After Bowel resectioning

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.

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.

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. 

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

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).