Sister Having Problems With Bowel Movements After Surgery

I am a 5 year colon cancer survivor (diagnosed at 47, surgery removed all of the tumor, no follow-up treatments were needed).  About a month ago my sister (56) was diagnosed with a rectal tumor.  My surgeon performed her surgery also.  He was able to remove the tumor and spare enough of her rectum so that she did not need a bag.  At this time he feels she will also be spared any follow-up treatments. 

 We are both aware of how blessed we are to be alive and to have been spared so much.  That said, my sister has come to me with some problems she is having.  Because my tumor was higher in the colon, I did not experience the same after effects so I need help from you so I can help her.

 She is having problems with her bowel movements.  One day she has diarrhea all day long then she can't go at all for several days....even with added fiber and laxatives.

 I know it is very soon after her surgery (a little over 2 weeks), what should she be doing?  How do you learn to regulate your bowels after surgery like this?  She's afraid to leave her house.

 Thanks for the help,

Martha

Martha,

 Was she reconnected without having any chemoradiation first? That can make a difference.  Her bowels will take time to adjust.  Usually it takes a good 4 weeks to get them anywhere under somewhat control and then, she will probably have multiple movements a day-not to scare you but it can be up to about 12.  Gradually this will taper down to 4-6 movements a day, and depending on how much of her rectum they had to remove, the amount of stool may not be much at each time.  Everyone differs after surgery.  It is not at all uncommon (after the first couple of weeks) to have to go multiple times in a row and then not have to go at all for the rest of the day.  Other people will eat and within a half an hour have to go to the bathroom.  Still others might be in the bathroom all the time without any rhyme or reason.  Unfortunately, it is way to early for your sister to have any type of regulation of her bowels.  You need to know that what she thought was "normal" before will probably not exist the same way again. 

I am assuming that if she had no other treatment, she was a stage I. Is that correct?  I also wonder why they didn't do a local excision on her as that is also the standard of care for stage I. 

 Time is what is needed with rectal cancer surgery.  Eventually it will get better, but it does take time.  Hope this helps a little.

Sorry to hear about your sister's problems. I am a three year survivor of rectal cancer. Her bowels may take a year or two to settle down, so she should just get to a point of acceptance about that. She will have a new normal, and it will not be as good as what she had before... but LIFE is better than the alternative, so one just has to accept the negative side effects as the new normal. 

However, she does NOT have to stay home. She can work around the problems and everyone has different solutions. For example,  there are special undergarments that she can wear, OR (my solution) is to wear a pad all the time to line my underwear.  This gives me enough time to locate a restroom when out and about, and if there is a bit of leakage I simply change the pad, and keep clean with portable packages of baby wipes that I carry all the time.  I never leave the house without a change of underwear... not that I need to use it very often, but it's good to be prepared. Another strategy is to identify where the restrooms are when out.  I locate a restroom when I first enter an area, like the mall, a restaurant. A third strategy is NOT to eat right before going out if I'm not going to be near a restroom (like when I go kayaking or boating.) The most problematic activity is eating out (as I often have to use the restroom immediately after eating). So I eat small meals, and only foods that I know do not bother me.  I avoid ground pepper and other very spicy foods. Other than that, I can eat most foods in small quantities.

Just to prove that this eating strategy works, I can tell you that I NEVER stay home, have a full and active life and that includes swimming, kayaking, biking, and walking several miles everyday. And I'm a retired 63 year old woman and love a new challenge so I'm trying new things everyday. I went on a cruise with my husband and two teen-age grandchildren less than four months after my surgery. I was still on chemo at the time (Xeloda, which has as a side effect loose bowels, or diarrhea.)  The only accomodation I had to make was that I could only eat breakfast and dinner.  If I ate lunch, I had problems with having to go to the bathroom and it would have interfered with our activities (snorkeling, kayaking, boating, BOB, snuba diving). So, I had a good breakfast, a few bites of yogurt for lunch (which is good for the intestines) and then had a leisurely dinner at the late serving at night.  Try to have your sister develop her own strategies for living and not having to stay home. I NEVER stay home. Encourage your sister to go out... she'll feel better and it will make her quality of life better... do not give in to cancer and stay home. Stay positive!!