Gastrointestinal Surgery

What is gastrointestinal surgery?

Gastrointestinal surgery is a subspecialty of general surgery that treats disorders of the oesophagus (gullet) stomach, liver, pancreas, gallbladder, and small intestine. These organs collectively make up the digestive system which can be affected by disease, diet, and emotional stress.

While many of the conditions associated with the digestive system can be treated with simple lifestyle changes and medication, some do require surgery by a general surgeon.

When should I see a specialist for gastrointestinal surgery?

There may be a variety of reasons why a patient would need gastrointestinal surgery. Some of the conditions where surgery is appropriate can include the following:

Gastroesophageal Reflux Disease (GERD) – sometimes referred to as heartburn or acid reflux, this condition occurs when acid from the stomach splashes up into the oesophagus, resulting in discomfort or pain.

GERD can be treated with a change in diet and/or medication, but sometimes surgery is needed to rectify the problem. If surgery is required, a procedure can be done where the surgeon uses a special device to reconstruct the anti-reflux valve at the entrance of the oesophagus to the stomach. This stops any splash back of stomach acid into the oesophagus.

Barrett’s Oesophagus – If GERD is not effectively treated, it can lead to something called Barrett’s Oesophagus, a condition where the tissue of the oesophagus is damaged. This damage to the tissue has a high risk of developing into cancer.

Surgery to treat this condition is done by ablating (burning) the damaged tissue of the oesophagus away, while minimising damage to the healthy tissue.

Gallbladder problems – You may need surgery to remove your gallbladder. This could be for a number of reasons, including gallstones, inflammation, and long-term pain.

Hernias – Hernias occur when small areas of tissue push through the abdominal wall. This can be painful and uncomfortable. Surgery is often recommended to prevent hernias from getting worse.

Did you know?

The gastrointestinal tract is about 30 feet long, starting at the mouth and ending at the anus.

What are the risks of gastrointestinal surgery?

Like any surgery, having gastrointestinal surgery carries some risk. Some of the more general risks include complications such as bleeding and infection, while more specific risks related to gastrointestinal surgery might include:

Ileus – the medical term for a lack of movement within the intestines that can lead to a build up, and potential blockage of food material. It can be referred to as paralysis of the bowel, and may need surgical intervention to be rectified.

Leakage – if you have had major surgery on your bowels, there may be some leakage at the site where parts of your bowel were joined.

Bowel changes – due to the nature of gastrointestinal surgery, you may initially experience changes in your bowel habits.

Your general surgeon will discuss the individual or specific risks for your surgery.

How do I prepare for gastrointestinal surgery?

If you have been scheduled for gastrointestinal surgery, there will usually be some preparation involved before the day of your operation. This may vary depending on the type of surgery you are having, but you can usually expect the following:

You may need to stop taking certain medications, as some might increase your risk of complications. Talk to your surgeon or anaesthesiologist about any medication you are taking. It may be a good idea to bring your medication with you on the day of your operation.

You will usually be expected to stop eating and drinking for a few hours, or even a day, before surgery. Your surgeon will advise you on the specifics of this.

If you have diabetes, your general surgeon will advise you on when to take your last dose of your hypoglycaemic agents.

What can I expect during gastrointestinal surgery?

When the surgical team are ready, you will be taken into the operating theater. The anaesthesiologist will then administer the anaesthesia or some form of sedation depending on the operation you will be having.

You will be connected to an echocardiogram (ECG) machine as well as a blood pressure machine to monitor your heart and circulation. Once you are asleep, you may also need a tube inserted into your airway to assist your breathing through your operation.

The surgical team will then proceed with the planned surgery.

Because of the nature of anaesthetic medication, you will not have any memory of the procedure.

What happens after my gastrointestinal surgery?

When you wake up from your surgery, you may have a number of tubes and wires attached to you. One of them will be a nasogastric tube (a tube from the nose to the stomach). This will likely be removed depending on when you can start eating and drinking on your own. Your nurses will advise you when you will be able to start drinking fluids. Avoid carbonated drinks following gastrointestinal surgery, and stick to water.

When you can start eating, you will only be allowed to eat soft foods. This allows your bowels a chance to recover from the surgery, and your nurses will advise you on when you can start eating solid food.

In addition, you will likely have a catheter in place. This is a tube that is inserted into your bladder via your urethra that allows urine to be drained away into a bag. This allows your medical team to monitor the amount of urine that you are passing.

You will also have a drip attached, which allows fluid to be administered into your body to keep you hydrated. Your general surgeon can prescribe pain medication to keep you comfortable.

Depending on the surgery you have had, it may take a few weeks to a few months to completely recover from your surgery. Your general surgeon will advise you on when you can return to normal activities.