Your Child’s Bowel Surgery
Your child is having bowel surgery. This operation may involve the small intestine, large intestine (colon), or rectum (where stool collects before leaving the body). Your child’s healthcare provider will discuss with you the reasons your child is having this surgery. This sheet tells you how to prepare for the surgery and what to expect during it. It also tells you how to help your child recover afterward.
Two ways of performing bowel surgery
The 2 methods of doing bowel surgery are:
Open surgery is the traditional method. It is done through one incision in the belly. This incision is large enough for the surgeon to have a direct view of the bowel.
Laparoscopic surgery (also called laparoscopy) is done through several smaller incisions in the belly. A laparoscope (a thin tube with a tiny video camera and a light attached) is inserted through one incision. This gives the surgeon a clear view of the inside of the belly. Surgical tools are then put through other small incisions to do the surgery.
Preparing a few weeks before surgery
Tell your child’s healthcare provider what medicines your child takes. This includes over-the-counter medicines, herbs, and supplements. Your child may have to avoid taking certain kinds of medicines before the surgery. This will help prevent problems during the surgery.
Preparing the day before surgery
Follow any directions your child is given for taking medicines and for not eating or drinking before surgery. This includes any instructions you are given for bowel prep.
The day of surgery
Here is what to expect on the surgery day:
Arrive at the hospital on time. You will be asked to fill out certain forms.
Your child will change into a gown.
An anesthesiologist or nurse anesthetist will meet with you. He or she will discuss the medicines that will help your child sleep through the surgery. Be sure to ask any questions you have.
Your child will be given an intravenous (IV) line. This gives your child fluids and medicines. Depending on the age of your child, the IV line may be put into the arm or the hand. The IV may be started after your child is asleep.
During the surgery
Here is what to expect during the surgery:
Your child will be given general anesthesia. This puts your child into a deep sleep. A breathing tube will be placed in the trachea or windpipe to help your child breathe during the surgery.
A soft tube called a catheter may be placed into your child’s bladder. This helps drain urine.
The surgery will be performed. Your surgeon will use either the laparoscopic or open surgery method that has been discussed with you.
Recovering in the hospital
Here is what to expect while your child is recovering in the hospital:
After the surgery, your child will be taken to the recovery room. This is also called the post-anesthesia care unit, or PACU. Later, your child may be moved to a regular hospital room.
Your child will be attached to monitors that check your child’s breathing, blood pressure, and pulse.
Your child will be given pain medicine to stay comfortable.
The catheter used to drain urine will likely be removed shortly after surgery. The IV line will stay in place for a few days.
Your child may be asked to get up and walk around soon after surgery. This helps improve blood flow and prevent blood clots. It also helps the colon return to normal function (if the colon was not removed).
Your child won’t eat or drink anything until the colon (if not removed) begins working again. When this happens, your child will be given a liquid diet. When ready, your child will then return to eating solid foods.
Your child may have been given a stoma (an opening in the belly) during the surgery. If so, stoma care will be discussed with you.
Your child may need to stay in the hospital for 7 days or longer.
Recovering at home
Here is what to expect while your child is recovering at home:
Bring your child back to the healthcare provider 7 days after surgery, as scheduled.
Being active helps the body heal. But too much activity can harm the healing incision(s). Your child may walk as much as is comfortable. But your child should avoid lifting heavy things or vigorous activity, such as running and sports.
Your child may have some bloating, loose stools, and more frequent bowel movements. This is normal after bowel surgery.
Give your child any prescribed medicines as instructed.
Follow any other instructions you are given for recovery.
When to call your healthcare provider
Call your child's healthcare provider if your child has any of the following:
Fever (See Fever and children, below)
Nausea or vomiting
Redness, swelling, discharge, or pain around an incision
Trouble passing stool
Blood in stool
Belly pain that gets worse
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
June 23, 2017
Management of patients with a colostomy or ileostomy. UpToDate, Overview of colon resection. UpToDate, Surgical principles of ostomy construction. UpToDate
Freeborn, Donna, PhD, CNM, FNP,Lehrer, Jenifer, MD,Turley, Ray, BSN, MSN