Possible changes caused by surgery to your bowel
Surgery for bowel cancer may cause the following late effects:
A hernia is a bulge caused by an internal part of the body, such as a part of the bowel, pushing through a weakness in the muscle or tissue wall.
Usually your muscles hold your intestines and organs in place. But after an operation, the area around the operation scar or stoma may become weaker and a hernia can develop.
The main symptom of a hernia is an ache or bulge in your tummy area (abdomen) or under the skin around your stoma. The bulge may not always be there but may appear when you cough, sneeze or strain your abdominal muscles. Your doctor will examine you by feeling around the area. They may also arrange a CT (computerised tomography) or ultrasound scan to give a picture of the hernia.
Smoking can increase the risk of a hernia developing. People who are overweight are also more likely to develop a hernia. Anything that increases the pressure inside your abdomen such as lifting heavy objects or straining can also increase your risk. You can reduce your risk of developing a hernia by:
keeping to a healthy weight for your height or losing weight if you are overweight
following a healthy, balanced diet
strengthening your abdominal muscles with regular moderate exercise such as walking, yoga, or gentle aerobics and stretching exercises
not straining on the toilet and avoiding constipation
learning how to lift heavy objects safely, so that your arm and leg muscles take the strain.
Hernias are often treated with an operation to repair the tissue wall. The operation is usually done through one or more small cuts in the abdomen. This is called laparoscopic or keyhole surgery.
If an operation isn’t right for you, there are specially designed hernia support garments available. It’s important that the size and fit are correct; so ask your doctor, specialist nurse or stoma care nurse for advice.
If a hernia is very small and not causing any problems, you might not need treatment but may be advised about lifestyle changes that could help.
After any type of surgery in the abdomen, bands of tissue (called adhesions) may form between abdominal tissues and organs. Normally, tissues and organs are slippery and move easily as the body moves. But, if adhesions form they can make tissues and organs stick together.
Most adhesions don’t cause problems. However, if you have also had radiotherapy to your bowel, you may be more likely to have symptoms.
Sometimes adhesions can cause pain in the abdomen. Rarely, they can cause a part of the bowel to twist or kink, pulling it out of place so that it becomes blocked. This can cause symptoms such as:
severe abdominal pain or cramping
loud gurgling sounds from the bowel
tummy (abdominal) swelling
inability to pass wind
If you have severe pain you should contact a doctor straight away, as this could be a sign of a blocked bowel. You may need tests such as x-rays or scans to check.
Often the bowel is only partly blocked and gets better (unkinks) after being rested for a time. This may mean not eating for a day or so and having fluids through a drip into a vein, or it may involve taking a liquid or low-residue diet.
A low-residue diet is high in protein, low in fibre, and more easily broken down into smaller particles by the digestive system. If the bowel is completely blocked, you may need an urgent operation to relieve it.
Most people don’t need treatment for abdominal adhesions as they usually don’t cause problems. Surgery is the only way to break adhesions that cause pain or bowel blockage. However, surgery may cause more adhesions to form, so it’s avoided where possible.