small bowel function - science please

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uklass
Regular Member


Date Joined May 2009
Total Posts : 65
   Posted 6/10/2009 10:31 AM (GMT -7)   
I've been to see my hospital consultant today - first time meeting the top guy and it was a bit of a mixed experience. He gave me a lot of time, put up with my tears but unfortunately his manner was a bit intense and not very reassuring at times.
 
Anyway......... I asked a question about how much small bowel I had left. The surgeon said 195cm and I've read in various articles that this would indicate 'short bowel syndrome', but he says not worried until goes below 100cm - I'm not having SBS symptoms so ok with this
 
However........I asked what the consequence of having relatively little bowel would have on function e.g. absorption, speed of transit etc. He said other than B12 and possibly occasional fat digestion there shouldn't be any problems: eat what I like and get on with my life!!!    
 
This can't be right? Since surgery in March I've been trying to do relatively low fat and fibre anyway, and generally trying to be healthier - thought I was doing it to reduce  chance of future strictures and generally not aggravating things so soon. I've gone from 1-2 very loose BMs pre-surgery to 4-6 formed ones now - I have to wait for things to finish before I can leave for work and I need to go again after a meal so there definitely has been some change in transit/digestion. I might even be better not doing low anything!
 
Any thoughts or knowledge appreciated............I'd be happy to not worry about what I eat but I can't believe most of the small bowel is not needed
 
Thanks
 
Penny
 

Rider Fan
Veteran Member


Date Joined May 2008
Total Posts : 1445
   Posted 6/10/2009 10:53 AM (GMT -7)   
The Mayo Clinic says the following:

A patient is generally considered to have short bowel syndrome when less than 100 to 150 centimeters, three to five feet, of functioning small bowel remains (about 20 percent of normal).

Your GI said to eat anything because diet plays no role in their usual 'standard of care'. He can't say for sure whether or not diet will help you or not. Of course you will feel better and be healthier overall i you eat better. As far as specific diets, it's really an individual thing, if what you're doing helps then I would stick with it.
32 y/o male. Dx'ed in 1999. No surgeries.

Current meds: Humira 2/27/09. 8mg prednisone. Udo's Choice Probiotics (30 billion). Can't tolerate any iron supplements or infusions.

Tried SCD, didn't work, now avoiding gluten and dairy.


Go Saskatchewan Roughriders!


CrohnieToo
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Date Joined May 2003
Total Posts : 9448
   Posted 6/10/2009 11:46 AM (GMT -7)   
Mayo told me in 1978 after my resection when I asked about foods and diet to "eat anything you want to, your intestines will tell you what and what not to eat". I found that advice to be RIGHT ON! Let your body tell you what you can and can't eat, we are all so different only our bodies know for sure what they do and don't tolerate well.
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.


uklass
Regular Member


Date Joined May 2009
Total Posts : 65
   Posted 6/16/2009 1:55 AM (GMT -7)   
Hi it's me again - still looking for answers...........and which supplements I might need to look at or diet stuff. found this section under Healing Well FAQ but the article is dated 1997 - anyone know if there is a more up-to-date one or where I can get this sort of info i.e. if you've had certain bits removed what effect it can have. the D vs. C is a daily balancing act but I don't want to be sideswiped by other things that have crept up over time
 
4.1 Q: What role does diet play in IBD?

Since the small intestine is where the body absorbs nutrients from food, CD patients may have problems absorbing these nutrients.  If more than two or three feet are either diseased or surgically removed, malabsorption, especially of fats, the minerals calcium and magnesium, and the fat soluble vitamins A,E, and D, can be a problem. Resection of at least two feet may also increase absorption of oxalate, which reacts with calcium to form kidney stones. A low oxalate and low fat diet will help prevent kidney stones. Spinach, cocoa beans, rhubarb, beets, instant coffee, diet sodas and tea are all high in oxalate. If only the terminal ileum, the last two to three feet of the small intestine, is diseased or resected, absorption will be normal except for vitamin B-12 which can be supplemented by monthly injections. Iron supplements are helpful in treating the anemia and patients should drink plenty of fluids to replace those lost from diarrhea.
I was never an anxious person and hope I will be less of a worry wort soon - please bear with me as I need to have answers if there are any
 
Thanks
 
Penny

Wolfie40
Veteran Member


Date Joined Dec 2008
Total Posts : 947
   Posted 6/16/2009 3:41 AM (GMT -7)   
I eat healthy but there are some things that disagree with me and I can no longer eat them. For me it's trial and error.
Diagnosed with Crohns in 2001
First and hopefully last Ileocecectomy 2/18/2009

Medications: Asacol, Precription Folic Acid, Multivitamin, 1000mg Calcium, Vitamin D, Probiotics,  Monthly B-12 injections.

Living a Great life with my Wife and my two Chocolate Labs
Hunter & Hailey.
I love them dearly.


gachrons
Veteran Member


Date Joined Mar 2007
Total Posts : 4527
   Posted 6/16/2009 5:09 AM (GMT -7)   
Hi I take a multi vitamin and calcium with vitamin D as well as B-12 needle once a month. I make sure my vitamin also has vitamin K in it as I think it too is one of the vitamins we need after resection. lol gail
Hallarious woman over 50 ,CD ,IBS 27 years--resection,fistula's,obstructions,hemmies,and still alive.lol gail
"Blessed are those that can give without remembering and recieve without forgetting ~Aurthor Unknown~Blessed are they that have the joy of helping others~     Moderatorin     gail


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 6/16/2009 8:13 AM (GMT -7)   
I have had two resections myself, and I personally cannot tolerate any kinds of vitamins whatsoever. I have even tried liquid vitamins and even childrens. They just upset my system really bad. I am able to tolerate my calcium with Vit D. I am thinking of adding additional Vit D as it is said to aid in the fatigue and joint pain we suffer with. I get B12 shots every other week, and those really help me alot. I live on the low residue diet all the time, because this is what works well for "me". I agree you should maybe try adding one new thing into your diet a week, that way you will know if it upsets "you" or not. Oh and one side effect I get from my low res diet is I have to fight constipation as there is not much fiber in the diet, but fiber and I are not friends:) So to help with that I take stool softners every night. But if you don't need to be on the low res diet, do slowly add things into your diet and see how you do.

Big Hugs
Gail *Nanners*
Gail*Nanners* Co-Moderator for Crohns Disease and Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia and Osteoarthritis and Anxiety. Currently my Crohns is in remission.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 6/16/2009 8:17 AM (GMT -7)   
Oh Penny, I forgot to ask you one thing. Do you take Probiotics at all. After my last resection I was going much like you 4-5 semi formed stools a day. I started taking my probiotics and now I am down to 1-2 a day. We tend to have a bacterial imbalance in our intestines and the probiotics tend to level out bacteria and less bm's was the happy consequence I got from them after I started taking them. I take a basic lactobacillus and it works great for me. Good luck!
Gail*Nanners* Co-Moderator for Crohns Disease and Anxiety/Panic Forum
Been living with Crohn's Disease for 33 years. Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium and Xanax as needed. Resections in 2002 and 2005. Also diagnosed with Fibromyalgia and Osteoarthritis and Anxiety. Currently my Crohns is in remission.
*Every tomorrow has two handles.  We can take hold of it by the handle of anxiety, or by the handle of faith"*

uklass
Regular Member


Date Joined May 2009
Total Posts : 65
   Posted 6/16/2009 11:00 AM (GMT -7)   
Thanks for all your replies
 
Nanners - I have just bought some over the counter probiotic capsules - says 4 billion friendly bacteria of lactobacillus acidophilus and bifidobacterium lactis. I've tried to understand the forum posts on this subject but most have gone over my head so have gone for something that sounds reasonable!! there were some products at the pharmacy that combined probiotic and vitamins in a capsule but I thought these might be too good to be true. I'm still on Flagyl - was put on this for 12 weeks post-surgery and it's coming to an end so I am wondering whether there will be an after-effect of such a strong antibiotic; probiotic seems a potential counterbalance?
 
I know I cannot tolerate high fat food like I used to (actually I couldn't before - I just put up with the aftermath!!) and so it makes sense that some vitamins won't be absorbed; I'll have to see if capsules dissolve properly if I haven't got that bit left. Finding out is so much fun???!!!!
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