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.
Use this guide as a source of information in the days leading up to your surgery. Bring it 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 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 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.
After your surgery, you’ll have a small wound where your ileostomy used to be. This wound will heal in about 4 to 6 weeks. You’ll 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.
Getting Ready for Your Surgery
This section will help you get ready for your surgery. Read it when your surgery is scheduled. Refer to it as your surgery gets closer. It has important information about what to do to get ready.
As you read through this section, write down questions to ask your healthcare provider.
Getting ready for surgery
You and your care team will work together to get ready for your surgery. Help us keep you safe by telling us if any of these things apply to you, even if you’re not sure.
I take a anticoagulant (blood thinner), such as:These are examples of medicines. There are others.
Be sure your healthcare provider knows all the medicines you’re taking.
- Warfarin (Jantoven®, Coumadin®)
- Clopidogrel (Plavix®)
- Enoxaparin (Lovenox®)
- Dabigatran (Pradaxa®)
- Apixaban (Eliquis®)
- Rivaroxaban (Xarelto®)
I take an SGLT2 inhibitor, such as:
- Canagliflozin (Invokana®)
- Dapagliflozin (Farxiga®)
- Empagliflozin (Jardiance®)
- Ertugliflozin (Steglatro®)
- I take prescription medicine(s), including patches and creams. A prescription medicine is one you can only get with a prescription from your healthcare provider.
- I take over-the-counter medicine(s), including patches and creams. An over-the-counter medicine is one you can buy without a prescription from your healthcare provider.
- 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 (A-nes-THEE-zhuh) in the past. Anesthesia is medicine to you sleep during a surgery or procedure.
- I’m allergic to certain medicines or materials, including latex.
- I’m not willing to receive a blood transfusion.
- I drink alcohol.
- I smoke or use an electronic smoking device, such as a vape pen or e-cigarette.
- I use recreational drugs, such as marijuana.
About drinking alcohol
It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.
If you drink alcohol regularly, you may be at risk for problems during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.
If you drink alcohol regularly and stop suddenly, it can cause seizures, delirium, and death. If we know you’re at risk for these problems, we can prescribe medicine to help prevent them.
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. Tell your healthcare provider right away if you:
- Get a headache.
- Feel nauseous (like you’re going to throw up).
- Feel more anxious (nervous or worried) than usual.
- Cannot sleep.
These are early signs of alcohol withdrawal and can be treated.
- Tell your healthcare provider if you cannot stop drinking.
- Ask your healthcare provider questions about drinking and surgery. All your medical information will be kept private, as always.
If you smoke, you can have breathing problems when you have surgery. Stopping for even a few days before your surgery can help.
About sleep apnea
Sleep apnea is a common breathing problem. If you have sleep apnea, you stop breathing for short lengths of time while you’re asleep. The most common type is obstructive sleep apnea (OSA). With OSA, your airway becomes fully blocked during sleep.
OSA can cause serious problems during and after surgery. Tell us if you have or think you might have sleep apnea. If you use a breathing device, such as a CPAP machine, bring it on the day of your surgery.
MyMSK (my.mskcc.org) is your MSK patient portal. You can use it to send and read messages from your care team, view your test results, see your appointment dates and times, and more. You can also invite your caregiver to make their own account so they can see information about your care.
Watch How to Enroll in MyMSK: Memorial Sloan Kettering's Patient Portal to learn more. You can also contact the MyMSK Help Desk by emailing [email protected] or calling 800-248-0593.
About your MyMSK Goals to Discharge Checklist
After your surgery, you’ll focus on getting well enough to leave the hospital. We’ll send a Goals to Discharge Checklist to your MyMSK account to help you track how you’re doing.
You can use your MyMSK Goals to Discharge Checklist to see the goals you need to meet before leaving the hospital. You can also update your progress throughout the day. Your updates send alerts to your surgical team about your progress.
To learn more, read Frequently Asked Questions About the MyMSK Goals to Discharge Checklist .
About Enhanced Recovery After Surgery (ERAS)
ERAS is a program to help you get better faster after your surgery. It’s important to do certain things before and after your surgery as part of the ERAS program.
Before your surgery, make sure you’re ready by:
- Reading 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 healthcare provider at your next appointment or call their office.
- Exercising and following a healthy diet. This will help get your body ready for your surgery.
After your surgery, help yourself recover more quickly by:
- Reading your recovery pathway. This is an educational resource your healthcare provider will give you. It has goals for your recovery. It will help you know what to do and expect each day.
- Starting to move around as soon as you can. The sooner you get out of bed and walk, the quicker you can get back to your normal activities.
Within 30 days of your surgery
Presurgical testing (PST)
You’ll have a PST appointment before your surgery. You’ll get a reminder from your surgeon’s office with the appointment date, time, and location.
You can eat and take your usual medicine(s) the day of your PST appointment.
It’s helpful to bring these things to your appointment:
- A list of all the medicines you’re taking, including prescription and over-the-counter medicines, patches, and creams.
- Results of any medical tests done outside of MSK in the past year, if you have them. Examples include results from a cardiac stress test, echocardiogram, or carotid doppler study.
- The names and telephone numbers of your healthcare providers.
You’ll meet with an advance practice provider (APP) during your PST appointment. They work closely with MSK’s anesthesiology (A-nes-THEE-zee-AH-loh-jee) staff. These are healthcare providers with special training in using anesthesia during a surgery or procedure.
Your APP will review your medical and surgical history with you. You may have tests to plan your care, such as:
- An electrocardiogram (EKG) to check your heart rhythm.
- A chest X-ray.
- Blood tests.
Your APP may recommend you see other healthcare providers. They’ll also talk with you about which medicine(s) to take the morning of your surgery.
Identify your caregiver
Your caregiver plays an important role in your care. Before your surgery, you and your caregiver will learn about your surgery from your healthcare providers. After your surgery, your caregiver will take you home when you’re discharged. They’ll also help you care for yourself at home.
Fill out a Health Care Proxy form
If you have not already filled out a Health Care Proxy form, we recommend you do now. If you already filled one out or have any other advance directives, bring them to your next appointment.
A health care proxy is a legal document. It says who will speak for you if you cannot communicate for yourself. This person is called your health care agent.
- To learn about health care proxies and other advance directives, read Advance Care Planning .
- To learn about being a health care agent, read How to Be a Health Care Agent .
Talk with a member of your care team if you have questions about filling out a Health Care Proxy form.
7 days before your surgery
Follow your healthcare provider’s instructions for taking aspirin
Aspirin can cause bleeding. If you take aspirin or a medicine that has aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Follow your healthcare provider’s instructions. Do not stop taking aspirin unless they tell you to.
To learn more, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E . You can find it in the “Educational resources” section of this guide.
Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements
Vitamin E, multivitamins, herbal remedies, and other dietary supplements can cause bleeding. Stop taking them 7 days before your surgery. If your healthcare provider gives you other instructions, follow those instead.
To learn more, read Herbal Remedies and Cancer Treatment .
Buy clear liquids
You’ll need to follow a clear liquid diet before your surgery. It’s helpful to buy clear liquids ahead of time. Read the section “Follow a clear liquid diet” for a list of clear liquids you can drink.
2 days before your surgery
Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs, such as ibuprofen (Advil® and Motrin®) and naproxen (Aleve®), can cause bleeding. Stop taking them 2 days before your surgery. If your healthcare provider gives you other instructions, follow those instead.
1 day before your surgery
Follow a clear liquid diet
You’ll need to follow a clear liquid diet the day before your surgery. A clear liquid diet includes only liquids you can see through. You can find examples in the “Clear liquid diet” table.
While you’re following a clear liquid diet:
- Try to drink at least 1 (8-ounce) cup of clear liquid every hour you’re awake.
- Drink different types of clear liquids. Do not just drink water, coffee, and tea.
- Do not drink any liquids you can’t see through, such as milk or smoothies.
- Do not drink sugar-free liquids unless you have diabetes and a member of your care team tells you to.
- Do not eat any solid foods.
How to follow a clear liquid diet if you have diabetes
Ask the healthcare provider who manages your diabetes:
- What to do while you’re following a clear liquid diet.
- If you need to change your dose of insulin or other diabetes medication, if you take them.
- If you should drink sugar-free clear liquids.
Check your blood sugar level often while you’re following a clear liquid diet. If you have questions, talk with your healthcare provider.
|Clear liquid diet|
|OK to drink||Do not drink|
Note the time of your surgery
A staff member will call you after the day before your surgery. If your surgery is scheduled for a Monday, they’ll call you the Friday before. If you do not get a call by , call 212-639-5014.
The staff member will tell you what time to get to the hospital for your surgery. They’ll also remind you where to go.
Instructions for eating before your surgery
Do not eat anything after midnight (12 a.m.) the night before your surgery. This includes hard candy and gum.
The Morning of Your Surgery
Instructions for drinking before your surgery
- If your healthcare provider gave you a ClearFast drink, finish it 2 hours before your scheduled arrival time. Do not drink anything else after midnight (12 a.m.) the night before your surgery, including water.
- If your healthcare provider did not give you a ClearFast drink, you can drink a total of 12 ounces of water between midnight (12 a.m.) and 2 hours before your scheduled arrival time. Do not drink anything else.
Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.
Take your medications as instructed
A member of your care team will tell you which medications to take the morning of your surgery. Take only those medications with a sip of water. Depending on what medications you take, 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.
- If you’re menstruating (have your monthly period), use a sanitary pad, not a tampon. You’ll get disposable underwear, as well as a pad if needed.
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 device for sleep apnea (such as your CPAP device), if you have one.
- 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 it to teach you how to care for yourself after surgery.
Where to park
MSK’s parking garage is on East 66th Street between York and 1st avenues. If you have questions about prices, call 212-639-2338.
To get to the garage, turn onto East 66th Street from York Avenue. The garage is about a quarter of a block in from York Avenue. It’s on the right (north) side of the street. There’s a tunnel you can walk through that connects the garage to the hospital.
There are other parking garages on:
- East 69th Street between 1st and 2nd avenues.
- East 67th Street between York and 1st avenues.
- East 65th Street between 1st and 2nd avenues.
Once you’re in the hospital
When you get to the hospital, take the B elevator to the 6th floor. Check in at the desk in the PSC waiting room.
You’ll 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.
When it’s time to change for surgery, you’ll get a hospital gown, robe, and nonskid socks to wear.
Meet with a nurse
You’ll meet with a nurse before surgery. Tell them the dose of any medicines you took after midnight (12 a.m.) and the time you took them. Make sure to include prescription and over-the-counter medicines, patches, and creams.
Your nurse may place an intravenous (IV) line in one of your veins, usually in your arm or hand. If your nurse does not place the IV, your anesthesiologist (A-nes-THEE-zee-AH-loh-jist) will do it in the operating room.
Meet with an anesthesiologist
You’ll also meet with an anesthesiologist before surgery. They will:
- Review your medical history with you.
- Ask you if you’ve had any problems with anesthesia in the past, such as nausea or pain.
- Talk with you about your comfort and safety during your surgery.
- Talk with you about the kind of anesthesia you’ll get.
- Answer your questions about your anesthesia.
During your surgery
When it’s time for your surgery, you’ll need to remove your hearing aids, dentures, prosthetic device(s), wig, and religious articles, if you have them. You’ll 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 and place compression boots 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’ll fall asleep. You’ll also get fluids through your IV line during and after 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).
Recovering after your surgery
This section will help you know what to expect after your surgery. You’ll learn how to safely recover from your surgery both in the hospital and at home.
As you read through this section, write down questions to ask your healthcare provider.
In the Post-Anesthesia Care Unit (PACU)
You’ll be in the PACU when you wake up after your surgery. A nurse will be keeping track of your temperature, pulse, blood pressure, and oxygen levels. You may get oxygen through a tube resting below your nose or a mask over your nose and mouth. You’ll also have compression boots on your lower legs.
You’ll get medication to control your pain and keep you comfortable. There are different ways 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.
- IV medications: Some people get pain medication into a vein through their IV line.
You’ll have 1 or more of these after your surgery. They’re all effective methods to control your pain. Your healthcare provider will talk with you before choosing the best one(s) for you.
Moving to your hospital room
You’ll stay in the PACU until you’re awake and your pain is under control. Most people move 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, a staff member will take you to your hospital room.
In your hospital room
The length of time you’re in the hospital after your surgery depends on your recovery. 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’ll 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 healthcare provider 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’ll be able to get back to your normal activities.
You can use your MyMSK Goals to Discharge Checklist to track your progress during your recovery. For more information, read the resource About Your MyMSK Goals to Discharge Checklist .
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’ll have some pain after your surgery. Your healthcare providers will ask you about your pain often and give you medication as needed. If your pain isn’t relieved, tell one of your healthcare providers. It’s important to control your pain so you can 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, one of your healthcare providers will give you a prescription before you leave. Talk with your healthcare providers 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 (lung infection). It will also help 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 instructions for using your incentive spirometer, 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 them.
Eating and drinking
Right after your surgery, you won’t be able to eat solid foods. You’ll follow a liquid diet. After that, you’ll 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’ll 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’ll also teach you how to do it yourself. They will have you practice packing your wound and changing your dressing before you go home. It’s helpful if your caregiver also learns how to care for your wound. This will make it easier for them to help you care for yourself at 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
Before you leave the hospital, look at your wound with one of your healthcare providers. Knowing what your wound looks like will help you notice any changes later.
On the day of your discharge, plan to leave the hospital between and Before you leave, one of your healthcare providers will write your discharge order and prescriptions. You’ll also get written discharge instructions. One of your healthcare providers will review them 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.
Read What You Can Do to Avoid Falling to learn what you can do to keep from falling at home and during your appointments at MSK.
Filling out your Recovery Tracker
We want to know how you’re feeling after you leave the hospital. To help us care for you, we’ll send questions to your MyMSK account. We’ll send them every day for 10 days after you’re discharged. These questions are known as your Recovery Tracker.
Fill out your Recovery Tracker every day before midnight (12 a.m.). It only takes 2 to 3 minutes to complete. Your answers to these questions will help us understand how you’re feeling and what you need.
Based on your answers, we may reach out to you for more information. Sometimes, we may ask you to call your surgeon’s office. You can always contact your surgeon’s office if you have any questions.
To learn more, read About Your Recovery Tracker .
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 healthcare provider tells you it’s healed. Call your healthcare provider 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. The pain usually gets better within 1 to 2 weeks.
Follow these guidelines to help manage your pain at home.
- Take your medicine(s) as directed and as needed.
- Call your healthcare provider if the medicine prescribed for you does not help your pain.
- Do not drive or drink alcohol while you’re taking prescription pain medicine. Some prescription pain medicines can make you drowsy (very sleepy). Alcohol can make the drowsiness worse.
You’ll have less pain and need less pain medicine as your incision heals. An over-the-counter pain reliever will help with aches and discomfort. Acetaminophen (Tylenol®) and ibuprofen (Advil® or Motrin®) are examples of over-the-counter pain relievers.
- Follow your healthcare provider’s instructions for stopping your prescription pain medicine.
- Do not take too much of any medicine. Follow the instructions on the label or from your healthcare provider.
- Read the labels on all the medicines you’re taking. This is very important if you’re taking acetaminophen. Acetaminophen is an ingredient in many over-the-counter and prescription medicines. Taking too much can harm your liver. Do not take more than one medicine that has acetaminophen without talking with a member of your care team.
- Pain medicine should help you get back to your normal activities. Take enough to do your activities and exercises comfortably. You may have a little more pain as you start to be more active.
Keep track of when you take your pain medicine. It works best 30 to 45 minutes after you take it. Taking it when you first have pain 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. You may have a lot of small bowel movements because your rectum can’t hold as much stool. Over time, your rectum will stretch and be able to hold more. 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
- 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.
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 or go swimming until your healthcare provider says it’s okay.
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’ll 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.
Your healthcare provider 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 because your rectum squeezes better when it’s full.
- 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.
Start by taking ½ to 1 teaspoon a day and take more of it as needed. Fiber can cause constipation if you’re not drinking enough, so drink at least 8 (8-ounce) glasses (2 liters) of water or clear liquids each day. If you have bloating and gas, take simethicone (GasX®) as needed.
You may also need to take a probiotic supplement. Taking probiotics may help your bowels work better. Ask your healthcare provider for recommendations.
If you’re having many bowel movements, your healthcare provider 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 healthcare provider 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 healthcare provider.
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 healthcare provider 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.
You’ll 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 healthcare provider when to start doing Kegel exercises. Starting too soon after surgery can be painful.
You can do Kegel exercises while you’re sitting, standing, and walking. To do Kegel exercises:
- Tighten your pelvic floor muscles (the muscles you tighten when you’re trying to hold back a bowel movement).
- Hold this position for 5 to 10 seconds.
- Release and rest.
Repeat this exercise 10 times, 4 times a day.
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 healthcare provider about your job. They’ll tell you when it may be safe for you to start working again based on what you do. If you move around a lot or lift heavy objects, you may need to stay out a little longer. If you sit at a desk, you may be able to go back sooner.
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 to go to all your follow-up appointments after your surgery. You can call your healthcare provider if you have questions 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. Your healthcare provider can refer you to MSK’s Counseling Center. You can also reach them by calling 646-888-0200.
Whether you’re in the hospital or at home, we’re here to help you and your family and friends handle the emotional aspects of your illness.
When to call your healthcare provider
Call your healthcare provider 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
- Leg cramps
Any of the following signs of wound infection:
- Increased pain
- Warmth at the wound site
- Drainage that looks like pus (thick and milky)
- Any questions or concerns.
Monday through Friday from to , contact your healthcare provider’s office.
After , during the weekend, and on holidays, call 212-639-2000 and ask to speak to the person on call for your healthcare provider.
This section has a list of support services. They may help you as you get ready for your surgery and recover after your surgery.
As you read through this section, write down questions to ask your healthcare provider.
MSK support services
Call if you have questions about your hospital admission, such as asking for a private room.
Many people find that counseling helps them. Our Counseling Center offers counseling for individuals, couples, families, and groups. We can also prescribe medicine to help if you feel anxious or depressed. Ask a member of your care team for a referral or call the number above to make an appointment.
Food Pantry Program
We give food to people in need during their cancer treatment. Talk with a member of your care team or call the number above to learn more.
Integrative Medicine Service
Our Integrative Medicine Service offers many services to complement (go along with) traditional medical care. For example, we offer music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy. Call 646-449-1010 to make an appointment for these services.
You can also schedule a consultation with a healthcare provider in the Integrative Medicine Service. They’ll work with you to make a plan for creating a healthy lifestyle and managing side effects. Call 646-608-8550 to make an appointment for a consultation.
You can visit our library website or call to talk with the library reference staff. They can help you find more information about a type of cancer. You can also visit the library’s Patient and Health Care Consumer Education Guide.
Our Nutrition Service offers nutritional counseling with one of our clinical dietitian nutritionists. Your clinical dietitian nutritionist will talk with you about your eating habits. They can also give advice on what to eat during and after treatment. Ask a member of your care team for a referral or call the number above to make an appointment.
Patient and Community Education
Visit our patient and community education website to search for educational resources, videos, and online programs.
Call if you have questions about preauthorization with your insurance company. This is also called preapproval.
Patient Representative Office
Call if you have questions about the Health Care Proxy form or concerns about your care.
Perioperative Nurse Liaison
Call if you have questions about MSK releasing any information while you’re having surgery.
Private Duty Nurses and Companions
You can request private nurses or companions to care for you in the hospital and at home. Call to learn more.
Cancers and cancer treatments can make your body feel weak, stiff, or tight. Some can cause lymphedema (swelling). Our physiatrists (rehabilitation medicine doctors), occupational therapists (OTs), and physical therapists (PTs) can help you get back to your usual activities.
- Rehabilitation medicine doctors diagnose and treat problems that affect how you move and do activities. They can design and help coordinate your rehabilitation therapy program, either at MSK or somewhere closer to home. Call Rehabilitation Medicine (Physiatry) at 646-888-1929 to learn more.
- An OT can help if you’re having trouble doing usual daily activities. For example, they can recommend tools to help make daily tasks easier. A PT can teach you exercises to help build strength and flexibility. Call Rehabilitation Therapy at 646-888-1900 to learn more.
Resources for Life After Cancer (RLAC) Program
At MSK, care does not end after your treatment. The RLAC Program is for patients and their families who have finished treatment.
This program has many services. We offer seminars, workshops, support groups, and counseling on life after treatment. We can also help with insurance and employment issues.
Sexual Health Programs
Cancer and cancer treatments can affect your sexual health, fertility, or both. MSK’s sexual health programs can help you before, during, or after your treatment.
- Our Female Sexual Medicine and Women’s Health Program can help with sexual health problems such as premature menopause or fertility issues. Ask a member of your MSK care team for a referral or call 646-888-5076 to learn more.
- Our Male Sexual and Reproductive Medicine Program can help with sexual health problems such as erectile dysfunction (ED). Call 646-888-6024 to learn more or make an appointment.
Social workers help patients, families, and friends deal with common issues for people who have cancer. They provide individual counseling and support groups throughout your treatment. They can help you communicate with children and other family members.
Our social workers can also help refer you to community agencies and programs. If you’re having trouble paying your bills, they also have information about financial resources. Call the number above to learn more.
Our chaplains (spiritual counselors) are available to listen, help support family members, and pray. They can contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can ask for spiritual support. You do not have to have a religious affiliation (connection to a religion).
MSK’s interfaith chapel is located near Memorial Hospital’s main lobby. It’s open 24 hours a day. If you have an emergency, call 212-639-2000. Ask for the chaplain on call.
We offer online education and support for patients and caregivers. These are live sessions where you can talk or just listen. You can learn about your diagnosis, what to expect during treatment, and how to prepare for your cancer care.
Sessions are private, free, and led by experts. Visit our website to learn more about Virtual Programs or to register.
External support services
American Cancer Society (ACS)
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
A resource for education, tools, and events for employees with cancer.
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
Provides support and education to people affected by cancer.
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.
LGBT Cancer Project
Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT-friendly clinical trials.
Provides reproductive information and support to cancer patients and survivors whose medical treatments have risks associated with infertility.
Look Good Feel Better Program
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.
National Cancer Legal Services Network
Free cancer legal advocacy program.
National LGBT Cancer Network
Provides education, training, and advocacy for LGBT cancer survivors and those at risk.
Lists Patient Assistance Programs for brand and generic name medications.
Provides prescription benefits to eligible employees and retirees of public sector employers in New York State.
Patient Advocate Foundation
Provides access to care, financial assistance, insurance assistance, job retention assistance, and access to the national underinsured resource directory.
This section lists the educational resources mentioned in this guide. They will help you get ready for your surgery and recover after your surgery.
As you read through these resources, write down questions to ask your healthcare provider.
- Advance Care Planning
- Call! Don't Fall!
- Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E
- Herbal Remedies and Cancer Treatment
- How To Use Your Incentive Spirometer
- Frequently Asked Questions About the MyMSK Goals to Discharge Checklist
- Information for Family and Friends for the Day of Surgery
- What You Can Do to Avoid Falling