At Home with very Frequent BMs after Rectal Surgery 12/30/09!

lizzydavis said:

This is what I experienced also...
I also experienced the same. This article might be helpful to you.

Quality of Life After Colorectal Surgery Annette Bisanz, B.S.N., M.P.H.


----------Following colorectal surgery, there may be a change in bowel function due to the change in the anatomical structure of the colon or rectum, or both. This may necessitate a bowel management program that is based on the same basic principles but needs to be individualized for each person. There is all the reason in the world to believe that your bowels can be managed after colorectal surgery.

----------These are the prerequisites for managing bowel control: · Be committed to the program and be willing to follow specific directions. Seek guidance from a professional when you are not achieving the goals of your program.

------- Keep your sense of humor. Following colorectal surgery, many people find themselves having several stools per day. Bowel movements may be clustered at certain times of the day, and often there is an inability to fully empty at one specific time. The normal frequency of bowel movements in a healthy population varies from 3 bowel movements per day to 3 per week.

-----The goal is to return to no more than 3 bowel movements per day. Transit Time of Food Through the Gastrointestinal TractEating a large meal or drinking a hot liquid will cause a normal peristaltic push down in the gastrointestinal (GI) tract.

---- When frequent bowel movements occur, drink less fluid with your meals, drink more fluids between meals, and avoid hot liquids. Medicinal Fiber to Change the Transit TimeIf you are having frequent stools, then introducing psyllium, a medicinal fiber also known as Metamucil, can slow down transit through the GI tract.

-----Most people take psyllium for constipation or to speed up transit time through the GI tract; however after colorectal surgery, your goal will be to slow down the transit time. To do this, take the prescribed amount of fiber right after a meal in very little fluid, approximately 2 oz., and no more fluid for 1 hour immediately after a meal. This allows the fiber to act like a sponge in the GI tract, soaking up excess fluid in the digestive system and thus slowing things down. One teaspoon should be taken after the same meal each day for 3 to 5 consecutive days. Then increase to 1 teaspoon psyllium 2 times per day.

-------Gradually increase the fiber by 1 teaspoon every 3 to 5 days until the GI tract transit time slows down a bit. Bowel TrainingOnce your stools become better formed and the transit time has been slowed down, the next step is bowel training, with the goal of emptying the colon fully at an expected time each day. Pick a meal of your choice around which you'll bowel train yourself. Bowel training is done around a meal since a big meal causes a push down the GI tract to make room for the food taken in.

-------Choose a time when you can consistently follow the program.
Then, · Before that meal drink 1 oz. of prune juice. · Eat the big meal.· Drink a hot liquid. If this does not produce results, you may try using a glycerin suppository after the hot liquid.· Do this for 3 straight days. If you don't empty as planned, substitute the glycerin suppository with 1/2 bisocodyl suppository. · If this is effective, stay with the program for 2 weeks and then stop using the suppositories. By this time, the stimulus for your bowel to empty will be the prune juice, big meal, and hot liquid. Adjusting the Bowel Management ProgramSince each person's body reacts a little differently, don't get discouraged if your program doesn't immediately help. Problem solving is the key to success, and little changes made after trying something for 3 days will help you determine what will work for you. Overall bowel management involves a gradual balancing of food, fluid, fiber, and medications.

_________Food: If your bowel is stimulated by a big meal, eat 1 big meal per day and 4 smaller meals. Certain foods affect people adversely, and you need to be aware of what you eat that may cause increased bowel movements. (High-fat and/or spicy foods seem to affect many people.) Fluid: Fluid with meals tends to increase peristaltic push-down. So, drink fluid in between meals instead of a large amount with meals and avoid hot liquids.

________Fiber: Adjust the amount of fiber gradually to determine how much fiber is required to slow down or speed up transit time through your GI tract and maintain soft, formed stool.
______Medications: If you are taking anitdiarrheal medications such as Lomotil or Immodium, as you gradually increase the amount of psyllium, try to decrease the amount of Lomotil/Immodium. Most people get good bowel control just by the use of fiber. However, keep yourself comfortable during the process of defining your maintenance bowel management program. Be patient with yourself. Remember, there is hope for bowel management, the goal being a high quality life after colorectal surgery. Next Issue: The Resource Review column will review the video "How your Bowel Works" by Annette Bisanz, B.S.N., M.P.H.

MY colorectal surgeon told me that things will improve over time. It have begun to see improvement. Hang it there!

Sundanceh said:

The Long and Winding Road
Hi MJ

My story is not anywhere close to anyone else's on this board - my experience with bowel resection is not typical.

I had 25x of radiation in the rectum and surrounding areas before surgery, so I was already a mess prior to a "major surgery" as you elude to above.

I was spared a colostomy as well and did not even get a temp, 'cause the margin was so small, I was afraid temp would turn to perm.

I now know why they do "temps." Of course, after all that radiation and the major surgery, I never did get to "rest" my bowels at all - they just kept going and going and going - like the Engergizer Bunny. I too could not get too far away - I had to work though and there were days when I just had to leave it was so bad - or I was too sick to even make it in.

So work and home was the best I could manage the first two years out. The next couple of years things began to settle down and has become largely what it will be for the remainder of my life. Bad days still happen and sometimes without notice, but you just take those days and remember where you were long ago.

So, to summarize, 2-4 years recovery for me (But I'm the exception not the rule) and life is what it is. I took the hard road and certainly paid to have it paved.

You've already said it - just takes time for the new bowel to figure out the new route, stuff has been removed that were important enough to be there in the 1st place, so when you take out key mechanisms, it stands to reason, that things will never be quite normal again - only what you can live with.

The days will pass - just roll with it - Time will help to heal this up and you'll look back like me and think "How did I do that?"

-Craig

k1 said:

Similar situation 4 months post op -- feeling discouraged
Initially after my resection I seem to be healing like you would expect, with stools getting more solid each day. Escaped a bag by less than an inch of rectum in my surgery. Somewhere around week 4 post op all hell broke loose and I started having what you are describing only sometimes up to 20 or more bm per day, and ran lowgrade fevers at night. And these bm also hurt -- you didn't mention if there was pain or not. This week I am four months post op and no improvement in bm although having fevers less often. My doctor said also at my one month post op appointment this would get better in time... it hasn't.

I was put on the Metamucil daily and also had to be put on iron supplements due to severe anemia. Was told both the Metamucil and the iron, as an added side effect, would "bulk up" my stools. Also tried to stop drinking with meals.

At 8 weeks post op had a CT scan that showed inflammation and infection in places in my colon that had been clear before surgery. I took two weeks of Levaquin and Flagyl and by the end of those prescriptions I was feeling much, much better. Finally, I thought, life is getting back to normal, could eat things and only had two or three bm per day and they were more solid. I remember going out to eat and enjoying it during those 10 days.

Exactly 10 days after finishing the antibiotics and living life somewhat normal bms for first time since surgery, it started all over again. My doc suspected C. Difficile infection and although I was tested three times for it the results were always negative. I'm getting ready to have another CT scan and not looking forward to it due to worry over too much radiation. Whenever the drs. deem it safe, another colonoscopy, to look for problems too. I would have had the ct scan last week but I was too sick with flu like symptoms and sinus infection to go there. Scar tissue, adhesions, obstruction have all been mentioned as possibilities.

Yes, it's hard to travel anywhere like this and I have had to go into a public restroom for a long period and finally leave, only to have to go back in it seven or eight times before it was safe to leave the store. It makes you not want to go out at all. I once missed an important post op appointment with my oncologist due to being stricken on the freeway in traffic, having to get to an exit and go in a burger joint and being there so long with diarrhea and painful bms that my appointment time ticked away. I lost my job due to running out of leave and at this point with these problems wonder how I can even look for work.

Due to the severe gastro distress I was having I could not get cleared to start chemo in January when I was supposed to start it. I was sent to a dietitian for consultation about three or four weeks ago and was put on a very low fiber diet. No vegetables, no fruits except canned peaches, white bread, white rice, nut butters and soy milk for protein (lactose intolerant to regular milk). No prunes, dried fruits etc. No nuts. This is all foreign to my way of eating since I have for years done whole grains and usually eat lots of fruits and a moderate amount of vegetables (usually raw).

The diet helped only a little, but a little is better than nothing However, this week I had to go on antibiotics for a severe sinus infection, and I'm having a major colon blowout now and thinking about discontinuing the antibiotics (Clarithromycin) and have had probably 30 bouts of debilitating diarrhea just today. It makes me very weak and not wanting to eat at all. I lost 22 lbs. since surgery but am losing it at a slower rate now than I was at first.

After four months I am wondering if this will ever end. This is the first time I have read the instructions on retraining the colon and appreciate the post. I will actually have to get over this blowout from antibiotics before I can try it.

I am discouraged and depressed about this predicament, and at this point wondering if it's going to be permanent. At least I'm not running fevers as often. But I have very little energy. Thinking this might be lifelong is really depressing. Thinking I have to eat white bread long term is also depressing! If a healthy diet helps you heal, what is the result when you can't eat a healthy diet? The dietitian said don't worry about it for now, but I do.