Your Child’s Bowel Surgery

Your child is having bowel surgery. This operation may involve the small intestine, large intestine (colon), or rectum. The rectum is 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 having bowel surgery

The 2 methods of doing bowel surgery are:

• Open surgery is the traditional method. It's 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 (laparoscopy) is done through several smaller incisions in the belly. A thin tube with a tiny video camera and a light attached (laparoscope) is put 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.

Getting ready a few weeks before surgery

Talk with your child’s healthcare provider about any 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. Also tell your child's provider about any allergies your child has.

Getting ready 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. You may be asked to wash your child with a special type of antibacterial soap called CHG (chlorhexidine) before coming to the hospital. This is to help reduce the chance for infection.

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. They 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 IV (intravenous) 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 (windpipe) to help your child breathe during the surgery.

• A soft tube (catheter) may be placed into your child’s bladder. This helps drain urine.

• To do the surgery your surgeon will use either the laparoscopic or open surgery method that has been discussed with you. Sometimes a laparoscopic surgery is changed during surgery to an open surgery for the health of the child.

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 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) and to prevent a bowel blockage (called an ileus).

• Your child may not eat or drink anything until the colon (if not removed) starts working again. But oftenn they can start eating or drinking by the next day. Your child may start with a liquid diet and slowly add more foods to make a regular diet as prescribed.

• Your child may have been given an opening in the belly (stoma) during the surgery. If so, stoma care will be discussed with you.

• Your child may need to stay in the hospital for several days or longer. How long depends on the procedure and their condition.

Recovering at home

Here is what to expect while your child is recovering at home: 

• Bring your child back to the healthcare provider for follow up as scheduled after surgery.

• 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 not lift heavy things or do vigorous activity, such as running and sports until the healthcare provider says it's OK.

• Your child may have some bloating, loose stools, and more frequent bowel movements. This is normal after bowel surgery.

• Give your child any prescribed or over-the-counter medicines as instructed.

• Follow any other instructions you are given for recovery.

When to call your healthcare provider

Call your child's healthcare provider right away if your child has any of the following:

• Persistent fever greater than 101°F (38.3°C). Always follow your healthcare provider's instructions on fever and when to notify them.

  • Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

  • For babies 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.

  • 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.

• Nausea or vomiting

• Redness, swelling, discharge, or pain around an incision

• Trouble passing stool

• Blood in stool

• Belly swelling or pain that gets worse or doesn't go away

• Weight loss

• Swelling in the legs

• Trouble breathing