatigue (feeling more tired or weak than usual)
    • Loss of appetite
    • Feeling dizzy when you stand
    • Headache
    • Leg cramps
  • Any of the following signs of wound infection:
    • Swelling
    • Increased pain
    • Warmth at the wound site
    • Drainage that looks like pus (thick and milky)
  • Any questions or concerns.

Monday through Friday from 9:00 am to 5:00 pm, contact your doctor’s office.

After 5:00 pm, during the weekend, and on holidays, call 212-639-2000 and ask to speak to the doctor on call for your doctor.

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Support Services

This section contains a list of support services that may help you get ready for your surgery and recover safely.

Write down your questions and be sure to ask your doctor or nurse.

    MSK Support Services

    Anesthesia
    212-639-6840
    Call if you have questions about anesthesia.

    Blood Donor Room
    212-639-7643
    Call for more information if you’re interested in donating blood or platelets.

    Bobst International Center
    888-675-7722
    MSK welcomes patients from around the world. If you’re an international patient, call for help arranging your care.

    Chaplaincy Service
    212-639-5982
    At MSK, our chaplains are available to listen, help support family members, pray, contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can request spiritual support, regardless of formal religious affiliation. The interfaith chapel is located near the main lobby of Memorial Hospital and is open 24 hours a day. If you have an emergency, please call the hospital operator and ask for the chaplain on call.

    Counseling Center
    646-888-0200
    Many people find that counseling helps them. We provide counseling for individuals, couples, families, and groups, as well as medications to help if you feel anxious or depressed. To make an appointment, ask your healthcare provider for a referral or call the number above.

    Food Pantry Program
    646-888-8055
    The food pantry program provides food to people in need during their cancer treatment. For more information, talk with your healthcare provider or call the number above.

    Integrative Medicine Service
    646-888-0800
    Integrative Medicine Service offers many services to complement (go along with) traditional medical care, including music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy.

    Look Good Feel Better Program
    www.lookgoodfeelbetter.org
    800-395-LOOK (800-395-5665)
    This program offers workshops to learn things you can do to help you feel better about your appearance. For more information or to sign up for a workshop, call the number above or visit the program’s website.

    MSK Library
    library.mskcc.org
    212-639-7439
    You can visit our library website or speak with the library reference staff to find more information about your specific cancer type. You can also visit LibGuides on MSK’s library website at libguides.mskcc.org.

    Patient and Caregiver Education
    www.mskcc.org/pe
    Visit the Patient and Caregiver Education website to search our virtual library. There, you can find written educational resources, videos, and online programs.

    Patient and Caregiver Support Program
    212-639-5007
    You may find it comforting to speak with a cancer survivor or caregiver who has been through a similar treatment. Through our Patient and Caregiver Support Program, you’re able to speak with former patients and caregivers. These conversations may take place in person, over the phone, or through email.

    Patient Billing
    646-227-3378
    Call if you have questions about preauthorization with your insurance company. This is also called preapproval.

    Patient Representative Office
    212-639-7202
    Call if you have questions about the Health Care Proxy form or if you have concerns about your care.

    Perioperative Nurse Liaison
    212-639-5935
    Call if you have questions about MSK releasing any information while you’re having surgery.

    Private Duty Nursing Office
    212-639-6892
    You may request private nurses or companions. Call for more information.

    Resources for Life After Cancer (RLAC) Program
    646-888-8106
    At MSK, care doesn’t end after active treatment. The RLAC Program is for patients and their families who have finished treatment. This program has many services, including seminars, workshops, support groups, counseling on life after treatment, and help with insurance and employment issues.

    Sexual Health Programs
    Cancer and cancer treatments can have an impact on your sexual health. MSK’s Sexual Health Programs can help you take action and address sexual health issues before, during, or after your treatment.

    • Our Female Sexual Medicine and Women’s Health Program helps women who are dealing with cancer-related sexual health challenges, including premature menopause and fertility issues. For more information, or to make an appointment, call 646-888-5076.
    • Our Male Sexual and Reproductive Medicine Program helps men who are dealing with cancer-related sexual health challenges, including erectile dysfunction. For more information, or to make an appointment, call 646-888-6024.

    Social Work
    212-639-7020
    Social workers help patients, family, and friends deal with issues that are common for cancer patients. They provide individual counseling and support groups throughout the course of treatment, and can help you communicate with children and other family members. Our social workers can also help refer you to community agencies and programs, as well as financial resources if you’re eligible.

    Tobacco Treatment Program
    212-610-0507
    If you want to quit smoking, MSK has specialists who can help. Call for more information.

    Virtual Programs
    www.mskcc.org/vp
    MSK’s Virtual Programs offer online education and support for patients and caregivers, even when you can’t come to MSK in person. Through live, interactive sessions, you can learn about your diagnosis, what to expect during treatment, and how to prepare for the various stages of your cancer care. Sessions are confidential, free, and led by expert clinical staff. If you’re interested in joining a Virtual Program, visit our website at www.mskcc.org/vp for more information.

    For more online information, visit the Cancer Types section of www.mskcc.org.

    External Support Services

    Access-A-Ride
    web.mta.info/nyct/paratran/guide.htm
    877-337-2017
    In New York City, the MTA offers a shared ride, door-to-door service for people with disabilities who can’t take the public bus or subway.

    Air Charity Network
    www.aircharitynetwork.org
    877-621-7177
    Provides travel to treatment centers.

    American Cancer Society (ACS)
    www.cancer.org
    800-ACS-2345 (800-227-2345)
    Offers a variety of information and services, including Hope Lodge, a free place for patients and caregivers to stay during cancer treatment.

    Cancer and Careers
    www.cancerandcareers.org
    A resource for education, tools, and events for employees with cancer.

    CancerCare
    www.cancercare.org
    800-813-4673
    275 Seventh Avenue (Between West 25th & 26th Streets)
    New York, NY 10001
    Provides counseling, support groups, educational workshops, publications, and financial assistance.

    Cancer Support Community
    www.cancersupportcommunity.org
    Provides support and education to people affected by cancer.

    Caregiver Action Network
    www.caregiveraction.org
    800-896-3650
    Provides education and support for people who care for loved ones with a chronic illness or disability.

    Corporate Angel Network
    www.corpangelnetwork.org
    866-328-1313
    Offers free travel to treatment across the country using empty seats on corporate jets.

    Gilda’s Club
    www.gildasclubnyc.org
    212-647-9700
    A place where men, women, and children living with cancer find social and emotional support through networking, workshops, lectures, and social activities.

    Good Days
    www.mygooddays.org
    877-968-7233
    Offers financial assistance to pay for copayments during treatment. Patients must have medical insurance, meet the income criteria, and be prescribed medication that’s part of the Good Days formulary.

    Healthwell Foundation
    www.healthwellfoundation.org
    800-675-8416
    Provides financial assistance to cover copayments, health care premiums, and deductibles for certain medications and therapies.

    Joe’s House
    www.joeshouse.org
    877-563-7468
    Provides a list of places to stay near treatment centers for people with cancer and their families.

    LGBT Cancer Project
    http://lgbtcancer.com/
    Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT-friendly clinical trials.

    LIVESTRONG Fertility
    www.livestrong.org/we-can-help/fertility-services
    855-744-7777
    Provides reproductive information and support to cancer patients and survivors whose medical treatments have risks associated with infertility.

    National Cancer Institute
    www.cancer.gov
    800-4-CANCER (800-422-6237)

    National Cancer Legal Services Network
    www.nclsn.org
    Free cancer legal advocacy program.

    National LGBT Cancer Network
    www.cancer-network.org
    Provides education, training, and advocacy for LGBT cancer survivors and those at risk.

    Needy Meds
    www.needymeds.org
    Lists Patient Assistance Programs for brand and generic name medications.

    NYRx
    www.nyrxplan.com
    Provides prescription benefits to eligible employees and retirees of public sector employers in New York State.

    Partnership for Prescription Assistance
    www.pparx.org
    888-477-2669
    Helps qualifying patients without prescription drug coverage get free or low-cost medications.

    Patient Access Network Foundation
    www.panfoundation.org
    866-316-7263
    Provides assistance with copayments for patients with insurance.

    Patient Advocate Foundation
    www.patientadvocate.org
    800-532-5274
    Provides access to care, financial assistance, insurance assistance, job retention assistance, and access to the national underinsured resource directory.

    RxHope
    www.rxhope.com
    877-267-0517
    Provides assistance to help people get medications that they have trouble affording.

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    Educational Resources

    This section contains the educational resources that were referred to throughout this guide. These resources will help you get ready for your surgery and recover safely after surgery.

    Write down your questions and be sure to ask your doctor or nurse.

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