Going Home after your Esophageal Surgery

Hospital Discharge Criteria

You may go home when your health care provider is comfortable with you tolerating foods and liquids and when your pain and nausea are reasonably controlled with oral medications. This is typically 1-3 days after surgery (3-5 days for pyloroplasty). You may stop taking your heartburn medication unless otherwise instructed. Patients with gastroparesis/pyloroplasty are asked to continue taking their antacid medication.

Postoperative Pain

Pain from the incisions is normal. It will vary from day to day and with activity level, but should gradually decrease over time. Mild esophageal pain is also common and can feel like heartburn. It has many causes, but most commonly is from surgical swelling/healing, spasm and distention from overeating or rapid eating.

If you had a laparoscopic surgery, you may also have aches in your shoulders and neck, particularly on the left side. This is due to the carbon dioxide that was placed inside your abdomen during the surgery. This is harmless, and the air will disappear within a few days. You may also notice some small air bubbles under the skin of your abdomen or chest that crackle when pushed. This is also normal and will resolve itself in a few days. The shoulder pain itself can last a few weeks in some patients and responds best to non-narcotic pain medication (liquid/crushed/chewable acetaminophen or ibuprofen) and heating pads.

Pain Medication

You may be given a prescription for pain medication (usually a narcotic such as Oxycodone, Percocet, Vicodin or Dilaudid) upon leaving the hospital. Usually this is in liquid form for your convenience but due to various and occasional regional pharmacy shortages, pills may be required.  As with all pills, please crush before taking them until you diet is sufficiently advanced (often 2-4 weeks).

Types of pain medication include:

• Narcotics. These are good pain relievers, but often cause constipation. Use bulk fiber products, prune juice or milk of magnesia as necessary for constipation. Narcotic pain medications affect your ability to drive and operate machinery safely. Do not take with alcohol.

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). Ibuprofen (Advil, Motrin) and naproxen (Aleve) are some examples of NSAIDs. These cause no effect on mental capabilities, but can cause stomach upset or bleeding if taken continuously.

• Acetaminophen (Tylenol). This has no effect on mental capabilities, but can cause liver damage if taken more frequently than every 4 hours. A reasonable strategy is to use acetaminophen or NSAIDs for minor pains and use narcotics for only major pain.

Note: It is our policy not to refill non-urgent prescriptions outside of business hours. This includes pain medication. Please plan accordingly, and call 303.398.1355 to request refills. In some situations, the prescription will need to be picked up or mailed. Narcotic pain medication refills may not be granted if the request is made more than 4 weeks after surgery unless a follow-up appointment is planned.

 

This information has been approved by Emily Speer, MD (January 2017).