Pain After Colostomy: Is It Normal?

Artificial anus

My father underwent surgery for rectal cancer on October 16, 2000, and it has been a month and a half since then.
He experiences significant pain every time he has a bowel movement.
I would like to ask Dr.
Wang if this phenomenon is normal.
If it is not normal, what could be the reason?

amingo, 30~39 year old female. Ask Date: 2000/12/02

Dr. Wang Qichao reply Surgery

I am not sure if your father's rectal cancer surgery preserved his anus.
1.
If the anus and perineum were removed, he would need a colostomy.
During the training period for the colostomy, there may be some pain initially (due to the stretching of the intestines), but over time, most patients gradually adapt, and the pain usually improves.
2.
If your father's anus was preserved and only a low anterior resection was performed, he may experience increased bowel frequency, urgency, diarrhea, incontinence, or pain during bowel movements due to the nature of rectal surgery.
Typically, these symptoms improve over one to two years.
3.
Additionally, if he received adjuvant radiation therapy, the situation can become more complex and difficult to explain.
However, patients in this category usually require long-term follow-up, and you may want to discuss this further with your father's attending physician.

Reply Date: 2000/12/02

More Info

Experiencing pain after a colostomy can be concerning, especially for patients who have recently undergone surgery for conditions like rectal cancer. It is important to understand that some level of discomfort can be expected after such a significant surgical procedure, but the nature and intensity of the pain can provide insights into whether it is normal or indicative of a complication.

Firstly, it is essential to recognize that a colostomy involves rerouting the bowel to an opening in the abdominal wall, which can lead to various sensations and discomforts as the body adjusts to the new arrangement. Post-operative pain can stem from several sources, including:
1. Surgical Trauma: The incision and manipulation of tissues during surgery can lead to inflammation and pain. This is typically expected and should gradually improve over time.

2. Bowel Function: After a colostomy, the bowel may take time to adapt to its new configuration. Patients may experience cramping or pain as the bowel begins to function normally again. This can be particularly pronounced during bowel movements.

3. Nerve Sensitivity: Surgery can affect the nerves in the abdominal area, leading to heightened sensitivity or pain during bowel movements or when the colostomy bag is changed.

4. Complications: While some pain is normal, severe or worsening pain could indicate complications such as infection, obstruction, or issues with the stoma itself. Signs of complications may include fever, increased swelling, redness around the stoma, or changes in bowel output.

Given that your father has been experiencing significant pain during bowel movements for a month and a half post-surgery, it is crucial to evaluate the situation further. Here are some steps to consider:
- Consult the Surgeon: It is advisable to return to the surgeon who performed the colostomy. They can assess whether the pain is within the expected range or if further investigation is needed.

- Pain Management: Discuss pain management options with the healthcare provider. They may recommend medications or techniques to help alleviate discomfort during bowel movements.

- Dietary Adjustments: Sometimes, dietary changes can help ease bowel movements and reduce pain. A diet high in fiber and adequate hydration can facilitate smoother bowel movements, potentially reducing discomfort.

- Stoma Care: Proper care of the stoma and surrounding skin is essential. If there are issues with the colostomy bag or irritation around the stoma, this could contribute to pain.

In summary, while some pain after a colostomy can be normal, especially during bowel movements, it is essential to monitor the intensity and nature of the pain. If the pain is severe, persistent, or accompanied by other concerning symptoms, it is crucial to seek medical advice promptly. Regular follow-ups with the healthcare team can help ensure that any issues are addressed and that your father receives the appropriate care and support during his recovery.

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