After Bowel resectioning

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Island girl
New Member


Date Joined Mar 2007
Total Posts : 10
   Posted 9/7/2007 5:12 AM (GMT -7)   
Hi Everyone, Island Girl here.  I have been away for a while, I had a bowel resectioning because of a blockage from my Crohn's and scare tissue.  I have a question and I am looking for any input.  Since I have had my bowel resectioning for the blockage the surgeon said that he saw no signs of active crohn's in my bowels, I have had the large and small intestines checked out and both show no active crohn's, so!  I am now having more signs of crohn's now then before my surgery, like eating and within an hour have cramping and need to go to the bathroom in a hurry and I wake up in the mornings and feel right crampy like I may have to go to the bathroom.  I enjoy coffee in the morning and I find that some days I can drink it, no problem, and other times I get the bathroom thing going on.  Mostly in is not diarrhea but soft stool or border line.  Any body experience this or have any thoughts.  I would appreciate it.  Thanking you in advance, Island Girl.

Barbz
Veteran Member


Date Joined Jun 2005
Total Posts : 848
   Posted 9/7/2007 5:21 AM (GMT -7)   
I had 12 inches of my small intestine TI removed in April of this year and i was the same way. My surgeon and my gi both told me that it has something to do with absorbing bile salt so they put me on quastran. It really helps when i take it!!! Maybe ask your doctor about that. What part of the intestine did you have removed?? Good luck i hope you feel better soon also when did you have your surgery? Barb

belleenstein
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Date Joined Feb 2007
Total Posts : 1010
   Posted 9/7/2007 7:20 AM (GMT -7)   
hi Island girl:

If you have had your terminal ileum removed (the last part of the small intestine before it empties into the large bowel) Barbz is right, you may have a problem with diarrhea caused by fat-malobsorption. But that kind of diarhea is very distinct. Typically these are large stools and very greasy. You will see fat floating on the surface of the water in the toilet, almost like grease in dishwater, or oil on water. Typically fat-malabsorption diarrhea is accompanied by lots of noise (gurgling) in the bowel shortly after a meal. The stools are also usually very foul smelling.

Remember you have had a major operation. It takes time for things to settle down. Your bowel has been cut and put back together and your intestines might be cranky and hyper-active for awhile.

Here's the thing, you have to be your own investigator and if something triggers an episode of diarrhea consistently (coffee) then you have to make the decision whether the offending food is worth the consequences. As you recover from surgery the important thing is to work towards wellness. Your body has been through a major insult, but the result is that you should enjoy a period when you can broaden your food choices. Try to make the most of this as nutrition is probably one of the biggest weapons we have in the long term to fight this disease. If you can enjoy really healthy food now (adding especially soluable fibres like whole grain breads and oatmeal etc) you might find that they actually help regularize your bowel habits. I remember when I was recoverin from my first surgery, I had spent so many years stuck with a really restricted diet because of my strictures that I was afraid to start adding bulk back into my diet. It really helped though. The key is slowly, slowly, slowly. Maybe you could begin a food diary for a couple of weeks and keep track of your food and your symptoms. It is sometimes easy to see patterns, as you already have with coffee.

The other thing to be aware of is the potential for crohn's to come back. While a certain amount of symptoms are to be expected if you begin to slip or if there is a marked increase in symptoms and you can't attribute them to food or life stresses, it's important to get re-evaluated. For me the deterioration was gradual and I just kept accepting further and further restrictions and misery because I could still function and because none of the blood work or SBFT picked up signs of disease activity. So I wasn't properly medicated to reduce the disease activity and I ended up with another severe stricture (years later). There are no guarantees that you won't need surgery again in the future, but if you are appropriately medicated it can significantly slow the process of stricture formation.

Good luck and keep posting.
Belleenstein:

30+ years living with Crohn's.


Dolly5577
New Member


Date Joined Sep 2007
Total Posts : 1
   Posted 9/7/2007 7:52 AM (GMT -7)   
First let me tell you all I think your site has helped me the most...The only REAL cure I have seen in my family was an Uncle that had a bag put on in the 1980s and no one told him why.....15 yrs later he had it removed and abt the same time my mother was diagn. with Crohns.
It is like "Hardening of the Arteries" and when food tries to go thru, the intestines contract to move down into the small & larg bowels....thickening of the walls create pain and with that you lose all the nurishments because your bowels are built up with tissue.....you feel tired, hair & nails are weak. Cramping are also related to food not digested,right....some days you feel good, then fever and bouts become stronger. I was told how lucky we are it didn't start in the brain? OK...its a tubal disease.
We have more cans of liquid diets ...I wish we had stocks.
Fats are not digested even in the healthiest intestines and dairy is a big no no. The vita B shots really help though.
Mother had surgery twice, abt 10 yrs between....but can it pop up at any time aft. its removed.....is it a DNA issue....Doc's...& we went thru Many, say it is. It runs in the families.
The only regret for her was the steroids they put her on....they didn't have the meds they have now. The Doc took 12 yrs to Diagn. her cause he had never, in all his 35 yrs of treatment seen a Crohns patient.
Now I see so many.

Island girl
New Member


Date Joined Mar 2007
Total Posts : 10
   Posted 9/7/2007 10:17 AM (GMT -7)   
Thank you Barbz and belleenstein, I had my surgery only shortly after you Barbz, I had mine in June this year and it was the TI.  How do you fine the quastran and what is it.? Belleenstein, that was good information about the fat malabsorbtion, I would never suspect such a thinng.  Thank you both for such information and at least now I know what to watch for.  Does fat malsbsorption also interfer with gaining weight, I had my surgery 4 months ago and I don't seem to have gained any weight back, is that part of it?  Also, I am the same as you were belleenstein, afraid of fiber, I still find myself second guessing if I should it the whatever in case I get worst instead of better. 

belleenstein
Veteran Member


Date Joined Feb 2007
Total Posts : 1010
   Posted 9/7/2007 12:01 PM (GMT -7)   
Questran is a brand name for cholestyramine. It is a drug that binds bile salts. Fat malabsorption diarrhea occurs in people who have no terminal ileum or whose ileum is severely diseased because they can no longer reabsorb bile acids which are released by the gall bladder in order to break fat molecules down into particles that can be used by the body. Normally the bile acids are reabsorbed through the intestinal wall and recirculate back to the gall bladder. When the terminal ileum has been damaged, the bile acids remain in the bowel and cause a form of diarrhea called steatorrhea. The cholestyramine binds with the bile acid and it is evacuated from the body in your feces.

Fat mal-absorption can contribute to weight loss issues, since fats are highest in calories. If you want to experiment, try cutting back on fat in your diet for a couple of weeks and see if you notice any difference. I manage my issues with fat-malabsorption by eating a low-fat diet and taking questran only when I need it, rather than on a regular schedule. That way I minimize the side-effects of taking questran which can include some bloating and excess gassiness.
Belleenstein:

30+ years living with Crohn's.


dragonfly137927
Veteran Member


Date Joined Sep 2006
Total Posts : 2527
   Posted 9/8/2007 8:16 AM (GMT -7)   
I dont have my gall bladder any more and havent since 99. I had my surgeries recently too. Some days I have loose stools or D up to 10 times, other days it is more fromed and only a few times. The days like that though I fell bloated and have lots of cramping
Dx with Crohn's 1987, symptoms as early as 1984.
Temp iliostomy February 2007, reversed June 2007, Ovarian cysts, migraines, allergies (incl food allergies) , oral allergy syndrome (diff than true food allergies), Asthma, Gall Bladder removed 1999, Inguenal hernia 1987
 
 


Island girl
New Member


Date Joined Mar 2007
Total Posts : 10
   Posted 9/10/2007 8:51 AM (GMT -7)   
belleenstein, thank you so much for your input and quick reply, It is appreicated.  I find it more informative to turn to you and others on this forum for information on things I am experiencing as you and the others are living with it and know what I am going through and that is more helpful than talking to a doctor who only knows what he has studied.  Thanks again!

Julia506
New Member


Date Joined May 2007
Total Posts : 9
   Posted 9/11/2007 1:27 PM (GMT -7)   
I had a subtotal colectomy in June 07 due to multiple stricture. Prior to surgery, I could not tolerate carbohydrates at all. Now, it is one of the foods I can tolerate the best! I have very little cramping and feel better than I have in years! I was so afraid to have it done, but luckily my rectum was fine so my doc just removed the colon but hooked up the ileum to the rectum and no bag! My GI put me on 6MP and allopurinol to prevent the Crohn's from returning (my body does not metabolize 6MP well, so the allopurinol helps with metabolizing the 6MP).

I hope I can contiue to feel wonderful, I just have to watch what I eat and drink (alcohol - no good).
Diagnosed with Crohn's Colitis 1983. Have been on prednisone (life saver back then), Asacol, Azulfadine, Pentasa amd 6MP. Did not follow my doctor's treatment plan, stopped taking all meds about 3 years ago. Had a subtotal colectomy June 2007. Feeling great and following doctor's orders to the letter of the law!!!
 
*********TAKE YOUR MEDICATIONS AS PRESCRIBED**********


Island girl
New Member


Date Joined Mar 2007
Total Posts : 10
   Posted 9/13/2007 4:35 AM (GMT -7)   

Thanks so much everyone for your input.  Went to see the surgeon and he mentioned the bile salt scenario but we decided not to rush into the medication side of things.  In the meantime, I have increased my fiber intake and it seems to be helping.  Thanks again for your help!

 

Bonnie-Island Girl  :)

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