Eating and bowel habit after bowel (colorectal) cancer surgery

After bowel surgery many people experience difficulties getting their eating and bowel habit back to normal. These difficulties may be relatively short-lived or they may continue indefinitely. Foods that could be eaten before surgery may now cause severe diarrhoea or constipation. Some people also find that they have less control over their bowels or have to use the toilet repeatedly over a period of hours before their bowel has emptied completely.

Some people found that their eating and bowel habit returned to normal very quickly after surgery. If they noticed a difference in their bowel habit it was easily managed. There was also no food that consistently upset their digestion as an after-effect of their surgery. One woman who was determined to restore her eating and bowel habit explains how she set about it:

Explains how she resolved to restore her eating and bowel habit to normal.

Age at interview 47

Gender Female

Age at diagnosis 38

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However, many people we talked to reported considerable difficulty with their eating and bowel habits after surgery, and especially after reversal of a stoma. One man describes the “vicious” attacks of diarrhoea he suffered after his ileostomy was reversed.

Talks about the attacks of diarrhoea he experienced after his ileostomy was reversed.

Age at interview 70

Gender Male

Age at diagnosis 68

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For many, problems with eating and bowel habits were or continue to be a cause of distress and a reminder of their illness. People whose symptoms are persistent or severe often felt that their bowel was ruling their life because it limited their ability to work, to travel, to socialise, and generally to feel confident and fully recovered. One man explains how his unpredictable bowel habit made it impossible for him to remain in his job. Another man felt he could not return to work as a cab driver because he could not control the foul wind that he now suffers from. A woman who suffers from severe constipation describes her diet and how her bowel habit poses problems when she travels:

Describes her difficulties with diet and bowel habit.

Age at interview 56

Gender Female

Age at diagnosis 53

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Explains how his unpredictable bowel habit made it difficult to cope with his job.

Age at interview 52

Gender Male

Age at diagnosis 45

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She needs a very high fibre diet that is difficult to maintain away from home.

Age at interview 54

Gender Female

Age at diagnosis 52

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Many of the people we interviewed said they were offered little or no advice about eating and bowel habit before or after surgery and were unprepared for what they had to face. Others said they had unrealistic expectations of how long it would take to re-establish satisfactory eating and bowel habits because no one had discussed the matter with them. Some people were offered contradictory advice by different health professionals. The National Institute for Health and Care Excellence (NICE) has produced guidelines which advise that all patients should now be given information on managing the effects of the treatment on their bowel function.

One woman explains how difficult she found it to get sound advice after her ileostomy was reversed. Another woman who is a vegetarian and needed advice on how to raise her calorie intake without eating too much fibre did receive useful advice from a dietician:

She didn’t understand that the change in her bowel habit might be permanent.

Age at interview 56

Gender Female

Age at diagnosis 53

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Explains her difficulty in getting sound advice about diet after her ileostomy was reversed.

Age at interview 54

Gender Female

Age at diagnosis 47

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She needed advice about how to adapt her vegetarian diet after surgery.

Age at interview 53

Gender Female

Age at diagnosis 39

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When people expressed an interest in meeting other bowel (colorectal) cancer patients it was often tied to wanting to know how they coped with their eating and bowel habit after surgery.

She wishes she could discuss diet and bowel habit with other colon cancer patients.

Age at interview 56

Gender Female

Age at diagnosis 53

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For more information on diet and bowel (colorectal) cancer see national cancer and bowel cancer organisations listed in our resources section.