Diarrhea and Urgency after Bowel Resection?

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WantRelief
Regular Member


Date Joined Feb 2006
Total Posts : 261
   Posted 1/27/2008 8:29 PM (GMT -6)   
Ok, so overall I'm feeling better from having my Terminal Illeum bowel resection 2 1/2 weeks ago.  HOWEVER, the diarrhea and urgency are ridiculous.  I can count on diarrhea after starting to eat, maybe 5-10 minutes into my meal.  Sometimes I feel like I can barely make it to the restroom. I'm really nervous about getting out in public and returning to work with this urgency to go to the restroom.  For those of you who have had this surgery, is this common and does it get better over time?  (I had my illeum, illeocecal valve and part of my right colon removed)  Please let me know what to expect as time moves forward......thanks guys!
31year old female
CD of Terminal Illeum and Rectum Diagnosed 12/04
Illeocolonic Resection 1/08
Current Meds: Pentasa, Fosomax, Iron, Vitamin b12 injections, Vicodin


pattytx
Regular Member


Date Joined Jun 2006
Total Posts : 139
   Posted 1/27/2008 8:49 PM (GMT -6)   

I've had two resections and it took some time after both to get a more predicatable bowel schedule! At first, I was constantly having "run-as-fast you can diarrhea"! Talk with your dr., though.  He/she can give you tips on things to do . . . I took lomotil/immodium for awhile and that helped.  I was also told to start fiber when I was able since I wasn't in danger of a stricture anymore . . .

Good luck!

 


Driver37
Regular Member


Date Joined Jun 2007
Total Posts : 93
   Posted 1/27/2008 9:12 PM (GMT -6)   
It's been almost two months for me and it's still a problem. I had half of my right colon removed. Questran seems to work better for me but sometimes I take Imodium also. I also started Humira recently and think that's starting to help. I understand your frustration, I was expecting some time of remission after surgery.

Chasity102304
Regular Member


Date Joined Nov 2007
Total Posts : 165
   Posted 1/28/2008 8:55 AM (GMT -6)   

I had pretty much the same resection done in July 07. It takes several months for things to slow back down. I am 6 months out and am FINALLY getting to where I can eat out or at family gatherings and not stress out about it. As always with Crohn's you never know so I am still aware of bathrooms and whatnot, but its much better. When I came home from the surgery and started eating it was about a 15-30 min period where I would stay close to the bathroom (and that would last for awhile till I was sure I wasn't going to go anymore) and now at this point, sometimes I might not go for 4-6 hours after eating. It will get better. :)

GOOD LUCK!


Fibromyalgia DX March 2003
Crohn's DX Jan 2006 (Symptoms since 96-Misdiagnosed as "female" problems-Major flare during pregnancy in 05 which lead to DX)
1st resection July 2007
Currently on Remicade/8 weeks


belleenstein
Veteran Member


Date Joined Feb 2007
Total Posts : 1010
   Posted 1/28/2008 8:57 AM (GMT -6)   
You might just need to give your bowel some more time to adjust. If you were suffering from a stricture prior to surgery, imagine how much work was involved in moving feces through that stricture (you probably felt it as pain, but the pain was really your bowel working hard). The bowel needs time to relearn how much effort it takes to move food through. Added to that, consider how cranky your bowel and abdomen must feel after being cut and sutured. Every bit of your bowel was taken out of its protected environment, laid on your abdomen and examined and then stuffed back inside. It all has to readjust again and it takes time.

Having said that, depending upon how much of your terminal ileum was removed, you may find that you will need to take a cholestyramine (Questran) supplement in order to remove bile salts that your body may no longer be able to effectively recycle. Do your stools look greasy (can you see a skim, like oil, on the top of the water in the toilet bowl?)

What kind of diet are you on? Sometimes after a resection, if there are too many simple sugars in the diet and not enough fibre that can contribute to diarrhea, but I would add fibre onlly in consultation with my surgeon this soon after surgery. It was recommended that I maintain a bland diet with not a lot of roughage for the first 3-6 months. But recommendations vary.

If you decide to try imodium temporarily just be careful not to overuse.

And remember, it has only been less than 21 days since your body endured a massive insult to the system. Is it possible to see your diarrhea as a prescriptive, in that it may encourage you to rest and recover, rather than pick up the threads of your busy life too quickly?
Belleenstein:

30+ years living with Crohn's.


WantRelief
Regular Member


Date Joined Feb 2006
Total Posts : 261
   Posted 1/28/2008 9:03 AM (GMT -6)   
Thanks Belleenstein, everything you said makes total sense!  I'm sure it is keeping me home and resting more than I normally would have.  Also, I did have a stricture with the pain you described so my gut was used to working much harder.  Thanks again!

31year old female
CD of Terminal Illeum and Rectum Diagnosed 12/04
Illeocolonic Resection 1/08
Current Meds: Pentasa, Fosomax, Iron, Vitamin b12 injections, Vicodin


dunny2
Veteran Member


Date Joined Jan 2007
Total Posts : 3200
   Posted 1/28/2008 12:52 PM (GMT -6)   
You say you had a terminal ileum resection done. Have you been told if they removed the ileo-cecal valve? If this is
the case, it would be one answer for you diarrhea.
I would ask your surgeon, as this is a problem that maybe with you for sometime...Good luck.
Vicky

Too many years with CD
Two bowel resections, several obstructions.


Laughter is the brush that sweeps the cobwebs from our hearts


WantRelief
Regular Member


Date Joined Feb 2006
Total Posts : 261
   Posted 1/28/2008 1:39 PM (GMT -6)   
Yes, they removed my illeocecal valve.

31year old female
CD of Terminal Illeum and Rectum Diagnosed 12/04
Illeocolonic Resection 1/08
Current Meds: Pentasa, Fosomax, Iron, Vitamin b12 injections, Vicodin


dunny2
Veteran Member


Date Joined Jan 2007
Total Posts : 3200
   Posted 1/28/2008 1:51 PM (GMT -6)   
Well, it would seem that you will have my problem, and that of many of us on here. Diarrhea will with you for awhile. Sometimes
the gut learns to adjust, and starts to form semi formed stool. Meanwhile, please watch your hydration and vitamin levels, especially
vit B12. When you have that valve removed, because of the constant diarrhea, we tend to suffer more with absorption issues. This is
something you need to talk to your doctor about. I have to have B12 shots bi-weekly, largely because my levels were not checked
enough.
Vicky

Too many years with CD
Two bowel resections, several obstructions.


Laughter is the brush that sweeps the cobwebs from our hearts


WantRelief
Regular Member


Date Joined Feb 2006
Total Posts : 261
   Posted 1/28/2008 1:55 PM (GMT -6)   
Vicky:  Have you  noticed that you are not absorbing other vitamins/nutrients as well in addition to vit.b12?  Have you experienced weight loss with the constant diarrhea or do you feel as if you are absorbing calories/nutrients from the food you eat?

31year old female
CD of Terminal Illeum and Rectum Diagnosed 12/04
Illeocolonic Resection 1/08
Current Meds: Pentasa, Fosomax, Iron, Vitamin b12 injections, Vicodin


dunny2
Veteran Member


Date Joined Jan 2007
Total Posts : 3200
   Posted 1/28/2008 2:50 PM (GMT -6)   
They have told me that there's high amounts of fat in my stool, which does indicate that I have absorption problems. I know
I'm lacking in potassium and vit D. My weight is an issue when I'm not on steroids, but since I never really get a chance to be
off steroids I hold steady at a healthy weight, otherwise I would probably be under.
So to answer you, no I'm not absorbing the right stuff..
Vicky

Too many years with CD
Two bowel resections, several obstructions.


Laughter is the brush that sweeps the cobwebs from our hearts


Driver37
Regular Member


Date Joined Jun 2007
Total Posts : 93
   Posted 1/28/2008 8:02 PM (GMT -6)   
Good info belleenstein and dunny2.

nawlinscate
Veteran Member


Date Joined Jan 2007
Total Posts : 656
   Posted 1/28/2008 10:36 PM (GMT -6)   

I had an ileal resection, with removal of the appendix and ileocaecal valve, in October, 1999--and, with rare exceptions, I've had the diarrhea and urgency ever since. Any medications that I've been given either (a) are opiates and keep me from driving when I take them, or (b) block me up miserably (e.g., cholestyramine), with uncomfortable gas bubbles and much worse diarrhea when the drug wears off. No doctor has been able to find a way to alleviate these symptoms.

Other people (as above) seem to have had better luck than I have with remedies after an ileal resection. What the heck--I'm used to the whole syndrome now.


sweeterthanhoney
Veteran Member


Date Joined Oct 2005
Total Posts : 540
   Posted 1/28/2008 11:51 PM (GMT -6)   
for someone who Diarrhea isn't an issue, does this surgery always come with D?
dx: fibromyalgia, IBS-C,Myofacial Pain Syndrome, Chronic Headaches, hypothyroidism,anemia, insomnia,mild depression.
 
Meds:
Clonazapam .25mgs, Oxy IR 2.5-3xs/day 5 mgs at bedtime, Synthroid, Zopiclone, flexeril 
 
Supplements:    professional vit/mineral, magnesium/malic acid, Ester C,
 
Daughter Jerica 17, Dx: Crohn's, amitriptyline 20mgs,   lactaid pills, calcium 1000 mgs/day. Forvia, Remicade [double dose]
 
 Husband with treatment resistant depression   Effexor-450mgs
 
                                     
Jerimiah 29:11                      
 


WantRelief
Regular Member


Date Joined Feb 2006
Total Posts : 261
   Posted 1/29/2008 8:46 AM (GMT -6)   
bumping up for those early birds.......

31year old female
CD of Terminal Illeum and Rectum Diagnosed 12/04
Illeocolonic Resection 1/08
Current Meds: Pentasa, Fosomax, Iron, Vitamin b12 injections, Vicodin


dunny2
Veteran Member


Date Joined Jan 2007
Total Posts : 3200
   Posted 1/29/2008 11:05 AM (GMT -6)   
Cate. I've tried all the remedies you mentioned, even opium & belladonna medicine, given by drops. As you say none of it is effective.

However, I'm now going into my 10th year and I'm beginning to see a change. I do now get some semi formed stool, but as silly as it
might sound, I have got used to diarrhea. It's become my way off life, and I find it preferable to the awful stopped up feeling.

My goal, and the gi's goal is to get my toilet visits down to 2 or 3. So that's my goal... Good luck to everyone else...
Vicky

Too many years with CD
Two bowel resections, several obstructions.


Laughter is the brush that sweeps the cobwebs from our hearts


LiLa
Regular Member


Date Joined Nov 2007
Total Posts : 106
   Posted 1/30/2008 9:01 AM (GMT -6)   
Hey there,

I had pretty much the exact same surgery as you described. Except that i had very severe D before it. Then after the surgery i had those awful feelings of urgency and D and pain everytime i ate, so i was utterly disappointed and thought the surgery had been a failure. But as one of the other members stated above- the ileocecal valve was removed which means your body can no longer deal with bile salts. This is where the Cholestyramine/Questran comes into it. I was totally depressed that
A) I had a big scar on my tummy at the age of 19, and
B) it had all been for nothing and i was having the same pain & D as before.

BUT as soon as my GE decided to tell me about the Questran and i started taking it, the D eased off completely and i never had another pain like the crippling pains i had before surgery. I would strongly suggest you give the Questran a go, i only needed 2 sachets per day, and now i only take 1. I prob have to take it for the rest of my life but it's a small price to pay - if i miss a sachet any day i get the pain & D back and it reminds me how lucky i am that just taking a sachet of Questran will take it away. It tastes disgusting i will admit BUT just use orange juice when mixing it. Believe me it's SOOOOOOOO worth it. And the added bonus is that it does not have any short or long term side affects at all.
Best of luck with everything..........

belleenstein
Veteran Member


Date Joined Feb 2007
Total Posts : 1010
   Posted 1/30/2008 10:50 AM (GMT -6)   
The thing with questran is that you can modify the amount you take to your needs. Because it is an off-label use -- it is primarily used to treat patients with high cholesterol, we crohnnies certainly don't need to take it the way it is prescribed. I think the regular dose is up to four grams (sachets) a day. Yuck! I too have issues with pain and flatulence when i take too much of this medicine. So I have found that even one-third of a sachet will stop my diarrhea and settle things down. And I don't use it every day, only as needed. Along with a low fat diet, that keeps the worst of my symptoms in check.
Belleenstein:

30+ years living with Crohn's.


Driver37
Regular Member


Date Joined Jun 2007
Total Posts : 93
   Posted 1/30/2008 12:40 PM (GMT -6)   
I also thought my surgery was a failure because of this. I still don't know if the ileocecal valve was removed, but after some reading about the right hemicolectomy I had, it looks like it at least probably took out part of the ileum. I'm going to have to ask the GI at my next appointment. I sure wish they would have told me about this so I would have been prepared. Maybe they were afraid I wouldn't go through with the surgery if I knew. It's been 2 months now so I'm still hoping the intestines are working it out and will settle down eventually. Questran does help me, but it's like with dunny a lot of the time it will stop me up but then when it's time to go, it's time to go, and not solid.
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