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rthornton, no colons, and semi colons-- help me, please.

neeliec
Posts: 106
Joined: Mar 2005

I had total colectomy on July 28-- last Thursday. Apparently all went well, and I went home 5 days post op. On the second day at home, I began to have abdominal cramps and vomited all night and most of the next day. I was re-admitted with severe dehydration and elevated white blood cells. NG tube went in, along with T"PN- nutrition and IV for hydration. Four days have gone by now-- and the NG tube is out. I am supposed to start on a lqd diet tonite and tomorrow and hope that all goes well. Ran (R thornton) Can you give me hope and advice?) Any others that can share how you fight the dehydration of not having a colon? How do you manage your bms and work?

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rthornton
Posts: 346
Joined: May 2005

It's interesting that I thought about you a couple of days ago, as I remembered you were having a total colectomy. I'm glad to hear the operation went well, but of course I am sorry to hear about the dehydration problems.

I never had problems with hydration, but my father had such problems when he had his colon removed (he has a J-pouch). He found that if he drank water, or any liquids, too quickly that they passed right though him as diarrhea. I think that one of the purposes of a colon is to absorb water from food, but without the colon to assume that responsibility a lot of water passes straight through (hence, many people with colectomies deal with excessive diarrhea). My father learned that, for him, he had a much easier time if he drank water but sipped it slowly. This way, his small intestine had an easier time absorbing the water and as an added plus it would not pass so quickly thru his system, so he had less diarrhea. Diarrhea will probably be the norm for you anyway, as your body learns to adjust to its digestive system. Eventually, you should adjust to it all but bathroom habits will never be the same. Most people, after colectomies, go to the bathroom several times a day. But again ... it's an adjustment. My father, after his surgery, would go about 10 times a day, and now he goes only 4 or 5 times. After my surgery, I was going 5 - 7 times, now only 4 or 5 times daily. You mention going on a liquid diet immediately, but I would guess that soon you will be placed on a low residue diet. After my surgery, for about two weeks I had to avoid high fiber foods. When the surgeon finally gives you the green light to eat whatever you want to eat, you might want to try adding fiber supplements to your diet and slowly incorporating high fiber foods back into your diet. They make the whole digestive process work much better. Also, I eat a lot of grits. That seems to slow down my system, so that I have less bathroom trips.

So, try drinking lots of water but drink it slowly, in small sips. Give your body time to adjust, and don't forget the trauma that your body has been through. I remember feeling impatient after my surgery and people had to remind me that I was still healing. And remember that fiber supplements and high-fiber foods will improve the performance of your new digestive system (but ONLY after the doctor takes you off the low residue diet).

I hope this helps. Let me know if you have any other questions. I hope that everything works out very well for you.

Rodney

cal79
Posts: 57
Joined: May 2005

I did not have the same surgery as you, but I had a temporary ileostomy which meant that the colon was not in use while the internal wounds healed. My stomal therapist advised me that one of the major functions of the colon is to absorb salt and water from foods. Therefore, after my surgery it would be a good idea to drink (or sip slowly!) electrolyte replacement drinks as they do a great job with dehydration while your body gets used to the new mechanics. This worked well for me, and I had no problems with dehydration or blockages after starting this . Hope all goes well!

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rthornton
Posts: 346
Joined: May 2005

Oh yeah! That is an excellent point about the colon absorbing not only water from food, but also bile salts. Without a colon, these bile salts can pass right on through the small intestine all the way through the anus, and they can create a burning sensation when you go to the bathroom. But again, it is an adjustment that your body will make. Eventually, the burning should go away.

For me the burning did not go away until very recently, but that is because I developed an anal fissure. My father had much better luck (no fissure for him!) and the burning stopped much sooner. It's just a part of the healing/adjustment process, and only something to keep in mind. You might never experience the burning diarrhea, which would be good. I just want to mention it because no one told me about it before the surgery.

Best wishes!

Rodney

neeliec
Posts: 106
Joined: Mar 2005

Thanks to your advice and encouragement. I do need to be patient-- I want sooooo much to be back at work!!!! I am starting to get a bit scared wondering if I'll be able to handle the new anatomy. Thanks to you and all my friends here, I am a bit more hopeful.

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rthornton
Posts: 346
Joined: May 2005

I am glad to be helpful in any way possible.

There is something I forgot to mention. Since you will probably be visiting the bathroom much more than you are used to, it will be good to get a sitz bath and use it 3 or 4 times a day. A sitz bath will be a good friend to have as you recover!

Rodney

steved
Posts: 835
Joined: Apr 2004

Not quite the same situation as I only had my rectum removed but can identify with your symptoms as had many of them after my ileostomy reversal. The periods of vomiting and pain occur when the bowel develops an obstruciton (which is usually mechanical not phcysical ie the bowel just doesn't move along rather than getting blocked in any way) which isn't uncommon after your surgery. The NG tube gives the bowel a rest and a chance to restart. This happened to me 2-3 times after my op and then settled. I know others herre have had similar episodes that have left them back in hospital dehydrated and needing iv fluids. It will pass and the bowel will then get a chance to start agin. Take it easy and accept it does take longer than many of us wich initally to settle. A few months on I am back at work and still need to keep an eye on wherre the loo is but with some loperamide and careful diet am doing okay. It took a few months though and still isn't 100% but slowly progress comes. I am not good at set backs and get very frustrated when they occur but just try to keep an eye on the bigger picture which is about making slow and steady progress.
Let us know how you get on and best of luck,
Steve

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jana11
Posts: 708
Joined: May 2004

I agree. When I eat a lot of natural fiber (fruits and veggies) I still get diarrhea. The additive fiber works great for me. I still take it every day, as rec by my surgeon. At first I didn't believe it because fiber is a treatment for constipation, but lots of GI surgeons rec it. I asked my friend who is a nutritionist for transplant surgeons; and she agreed. Start with just a little. Smooth transitions are better.

Also, when you have chronic diarrhea, the diet that helps is the BRAT diet. Banana (for potassium), rice, apple sauce (no peel because of the fiber, and toast (dry). NO dairy products, butter, sauces. The sports drinks have electrolytes in them; and are therefore very good.

I hope you heal quickly. Hang in there. jana

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