Tagged As: Small Bowel Resection
Question:
I recently (2 weeks ago) had 3 ft. of small bowel (ileum) and a small portion of my colon removed. This is my first surgery for CD and I am really worried. �I have the WORST diarrhea (sp) that I have ever experienced in my life! And I have been battling CD for 10 years with bouts of extreme D!�Nothing but bile comes out, I mean where the heck is the food I am consuming? My ROIDS can't take this much longer and I can't leave the house without a local map of bathroom havens and an emergency roll of TP! Is this normal? Those of you that have had this surgery or similar bowel resections, I welcome your comments and advice.
Answer:
You should be taking colestid or questran(I prefer the former personally)but also realize that it does take time for your system to re-adjust. �Heck, in my case it was almost a year following the second resection. �What was interesting about that, however, was that the bile acid diarrhea didn't start to appear approximately ten months after the surgery. Just hang in there, be especially careful of your diet at this time, and you'll come out fine. I have tried Questran and Colestid. �The Colestid didn�t do much that I can remember, and the Questran gives me that bloated, 'ohmygod-I'm-getting-obstructed-again' feeling, even on the lowest dosage recommended by my GI Doc. I am in a Catch-22 Situation. �I absolutely must do something for this D.�I have also tried anti-spasmodic drugs in the past like Lomotil and Bentyl and others, but I am just so dadgummed sensitive to meds that I find it difficult to cope with every day life while taking such drugs. I'm a weenie! �I was hoping that this 3rd dose of Remicade would help with the D. �I had the Remicade just 9 days after surgery, right before I was released from hell, I mean the hospital. Anyways, I really appreciate the advice! My incision site is doing well, but like you, I feel like the inside incision, on the actual gut, is way more sensitive. I fancy at times that the pain I feel is from the removed, strictured portion of my intestines. Much like the phantom pain in an amputated limb! �Unfortunately, or fortunately, depending on how you look at it, I realize the pain is all too real, especially when I press on the region of my abdomen which once housed my poor terminal ileum. �That is from where MOST of my problems came. Obstruction after obstruction after obstruction. �This last time I had an obstruction, there was no sign of active disease, only scarred remains causing the trouble, so my GI decided that it was the right time to operate. I think I am in remission. �And hopefully after I heal from the surgery and my gut returns to some semblance of normal, I will be disease and stricture free, FOREVER!!!! Yeah, I know there is no guarantee, but, hey, I can dream can't I? I also had a bowel resection 2 weeks ago. Unfortunately, I can't give you advice about the diorama, because all I've had is severe constipation. �I had about five days of diarrhea, but then I think the total lack of fiber that I've been eating has kicked in! I hear that the shortened intestine takes a while to re-learn (or whatever) how to properly process food again. Why don't you give the surgeon a ring to allay your worries and leave a message, see what he says, I'm sure he wouldn't mind (at least mine told me _he_ wouldn't mind). How well have you recovered from the wound at this stage? I've pretty much totally recovered from the actual cut it's just the internal joins that make me wince when I sneeze or have a good belly laugh! �One rowdy and playful fellow from work came up to me and gave me a light, playful punch in the side, totally unaware that I'd had abdominal surgery. The git, luckily he missed the worst bits or I would have had to kill him!! Hope you recover alright and get over the diorama. I had the same operation. Just after 5 months I was back to where I started. I tried changing my diet. After a while it was apparent that eating meat makes matters worse for me, so I have been a vegetarian since. There may be other things that are different for individual patients. Hang in there, After reading the responses I see you have tried some of the meds available. I don't know how much of your large bowel you have left but it is that area that handles the water absorption and that may be part of the problem with the loose stools (watery stools) until it can start to compensate and starts to absorb water again. �I have an ileostomy (no large bowel) and my small intestines (what is left of them) absorbs water as much as it can. �You need to drink LOTS of water so you don't become dehydrated. �I would recommend that you ask your doctor to refer you to a nutritionist that may be able to help you with a diet to slow down your stools. I wish you well as I know what you are going through. The solution for me was deodorized tincture of opium (DTO). A few drops in a little water, and a wait of about an hour for it to take effect, and then I am locked up tight for another 4 or more hours. I had no side effects except maybe a little sleepiness when first getting used to the drug. However it IS an opiate and it can be overused and abused. If you are an addictive type of person, you probably shouldn't take it. It's also not commonly used in the USA, and your doc may be unfamiliar or afraid of it. I've taken it almost every day for many years, and for me it means the difference between a semi-normal life and a life tethered to the toilet. The phantom pain is an interesting thing. Four years down the track I still get it occasionally. Of course given the way the disease is at the moment, it may not be phantom pain. Get some Ilex cream for the butt burn there are also other creams that work. Go over to ww.j-pouch.org click discussion then general discussion; there are many posts on how to fix butt burn. They are experts over there, although most do not have a colon. Then if the colestid fails(which I'd be surprised would happen at higher doses like six or more pills a day)you might try Shaman Botanicals Normal Stool Formula(website address is www.shamanbotanicals.com). I've found it pretty helpful but hasten to add that I'm pretty much over the bile acid problem I had following surgery. �It is only a problem if I eat foods pretty high in fat (like too many toffee coated peanuts which I love or too many French fries which I also have a weakness for, damn!). I completely know where you're coming from. �I had a bowel resection and 4 strictureplasties four weeks ago. �They removed one foot of bowel and it was the piece that connects the small intestine to the colon. �I was told that this is the region of bowel that binds the stools (something about bile acids that I don't quite remember) and until the new region learns to do this, I'll have diarrhea. �The doctors also told me that the more work they do, the more difficult the recovery. �Three feet sounds like a lot to remove at once, maybe your body needs time to adjust to the change. Anyway, I, too, was having terrible diarrhea. �I was going at least 15 times a day, and soon got my bottom so irritated that I started having really bad rectal bleeding. �I was incredibly discouraged because everyone was so upbeat about how I'd feel after the surgery, and I actually felt a lot worse. Questran has helped a little. You said it made you feel blocked. �That's happened to me in the past. �This time I'm taking name brand Questran, as opposed to the generic. It's easier to control the portions, and I'm taking a very small dose. �I started at just half a packet/day. �Now, I'm taking a half packet three times a day. �I'm also using Anusol HC suppositories to help the bleeding, and they seem to be working. �It sounds like I'm two weeks ahead of you in terms of recovery, so maybe you'll start to feel better soon. �I am, but it's taken a lot longer than I expected. I can add nothing constructive to this thread other than a handy way to remember how to spell Diarrhea, which I gleaned years ago . Just remember this-Dash In A Rush, Run Hard Else Accident! If I even THINK of eating any kind of nut I will end up in the hospital with an ng tube in my nose and a horrible flare up with an obstruction fast enough to make your head spin! �My absolute favorite is hazel nuts. �What I wouldn't give to eat nuts again! Oh how I envy you! �Have some for me! �Just don't overdo and end up sick or I'll feel guilty! �LOL!! �Be well and enjoy! Don�t worry too much. �You�ve just had major surgery and it takes at least 6 weeks just for your body to recover from the shock of surgery. �I know it�s a real pain with all the D. but your intestines will take a while to adjust, a while meaning a good few months I would think. �You may never return to normal but I�m sure it will improve with time. �I have an ileostomy now and normally this results in continuously having diarrhea but my intestines have adjusted over the years and most of the time my stools are quite normal - depending on what I eat. You just concentrate on getting better, have lots of rest and make sure you treat yourself. �Oh, and make the most of the time off work!!!! �If things don�t improve within a few months then see your dr. as there are drugs that can help with the absorption of the excess water. �For now make the most of your good friends and family and have them do your shopping etc. if you can, I�m sure they won�t mind after all you�ve been through I�m sure they�ll be only too glad to help in whatever way they can. Where do you live anyway. �I know in England you can order your shopping from Tesco�s over the internet. �They have a 5 pound delivery charge but it�s well worth it if you have a lot of shopping. �If you want the address email me and I�ll send it to you.
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