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Q: Total Abdominal Colectomy
asked by: macbeck5 on February 10th, 2006
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So, I just had a colectomy :( ( the whole large intestine removed)....What should I worry about and what will my body be lacking? Will I come into trouble down the road? I feel helpless because there isn't much info on this matter
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lerinmartin
replied on February 27th, 2006
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I'm 23 and had a total colectomy when I was 14 after years of ulcerative colitis. I could probably answer some of your questions...

Do you have a jpouch now or ostomy?
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macbeck5
replied on February 27th, 2006
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They just connected it down to the rectum. I don't know what and if I am going to be deficient on anything or what to do when I get backed up....I have been a little constipated and I am scared to death to take anything for it. And sometimes my feces is black!!! Kind of scary.
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sunnystatemom
replied on March 12th, 2006
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I had a total abdominal colectomy one year ago and everything was going just fine until about 2 weeks ago. I was able to have normal bm's an now I don't feel like I can go. I also am scared to take anything for it other than my normal 2x a day metamucil. I also had my small intestine reconnected to my rectum. I am concerned I have scar tissue or a bowel obstruction any advice on how I would know?
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macbeck5
replied on March 13th, 2006
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I only take benefiber twice a day!!! And all the roughage like carrots, lettuce, corn, etc hurt to no end when it is time to go poo. I hope someone is out there that could give advice. I have been having sharp pains where my intestine was connected to my rectum. And I too would like to know what to do.....I have been having trouble with bm's and I am getting scared. It has been 9 months since my surgery.
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lerinmartin
replied on March 20th, 2006
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If you absolutely cannot "go" and your abdomen is distended, and you have sharp pains, that is most likely a bowel obstruction or an adhesion. In which case, you need to seek immediate medical care. I've had a couple bowel obstructions/adhesions and they're not fun. They had to do a sigmoidoscopy to correct the problem. To do this, they made very small (1/4 in.) incisions in my abdomen, stuck two cameras in there and did t he surgery through the other hole. These healed up nicely and left unnoticable scars. The second time, they went through the same scars.

As far as depletion, your small intestine pulls most nutients out of your food before it moves to the colon. The main thing you need to worry about it dehydration. It's very easy to get dehydrated since you don't have a large intestine. My stools are usually loose, but formed and I use the restroom about 6 - 8 times a day. A lot depends on what I eat. I've learned to incorporate some kind of salad or veggie into every meal. Otherwise, stools have more of a diarrhea consistency. And this helps me have regular, predictable bowel movements. I absolutely stay away from things like nuts, popcorn, sunflower seeds, seeds of any kind, spicy food, eggs, and dairy products. Most of these need no explanation because, as you can imagine or have experienced, the food we eat comes out pretty much the same as it goes in.

Not sure about the black stools...

Let me know if you have more questions. Anything specific I can help with..
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macbeck5
replied on March 20th, 2006
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Thank you so much!!! I was wondering if I was alone with this problem!!! Now, I drink tons of water due to the dehydration....But what do I do about the gas build up.....I mean, I eat lots of fruit such as peaches and applesauce and such....But my stomach gets so distended by the end of the night and I have tons of pressure to poo, but it seems as though I can't always get a complete bowel movement and that my body has a shut off switch after a short time of pushing.....Like it plugs up and then I have to wait for a while to finish.....And what about the horrible loud flatulence with every bowel movement????

I am going to ask lots of questions because I haven't had anyone to ask....My doctor is a state away and I haven't reallygotten lots from him

dont forget that corn doesn't do much for the system....It hurts coming out!!! And I do have sharp pains all the time when my intestine is full..... Is that normal?

I really want to thank you for responding.....There isn't anything else out there for the information!!!!
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lerinmartin
replied on March 22nd, 2006
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It's good that you drink lots of water. That keeps keep your digestion running smoothly.

Depending on what I eat, I also get gas pretty bad. Usually I have it throughout the day. Food doesn't stay in me long enough to cause a noticeable odor so it's not usually a problem. The only think to do about gas is try and prevent it. Stay away from dairy, broccoli, eggs, gum is a huge one for me. I do not chew gum ever. I'll look like i'm in my first trimester if I do. I don't drink soda or eat hard candy. Carbs make me bloated anyway so I try to stay away from those and excessive sugar. (no, chocolate, candy, cakes, ice cream).

If your gas gets painful, beano before a meal prevents it, also gas-x after a meal works well too. I don't mess with those too much though since a little bit of air in your tummy is good. It keeps things moving along.

One other alternative is runnning. Somehow, while you're running, your body absorbs the gasses in your intestines. I've never had gas after a nice run.

Ok, pressure to go #2, but you feel like there's a shut off switch. Initially, I experenced this too. Since you have no large intestine, you can't store as much food as you used to be able to. Therefore, your meals have to be much smaller. Eating a huge thanksgiving dinner in one sitting is out of the question (for me). I'd be miserable. Instead, I started eating very small portions throughout the day. Instead of 3 big meals, I eat 6 small meals a day. I'm never excruciatingly full and don't experience the "shut off" switch any more. Also, I try to eat some kind of veggie with each meal to keep things flowing along. I mostly stay away from fruits for sugar and they make me gassy. Especially apples!

"going" now is a quick process for me. About 7-8 times a day depending on my diet and a very small amount. About 1/2 cup i'd say. And no pushing required. When your body needs to empty itself, it'll let you know. And pushing puts a strain on those stiches that are still healing (a very delicate area that you want to take good care of. A very small portion of your rectum still has uc so you don't want to irritate it.)

loud flatulence. Yes, this is something i've struggled with for years. I'm now 22 and have been trying to figure out ways to quiet this occurence since I was 14. There are a few tricks. Flush at the same time you think there will be a noise. The noise is usually quick so the flush works. You'll get to where you can time it so the loud rumble at the end will be in sync with your bm. Then, of course, you have to flush again when you're done. It also works well because it's a courtesy flush, although there's usually not much of a "normal" smell. Another trick is to take a few sheets of tp and hold them over your bum while you go. If there's a lot of stool, just let it drop into the toilet and get another wad. This, in combination with the syncronized courtesy flush works great. I can usually get away with going just about anywhere (although I hate bathrooms which are connected to the bedroom/living room or that have tile floors, etc.) i've become hyper aware of bathroom necessities. You will too:)

if it hurts to go, give your tummy a break. Stick to water for a day until you clear yourself out. Then ease back into it with small intestine friendly foods like toast, applesauce, mashed potatoes with a salad (can't forget the greens!) to keep you from binding up. You'll feel a ton better.

Finding the right balance is key. After I had my surgery, I had no idea what to expect. I kept track of how different foods affected me, stool consitency, gassy, constipated, came out whole, diarehea sp?, etc. Then, I took that and mentally made note of 'safe' foods. Of course, I goof every once in a while, but for the most part, i've got it down to a science. Also, watch your sodium intake. Since I don't have a large intestine, I retain more water than normal. Like P percent more. The only way around swollen ankles and a puffy face is drink gallons of water a day and do not consume salt. Period. I hope you don't have this problem though.

As far as sharp pains, i'd say try to eat smaller meals more frequently. And stay away from foods that make you gassy or don't digest well (popcorn, corn, broccoli, dairy, soda)

hope this helped.
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