Colonoscopy is indicated for patients having symptoms concerning for colorectal cancer or inflammatory bowel disease. Screening colonoscopy is indicated for average risk patients at age 50. Newer guidelines recommend screening start at age 45 for African Americans. If a family member has had colorectal cancer or adenomatous polyps before the age of 60, it is recommended you start screening 10 years before their age at diagnosis. There are certain hereditary cancers that can occur earlier in life and screening recommendations may vary. Discuss these situations with your doctor.
Colon Rectal Surgery FAQs
Yes, you will be given sedation during your endoscopy that will make you comfortable.
No, because you are given sedation medications, it is recommended that you take the rest of the day off and relax. You should not make any major decisions, drive, drink alcohol, etc. after receiving sedation on the day of your procedure.
Yes, as you will be receiving sedation medications during your endoscopy, it is required you have a safe ride home following your procedure.
Yes, you will need medical clearence to proceed with a surgical procedure.
No. Spotting blood may occur if your hemorrhoids act up around the time of your colonoscopy due to the bowel prep, etc. Major bleeding is considered a complication and you should notify yor doctor and/or proceed to the emergency room.
Too much blood is over a cupful or ongoing bleeding filling the toilet. Spotting with bowel movements, blood on the toilet paper, etc. is considered minor.
Yes, after anorectal surgery (abscess, fistula, hemorrhoid, biopsy), it is normal to have spotting bleeding for up to two weeks as the tissues heal.
Body temperatures can fluctuate after srgery. Temperatures over 101F are cosidered surgical fevers and you should notify your doctor.
Patients can frequently become constipated after surgery. This can be exacerbated by taking narcotic pain medications that further constipate people. Most patients are prescribed fiber and/or stool softeners after surgery to combat this constipation. If you continue to hae problems, you can start taking Miralax or milk of magnesia to get your bowels going. If you have kidney or heart failer, contact your doctor as some of these medications may be contraindicated. Enemas are not recommended if you have had a rectal surgery unless indicated by your doctor as you may cause damage to the surgical site.
Blood in the stool can be caused from bening conditions such as hemorrhoids, tears in the anal carnal (fissure) or abscesses. More serious causes include cancer, tumors, inflammatory bowel disease and diverticular disease.
No, we do not do colonic cleansing nor recommend it for any patients. A healthy diet high in fiber, fruits and vegetables and low in red and processed meats is recommeded for good bowel function and a healthy colon.
Fiber is the indigestible portion of plant foods that absorbs water and aids in defectation. It is recommended that you consume 25-30 grams of fiber per day. Foods high in fiber include artichokes, beans, broccoli, carrots, berries ,apples, bananas, pears, apricots, certain cereals etc. It is often hard for Americans to regularly consume enough fiber in their diets and fiber supplements such as Konsyl, Metamucil and Citrucel are recommended.
Colorectal surgeons perform a wide variety of procedures on the distal rectum and anal canal. This includes excising hemorrhoidal tissue, repair of fistulas, treatment of anal fissures, and removal of both benign and malignant lesions. These procedures are usually performed on an outpatient basis meaning that you will be discharged from the hospital the same day.
Immediately after your procedure, you will wake up in the PACU (post anesthesia care unit). You will have close supervision by nursing staff to make sure you are awake and alert after surgery. After you are awake and alert, it is okay for you to start taking in food by mouth. The nurses will go over discharge and wound care instructions with you.
Your surgeon may have specific instructions for your postop care. However, in general the recovery period is 2 to 3 weeks. Depending on your procedure, you may be instructed to do daily dressing changes with clean gauze. Sitz baths (sitting in a tub or basin of clean, warm water for 5-10 minutes) is also encouraged. This will provide some pain relief and also help clean the area. For 1 to 3 days after procedure, light activity is usually suggested however daily activities are fine. One should not drive or make important decisions while on pain medication. Exercise is fine but you should start with very light activity and slowly increase this as tolerated. You may have a small amount of blood or cloudy drainage from your surgical site. It is not uncommon for the drainage to have a slight odor. As long as you are overall feeling well and the drainage is decreasing, there is no need for concern. If you have any questions, there is always someone available to speak to at the office (both during the daylight hours and at night).
Pain medications are usually provided and we also inject local anesthetic at your surgical site. That being said, it is not uncommon to have pain at the surgical site, especially with excisional procedures such as skin tag removal or excisional hemorrhoidectomy. Worsening pain and worsening drainage should prompt a call to the office. Persistent fevers, nausea, vomiting and abdominal pain are also things to let the office know about. After anorectal surgery, it is not uncommon to have urinary retention. If you have not urinated for a significant amount of time and have pelvic pressure you should call the office. This usually resolves; however, in some cases, it will not. You may be instructed to present to the emergency department for evaluation and potential urinary catheterization. As a general rule, if you are feeling poorly and have concerns please call our office to discuss.
We “encourage” healthy eating with non-processed foods, as well as fruits and vegetables. Your surgeon may discuss a stool softener with you. Eating a high-fiber diet is also “encouraged”. Supplementation such as Metamucil, Benefiber, or Citrucel should be used to help people meet their daily requirements of fiber. The average person should be getting 25 to 35 g of fiber per day from various sources. Drinking plenty of water is also recommended.
After any anorectal surgery, the first few bowel movements may be very painful. Sitz bath’s and warm compresses can help with pain control. We also provide pain medication for the immediate postop. As a side note, it is important to not take a significant amount of pain medication because that can lead to constipation, which can actually make you bowel movements worse. Hydration, fiber, and potentially stool softeners are things that may be discussed with you to help with postoperatinve bowel movements. This discomfort may last 1 to 2 weeks, but should be decreasing the farther out from surgery you are.
Follow-up is usually in approximately 3 weeks. Your follow-up appointment does not have to be exactly at the 3-week mark. If you have any questions, please do not hesitate to call our office. At your follow-up appointment, your surgeon will assess how you are doing. The surgeon will look at the surgical site and discuss further recommendations necessary to continue to treat your diagnosis.