advice please on bowel prep before ileostomy

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Cleos
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Date Joined Jan 2011
Total Posts : 38
   Posted 5/9/2011 8:30 PM (GMT -6)   
Hi, I am fairly new to this forum. In 2007 I was diagnosed with Scleroderma, my digestive system has been affected with this, and now have Colonic Inertia.
 
I have seen a general surgeon, and plan to have an loop ilestomy in the next couple of months. I am a little confused, I asked my doctor whether i would need any bowel prep, before surgery and he said no. I do know that I have some impacted faeces in my colon, and asked my dr what would happen to the impacted faeces, when I have the ileostomy. He didn't seem too worried about it and said that either I would pass it out along with the mucous or it would stay there.
 
To me this didn't seem right, and I will take some laxatives a couple of days before the surgery, to try and clean myself out as much as I can.
 
Your thoughts and imput are welcome.
 
Many thanks
 
Summer

Another UC wife
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Date Joined Jun 2007
Total Posts : 2111
   Posted 5/9/2011 8:42 PM (GMT -6)   
Maybe I'm wrong but I thought most of these surgeries are performed by colo rectal surgeons....not saying a general surgeon isn't qualified but this is such an important surgery that you want to be sure he is definitely the right one for your surgery. If you have researched him and he has done a lot of these procedures then he should be perfectly fine.

Insofar as the prep beforehand I have read various preps recommended to different people undergoing their surgeries. My husbands surgeon required a normal prep so he would be totally cleaned out. It wasn't easy to do that final prep but the fact it was the last one helped him get through it. Whatever his reason we didn't question it as it made sense to get as much of that stuff out of there to hopefully eliminate any kind of problem during or after surgery.

Good Luck.
64 yr old male suffered with UC & in May 06 had a severe flare & hospitalized 6 days...various prednisone treatments leading to steroid dependence and osteopenia, 12 asacol, 200 mg Imuran, failed remicade infusions Jan-May 2010 Dependence on pain meds. Made decision 6/10 to have surgery which was on 12/17/10 (total proctocolectomy & ileostomy - unable to have the j-pouch) and no longer in pain.

Cleos
Regular Member


Date Joined Jan 2011
Total Posts : 38
   Posted 5/10/2011 12:05 AM (GMT -6)   
Thank you for your response. General surgeons are
qualified to perform the ileostomy. I have fully checked him out, and also have a friend that has had an ileostomy performed by him.

My friend also had a loop ileostomy, and had bowel prep before surgery. When I questioned my doctor about bowel prep, he mentioned that my gastroenterologist didn't think i needed one.

I don't think it can hurt anyway, if I try and clean myself out as much as possible.

Another UC wife
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Date Joined Jun 2007
Total Posts : 2111
   Posted 5/10/2011 6:31 AM (GMT -6)   
Wonderful - glad you checked him out - sometimes some people just put their faith and trust in a doctor/surgeon they are seeing and don't research it fully. My feeling is "this is not a dress rehearsal" and you want as much in your favor as possible.

I'm with you on prepping too...it can only help even though it is literally a pain in the butt why not clean out the area.

Let us know how you make out...it is also good that you have a friend who can help and assist you. We knew nobody and relied on this forum for support and advice which was priceless.
64 yr old male suffered with UC & in May 06 had a severe flare & hospitalized 6 days...various prednisone treatments leading to steroid dependence and osteopenia, 12 asacol, 200 mg Imuran, failed remicade infusions Jan-May 2010 Dependence on pain meds. Made decision 6/10 to have surgery which was on 12/17/10 (total proctocolectomy & ileostomy - unable to have the j-pouch) and no longer in pain.

2b ColonFree
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Date Joined Nov 2008
Total Posts : 2603
   Posted 5/10/2011 6:44 AM (GMT -6)   
hi Cleos and welcome to healingwell!
 
if i understood you right, they are not cutting out any part of your bowels, but just taking out a loop and creating the ostomy, right? this should be a very simple procedure. i had a total colectomy on Aug 2009 with ileo-rectal anastomosis due to colon inertia and since it didn't work b/c of my pelvic floor dysfunction + having a slow small intestine, i had a loop ileostomy done July 2010. creating the ostomy alone took only 20 mins! at least that's how it was for me.
 
the question is what is the purpose of this surgery. i understand that it's first of all to give you relief from your constipation and see whether a loop ileostomy can give you that relief, but are your drs and you hoping that after creating the ostomy your colon will start working again? i know colorectal surgeons and gastro drs have this theory that creating a loop ileostomy will give the bowels a rest and they will start functioning again. i've talked to few ppl who had that done (including my own experience) and it didn't work for us. but maybe there are ppl out there that it did work for them? do you know of any?? if there are, i'm very interested to know.
 
so if the purpose of your surgery is to see whether the ileostomy gives the bowels a rest and they will start functioning, then maybe that's why your drs want the stools to stay in your colon, so they can see if it starts working and getting rid of the stools..??? i don't know, cuz otherwise why let you stay with all that stuff still stuck inside of your colon, which can make you very uncomfortable. if your colon doesn't start working on it's own arter creating the loop ileo (and i really doubt it will), and you won't be able to rid of the stools, it will be just aweful for you to be left with all that stools in you.
 
if i were you, i would tell the drs that if they don't mind, i'd rather have the prep and to prescribe me the prep stuff. i wouldn't want to stay with a colon full of it and not being able to ever expel it... even if you have your whole colon perfectly cleaned out before the surgery, it will still continue to produce mucous, so there will always be stuff in there that needs to be expelled anyway. i have only 20 cm of colon (the rectum, which is part of the colon) still there and it produces lots of mucous all the time, but b/c of my pelvic floor dysfunction i can't expel it on my own at all and have to do enemas. but havng your whole 1.5 meters of colon still in - enemas cant clean it all.
 
i agree with you, going to this surgery w/o doing a prep first doesn't seem right at all to me either. do your best to clean your self out before surgery. i would also advice to go on a low residue/low fiber diet while before the prep (few days-week) and then 2 days before the prep only liquids, then the prep. i wish you the best of luck with the surgery and that everything works out for you.

blueglass
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Date Joined Dec 2010
Total Posts : 3332
   Posted 5/10/2011 7:01 AM (GMT -6)   
My surgeon had me do two days of clear fluids and two enemas the night before. But that was for a permanent ileo, and I had the opposite problem, so I don't know how relevant that is.
48 years old, female.
2004 dx indeterminate colitis. Back and forth between Crohn's and UC dx. Many drugs, minimal success.
2010-11 Crazy skin and eye complications, high fevers, bad flaring. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

Cleos
Regular Member


Date Joined Jan 2011
Total Posts : 38
   Posted 5/11/2011 12:15 AM (GMT -6)   
Thank you all so much for the advice.

2B colon free, The reason I am having a temporary Ilesostomy, is to give my colon a break and also to see how I cope with an ileo.

If I go well with the temporary Ileostomy, then he will do a permanent one. I am not sure what this surgery is called, so forgive my ignorance. Is that is where the whole colon is removed?.

Also, I do not know anyone who has had an ileo, then had it reversed, and the bowel begins working again. I am very new to all of this, and I am only learning now the beginnings of all the terminology.

Many thanks

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 5/11/2011 12:30 AM (GMT -6)   
having your colon removed is called a colectomy. you're not having your colon removed, just a loop ileostomy done, so it is called loop ileostomy.

i was hoping you knew of ppl this procedure helped them.

anyways, good luck and keep us posted.
Hodaya
06/05/2007 - STARR procedure
colonic inertia w/pelvic floor dysfunction
08/16/2009 - total colectomy w/ileorectal anastomosis
07/08/2010 - loop ileostomy

villager
Regular Member


Date Joined Aug 2010
Total Posts : 130
   Posted 5/11/2011 2:30 AM (GMT -6)   
blueglass - its odd how different hospitals do the same op differently - among all the many things i was worried about before my perm ileo op was having to do the prep & complete it during my day in hosp before surrgery - bad enough doin it at home before a colonoscopy but in a ward with others about - i just was not lookin forward to it - happily when i asked my surgeon he merrily replied 'dont worry about it we'll clean you out properly before we start' - it was done just after the anesthetist did her part so i was happy in that score - i generally didnt mind the picolax sachets but the 'kleen prep' was like downing the outflow from a chemical factory - i could not be in the same room as kleen prep without being ill

its all history now

hi Cleos - hope your op & the lead up to it goes well

cheers
UC since 1990, not a lot of fun
Qualified as ileostomate May 2010, a much happier boy now
panproctocolectomy, abdomino perineal resection, perm ileostomy
my colon may not be, but my heart is in the right place !!

Christine1946
Veteran Member


Date Joined Aug 2008
Total Posts : 5965
   Posted 5/11/2011 9:34 AM (GMT -6)   
     I had a total colectomy with end ileostomy done last June because of ulcerative proctitis.   I was prednisone dependent for some time too.  My surgeon's assistant told me to take the Miralax prep but when I went for my pre-op testing, the surgeon himself told me no prep needed, just clear liquids for 24 hours beforehand yeah .  That went over well tongue !  His assistant just stared at him..lol.  Anyway, I am still here, so everything was ok.  I had some complications post surgery but don't believe it was because I didn't take a prep.  One of the residents told me I could eat (too soon after surgery), about three days and BOY did I ever regret that.  Had to have that nasty NG tube stuck down there again.  Oh well, live and learn.
     Good luck to you!!!

Cleos
Regular Member


Date Joined Jan 2011
Total Posts : 38
   Posted 5/12/2011 9:48 PM (GMT -6)   
Thanks everyone for the advice, it is much appreciated.

My doctor told me that I could eat a normal diet straight away after the ileostomy, and the only painkillers that I would need was Paracetomal.

So I shall wait and see, what happens.

Take care
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