Enhanced Recovery After Surgery


 

Enhanced recovery after surgery, known as ERAS is a multimodal approach to surgical care that has been shown to improve recovery after surgery, especially in patients undergoing colorectal surgical bowel resections. Patients typically experience less pain, faster recovery and a shorter hospital stay with ERAS. This approach requires a very good cooperation between Surgeons, the Anesthesiologists, Nurses and the entire surgical team.

adobestock_225253469.jpegERAS for colorectal resection surgery usually starts with a high carbohydrate drink 90 to 120 minutes prior to surgery. This helps to keep the bowels functioning during and after surgery. Medication given prior to surgery has also been found to improve the comfort level after surgery. Intravenous fluids are carefully monitored during surgery to decrease the possibility of fluid over load and edema or swelling of the intestines. Injections of long lasting anesthetics into the abdominal wall or spine may also reduce post operative pain and aid recovery.

After surgery patients are encouraged to get out of bed and walk early in their hospital stay. Food intake is started early and patients may eat regular foods as they are able to tolerate them.

Pain medication is diversified and individualized to include non-opioid pain medication which can inhibit the normal return of bowel function.

adobestock_246575247.jpegUsing these techniques, hospital stay has been decreased and recovery has been shown to be improved.

At ASCRS we are always looking to improve our patient’s experience and recovery following surgery.



Filter by Language:

Colorectal Cancer Risk Colorectal cancer—cancer of the colon and rectum—is the second leading cancer killer in the United States affecting both men and women.  Your risk increases as you age.  Some people are at even higher risk depending on their personal or family history....
Following treatment for either colon or rectal cancer, ongoing follow-up to detect recurrent disease is considered an important part of patient care for colorectal cancer. Colorectal cancer follow-up refers to a systematic approach to monitoring patients for new or recurr...
  Enhanced recovery after surgery, known as ERAS is a multimodal approach to surgical care that has been shown to improve recovery after surgery, especially in patients undergoing colorectal surgical bowel resections. Patients typically experience less pain, faster reco...
Irritable bowel syndrome (IBS) is a common disorder affecting over 15 percent of the population. The following information has been prepared to help patients and their families understand IBS, including the symptoms, causes, evaluation, and treatment options. IBS is one ...
OVERVIEW There are a variety of diseases and conditions of the colon and rectum for which surgery is recommended.  In addition to the decision to undergo surgery, patients are often faced with a choice of traditional or minimally invasive surgical techniques.  In order t...
Obstructed Defecation Syndrome (ODS)
WHAT IS HPV? HPV stands for human papillomavirus. HPV is a collection of 150 related viruses that can cause a variety of different problems of the genital and anal skin. It is the most common sexually transmitted infection (STI) and can cause genital and anal warts, a pr...
A rectocele is a bulging of the front wall of the rectum into the back wall of the vagina. The rectum is the bottom section of your colon (large intestine). This is a very common problem that often does not produce symptoms. Other pelvic organs can bulge into the vagina, incl...
WHAT ARE ANAL WARTS? Anal warts (also called "condyloma acuminata") are a condition that affects the area around and inside the anus. They may also affect the skin of the genital area. They first appear as tiny spots or growths, perhaps as small as the head of a pin, and may...
WHAT IS A RECTOCELE? A rectocele is a herniation (bulge) of the front wall of the rectum into the back wall of the vagina. The tissue between the rectum and the vagina is known as the rectovaginal septum and this structure can become thin and weak over time, resulting in a r...
Laparoscopic or “minimally invasive” surgery is a specialized technique for performing surgery. In the past, this technique was commonly used for gynecologic surgery and for gall bladder surgery. Over the last 10 years the use of this technique has expanded into intestinal s...
  Pelvic floor dysfunction is a group of disorders that change the way people have bowel movements and sometimes cause pelvic pain. These disorders can be embarrassing to discuss, may be hard to diagnosis and often have a negative effect on quality of life. Symptoms vary...
Pelvic floor dysfunction includes a group of disorders causing abnormalities of bowel storage and bowel emptying, as well as pelvic pain.   This information is intended to help patients gain a better understanding of the disorders making up pelvic floor dysfunction, as we...
Pruritis ani is a common medical problem affecting both men and women. This information was composed to help patients understand pruritis ani, its symptoms, evaluation, and treatment options.  This information may also be helpful to individuals or caregivers of patients w...
  OVERVIEW Anal cancer is an abnormal growth of cells in or around the anus or anal canal which is the short passage through which bowel movements pass. The most common type of cancer found in this location is believed to be related to a type of viral infection known as...
Anal warts (condyloma acuminata) are caused by the human papilloma virus (HPV), the most common sexually transmitted disease (STD). The warts affect the area around and inside the anus, but may also develop on the skin of the genital area. They first appear as tiny spots ...
WHY IS IT SO IMPORTANT? Colorectal cancer — cancer of the colon and rectum — is the second leading cause of cancer-related deaths in the United States. It surpasses both breast cancer and prostate cancer in mortality when both men and women are combined. The general populati...
WHY SHOULD THERE BE A POSTOPERATIVE FOLLOW-UP PROGRAM? Surgery is a highly effective treatment for colorectal cancer. But even when all visible cancer has been removed, it is possible that small clusters of cancer cells may be present in other areas of the body. These ca...
There are many myths surrounding colon cancer, and the following information helps to set the record straight. If you are concerned about colon cancer, or if you have a strong family history of colorectal cancer, you should ask your doctor if you need to see a colorectal ...
Colorectal Cancer Awareness Month March is Colorectal Cancer Awareness Month, and it is a great time to learn more about colorectal cancer. Here are some of the most frequently asked questions, and please ask your healthcare provider if you have additional questions.  What ...
WHAT IS CONSTIPATION Constipation is a common complaint and usually simple to prevent and easy to treat when it occurs. In some cases, constipation may reflect a more serious problem that will require the help of your medical provider to suggest tests, medical interventi...
Diverticular disease is the general name for a common condition that involves small bulges or sacs called diverticula that form from the wall of the large intestine (colon). Although these sacs can form  throughout the colon, they are most commonly found in the sigmoid c...
WHAT IS FECAL INCONTINENCE? Fecal incontinence (also called anal or bowel incontinence) is the impaired ability to control the passage of gas or stool. This is a common problem, but often not discussed due to embarrassment. Failure to seek treatment can result in social ...
THE ROLE OF GENETICS Genes are inherited from each parent. They determine various physical features and may predispose people to certain diseases. All cancers, but especially colon and rectal cancers, commonly referred to as colorectal cancer (CRC), have hereditary facto...
  Constipation is a very common complaint affecting upwards of 15% of all Americans.  Fortunately, constipation is usually is easy to avoid and easy to treat when it occurs. Occasionally, symptoms of constipation may be a sign of a more serious problem requiring medical ...
OVERVIEW Colorectal cancer is a common malignancy for both men and women.  Screening for colorectal cancer is the process of identifying apparently healthy people who may be at increased risk of developing this disease. This information was prepared to help patients unde...
WHAT IS THE RISK OF COLORECTAL CANCER? Colorectal cancer is the third most common non-skin cancer, affecting men and women of all ethnic groups. Over 140,000 people will be diagnosed with colorectal cancer each year and more than 50,000 will die; the lifetime risk is 1 i...
Get regular colorectal cancer screenings beginning at age 45.* If you have a personal or family history of colorectal cancer or colorectal polyps, or a personal history of another cancer or inflammatory bowel disease, talk to your doctor about earlier screening. Eat plen...
Screening tests for colorectal cancer can save 30,000 lives each year. These tests not only detect colorectal cancer early, but can prevent colorectal cancer. In one test, non-cancerous polyps are removed before they become cancer. When you turn 45* years of age you should ha...
WHAT IS THE COLON? The colon is also known as the large bowel or large intestine. It is an organ that is part of the digestive system (also called the digestive tract) in the human body. The digestive system is the group of organs that allow us to eat and to use the food we ...
WHAT IS ULCERATIVE COLITIS? Ulcerative colitis (UC) is an inflammatory disease affecting the large bowel (colon and rectum). In UC, the inflammation is confined to the internal lining of the intestinal wall (mucosa). Medical management is typically the first option for t...
OVERVIEW The purpose of this education piece is to provide information on the background, causes, and treatments of diverticular disease and its complications. This information is  intended for a general audience. Diverticular disease most commonly affects adults and may...
OVERVIEW The purpose of this patient education piece is to provide providers, patients and their families with information on the background, causes, and treatments of fecal incontinence.   WHAT IS FECAL INCONTINENCE? Fecal incontinence is the impaired ability to contr...
THE ROLE OF GENETICS Genes are made up of DNA. They are the basic units inside a cell by which we inherit traits from our ancestors and pass down traits to our children. Our genetic information, found in our DNA, determines much about us: for example, our eye and hair co...
OVERVIEW An ostomy is a surgically created opening between an internal organ and the body surface. Ostomies are often created as a part of intestinal surgery when there must be a new way for intestinal waste to leave the body.  This information was prepared to help patie...
Colorectal cancer — cancer of the colon and rectum — is the second leading cancer killer in the United States and all women and men aged 45 and older are at increased risk. The good news is that colorectal cancer is preventable and, if detected early, curable.    Dependin...
Pilonidal disease is a chronic skin infection in the crease of the buttocks near the coccyx (tailbone). It affects about 70,000 people in the US annually and is more common in men than women. Most often it occurs between puberty and age 40. People who are overweight and w...
OVERVIEW Crohn's disease is a chronic inflammatory disease of unknown origin potentially affecting all parts of the gastrointestinal tract. While medical management of the disease is often the first choice, surgery may be indicated for specific reasons. Crohn's disease m...
Colon cancer is a common malignancy in the United States. The treatment of patients with colon cancer can be complicated and may require a team of surgical and medical specialists. This review provides general information for patients and their families, covering colon ca...
WHAT IS RECTAL CANCER? The rectum is the last six inches of the large intestine which is composed of the colon and rectum. Colon and rectal cancers both arise from the inner lining. Despite the similarities, colon and rectal cancers are treated differently due to differenc...
  WHAT IS COLONOSCOPY? Colonoscopy is an effective procedure to diagnose abnormalities of the large intestine and to screen for colorectal cancer and colorectal polyps. A colonoscope is a long, thin flexible instrument that provides magnified views of the colon and rectum...
Anal pain can occur before, during, or after a bowel movement. It can range from a mild ache that can get worse over time to pain that is bad enough to restrict daily activities. Anal pain has many causes, most of which are common and treatable. However, if anal pain does not...
Colorectal polyps are commonly found during standard screening exams of the colon (large intestine) and rectum (the bottom section of your colon). They affect about 20% to 30% of American adults. Polyps are abnormal growths that start in the inner lining of the colon or rec...
Pruritis ani means “itchy anus” in Latin. This condition causes irritation of the skin near the anus, resulting in a strong urge to scratch the area. In many cases, no specific problem is found to explain the itching. These cases are called “idiopathic” (from unknown caus...
WHAT IS RECTAL PROLAPSE? Rectal prolapse is a condition in which the rectum (the last part of the large intestine before it exits the anus) loses its normal attachments inside the body, allowing it to telescope out through the anus, thereby turning it “inside out.” While thi...
Irritable bowel syndrome (IBS) is a common disorder, affecting an estimated 15% of the population. It is one of the several conditions known as functional gastrointestinal disorders. This means the bowel may function abnormally, but tests are normal and there are no detec...
  MINIMALLY INVASIVE SURGERY Many diseases and conditions of the colon and rectum are treated surgically. A surgeon may use traditional (open) or minimally invasive techniques depending on the individual case. Minimally invasive colon and rectal surgery is a continually...
The anal canal is a short tube surrounded by muscle at the end of your rectum. The rectum is the bottom section of your colon (large intestine). When you have a bowel movement, stool leaves your body from the rectum through the anal canal. Cancer begins when some of the b...
Often described as "varicose veins of the anus and rectum,” hemorrhoids are enlarged, bulging blood vessels in and around the anus and lower rectum. The rectum is the bottom section of your colon (large intestine). The tissues supporting the vessels stretch. As a result, ...
WHAT ARE HEMORRHOIDS? It is important to note that all people have hemorrhoidal tissue as part of their normal anatomy. Only in a minority of people do hemorrhoids become enlarged or otherwise symptomatic. Hemorrhoidal tissue lies within the anal canal and perianal area ...
The anal canal is a short tube surrounded by muscle at the end of your rectum. The rectum is the bottom section of your colon (large intestine). An anal fissure is a small rip or tear in the lining of the anal canal. Fissures are common, but are often confused with other ...
  WHAT IS AN ANAL FISSURE? An anal fissure is a small tear in skin that lines the opening of the anus. Fissures typically cause severe pain and bleeding with bowel movements.  Fissures are quite common in the general population, but are often confused with other causes ...
ANAL ABSCESS AND FISTULA An anal abscess is an infected cavity filled with pus near the anus or rectum.  An anal fistula (also called fistula-in-ano) is a small tunnel that tracks from an opening inside the anal canal to an outside opening in the skin near the anus. ...
WHAT IS AN ANAL ABSCESS OR FISTULA? An anal abscess is an infected cavity filled with pus found near the anus or rectum.  Ninety percent of abscesses are the result of an acute infection in the internal glands of the anus. Occasionally, bacteria, fecal material or foreig...