The digestive tract is a sensitive ecosystem that’s filled with healthy bacteria, microorganisms, and various organs. It helps your body break down food, extract essential nutrients and vitamins, and expel leftover waste. Your digestive system is what powers your body. It provides your cells with energy they need to do their job. This process begins as soon as you start chewing your food and only ends once the same food has exited your body through the rectum and anus. Your salivary glands, esophagus, stomach, and intestines move food between these beginning and end points. While your small intestines are primarily responsible for breaking down food and beginning nutrient absorption, your large intestines work to extract remaining nutrients, water, and salt for your body to use. This is an efficient process that’s carried out automatically each day. However, in some instances, the large intestines—also known as the large bowel or colon—can be damaged and needs to be removed. Here, we’ll go over everything you need to know about large bowel resections.
Understanding Your Colon
The terms colon, large intestine, and large bowel are all interchangeable. They refer to the same organ in your digestive tract. The large intestine attaches to the end of the small intestine and is similar in appearance, but wider and shorter. In healthy adults, it reaches about five feet in length. Your colon is primarily responsible for water extraction from your food source, thus hardening waste to form stool. In a healthy individual, stool then enters the rectum and leaves the body through the anus. When the colon isn’t working correctly, a large bowel resection may be needed to support your body’s digestive process. There are three parts of your colon that can be affected:
- Ascending Colon – this connects to the small intestine. It’s where food enters the large intestine.
- Transverse Colon – this runs across the upper part of your stomach. It’s the middle portion of the large intestine.
- Descending Colon – this connects your large intestine to your rectum. It’s where waste is processed from your transverse intestine and turned into stool.
What is a Large Bowel Resection?
A large bowel resection is commonly referred to as a colectomy. The purpose of performing one is to remove the diseased or damaged section of your large bowel so that your body can continue functioning it’s best. Removing problematic areas can also reduce the likelihood that a greater area of your colon is affected. There are two different types of large bowel resections, total colectomies and partial colectomies. During a total colectomy, the surgeon needs to remove the entire colon. A partial colectomy occurs when only one part of the large intestine needs to be removed. Some different types of partial colectomies include a hemicolectomy, a proctocolectomy, and a sigmoidectomy. During a hemicolectomy, either the right or left side is removed. In a proctocolectomy, some or all of the colon is removed in addition to the rectum. When a sigmoidectomy is performed, the bottom section of the colon—the area that connects to the rectum—is removed.
Reasons for a Large Bowel Resection
Large bowel resections are only performed when medically necessary. They remove damaged or diseased tissue so that it doesn’t spread, and your body’s digestive system remains intact. Some of the most common reasons for a large bowel resection include:
- Precancerous Polyps
- Colon Cancer
- Interstitial Diverticulitis
- Intestinal Blockages
- Volvulus
- Ulcerative Colitis
- Infection
- Intestinal Bleeding
- Intussusception
How a Large Bowel Resection is Performed
Every year in the United States, more than 600,000 procedures are performed to treat various colon diseases. If you need to undergo a colectomy, your doctor will provide you with detailed instructions on how to prepare. You’ll need to discuss your current list of medications with your doctor to determine whether to stop taking them prior to the surgery. Always include supplements and vitamins during this communication, as they can impact anesthesia and healing. You should also inform your doctor about any recent illnesses or flare ups from underlying conditions. For a successful surgery, it’s important to stay hydrated, stop smoking for least a few weeks before the surgery, and increase your fiber intake. You may need to take an enema to clear your colon and avoid eating or drinking anything for a specified period of time.
The surgery can be performed either laparoscopically or using open surgery. During laparoscopic surgery, small incisions are made on your abdomen and a scope with a camera is inserted to provide the surgeon with a viewing field. Your abdominal cavity is then filled with a harmless gas to expand the surgical area and increase precision. The surgery is performed through the small incisions using medical instruments. This technique reduces scarring and can expedite healing time. During open surgery, a larger incision is made in your abdomen and surgery is performed with your organs exposed. There are advantages and disadvantages to each. Discuss your surgical options with your doctor to determine the best course of action for your large bowel resection.
Large Bowel Resection Risks
Large bowel resections are fairly straightforward procedures, meaning that the complications are generally rare. However, there are risks with any surgery, so it’s important to be vigilant during your recovery and keep an eye on your incision sites. Some of the most common risks of any type of surgery include bleeding, infection, blood clots, heart attack, stroke, difficulty breathing, or damage to nearby organs and structures. Risk factors specific for large bowel resections include abdominal bleeding, incision or parastomal hernias, damage to the bladder, scar tissue within the intestine, dehiscence, or problems from a colostomy.
When to Call Your Doctor
If you notice any signs of infection or problems with your incision site, seek medical attention immediately. Your doctor will go over warning signs for specific risks and if anything feels off, don’t hesitate to seek help.
Recovery Tips for a Large Bowel Resection
You’ll need to stay in the hospital for about a week after your surgery so your medical team can monitor your progress and reduce your risk of complications. Following your release, your doctor will provide you with post-op instructions that you’ll need to follow. Make sure you adhere to these instructions and ask questions as needed.
In some instances, a large bowel resection will result in a colostomy. This occurs when a surgeon is unable to reconnect two healthy ends of your large intestine. Colostomies can be temporary, which gives your bowel time to heal, or permanent. If you need a colostomy during your large bowel resection, a small opening is made in the abdominal wall. This is called a stoma. Then, the healthy end of your large intestine is connected to the stoma so that waste will flow out of the opening and bypass diseased or damaged areas of the colon. You’ll need a colostomy bag to catch waste product that comes out of the stoma, which needs to be emptied periodically throughout the day.
While colostomy bags aren’t always permanent, they do require a major lifestyle change. Your doctor and an ostomy nurse will show you have to maneuver your pouching system, how to check your stoma for signs of complications, how to care for the peristomal skin, and how to change your pouch with ease. If you have any questions during your recovery, don’t hesitate to reach out to your medical team.
Life After a Large Bowel Resection
After the initial recovery period, you’ll be free to resume your regular activities. Always report any signs of pain or problems with your incision and avoid lifting heavy objects or participating in strenuous activity until cleared by your doctor.
If your large bowel resection results in a colostomy, you’ll need to find a pouching system that fits your lifestyle. However, living with a colostomy doesn’t mean you’ll face a life full of restrictions. If you’re having difficulty adjusting to changes, consider joining an ostomy support group. To find a meeting, look on the list of support groups affiliated with The United Ostomy Associations of America (UOAA). UOAA is a national, 501(c)(3) nonprofit organization that supports, empowers, and advocates for people who have had or will have an ostomy. To help make your transition as easy as possible, Byram Healthcare has an array of ostomy supplies that can be delivered to your door discretely and in a timely manner.
