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After resection - how would I know if Crohns came back ?

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Crohn's Disease
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Posted 10/14/2010 8:17 AM (GMT 0)
Hi a question for anyone who has had a resection and a return of Crohns.  I had an open resection 4 weeks ago, about 30cm of small bowel containing strictures and active Crohns.  My surgeon says I am now Crohns free.  Since the op I have had an infection and was readmitted to hospital to have a drain fitted and hit with high dose antibiotics.  Now finished antibiotics and drain has been removed so hopefully I can start to recover.  My question is as I am still having a lot of explosive bowel movements (and have been warned this could go on for some time) how would I know if I had been unlucky and the Crohns had set up camp again as D was my main symptom ?  I am seeing my surgeon again in 4 weeks but my GI didn't want to see me for 6 months. Any advice would be welcome, I know resection can be an end to problems for a long time for some but others have have been back to square one very quickly. thanks   
Posted 10/14/2010 2:15 PM (GMT 0)
I had a lower bowel resection and my symptoms have returned, 7 years later. Althought it is common for the 'disease' to return to the site of the resection, mine has shown up in my small intestine involving the ileocecal valve.

Crohn's never goes away - it isn't curable, so for your surgeon to say you are Crohn's-free isn't really true. I believe he should have said he removed all visible active diseased tissue.

Worry is stressful - that's the last thing you need right now. You might want to put a call into your GI doc and discuss your concerns. To say severe diarrhea "could go on for some time" is a bit vague.

Good Luck!
Posted 10/14/2010 2:25 PM (GMT 0)
Explosive diarrhea is very common after a resection. After each of my surgeries I had explosive diarrhea for about 4-6 weeks until my bowels adjusted to the changes. Some folks will continue to have diarrhea due to the surgery. They take something like Questran to help bulk up the stools. I think if your Crohns were active again you would really know it with additional symptoms and the diarrhea.

My biggest suggestion to you though is to make sure you get back on some type of maintenance med right away. After my first resection my GI (now fired) told me I no longer needed meds, so I didn't take them. I ended up having to have a repeat surgery only 3 years later due to another obstruction. So get back on meds if you are not already. Good luck!
Posted 10/14/2010 5:01 PM (GMT 0)
Mine returned after a month, but my symptoms were things like vaginal and peri-anal sores that I get when I flare, extreme gas, joint pain, etc. I did have the big D after surgery but that has slowed down considerably and is a typical side effect of the surgery for some time.

We did a scope 8 weeks after my resection and there was already inflammation. I actually asked for the scope; part of me was in denial that my disease was so active again so soon and part of me thought it might be in my head ;) No doubt about it, it was rearing it's ugly head in the same area again. I now have an external fistula as well. Fun fun!

I'm surprised your GI doesn't want to see you for 6 months. I saw my surgeon for a routine followup a few weeks after surgery and he released me back to my GI. My GI saw me 4 weeks post surgery to talk maintenance meds but by that time, I was already having symptoms so we talked more than that =)

Is your surgeon giving you a script for maintenance meds? You don't want to wait 6 months for those!
Posted 10/15/2010 1:14 PM (GMT 0)
mine returned within 3 months. I was having nasusa, stomach pains, but no "D"- which i rarely get with my CD. Dr. finally did another colonoscopy and there it was-inflamation and such right where the resection was done. I have since had more problems and have had another CT scan with barrum. There is already narrowing at the site and Dr put me back on soft foods while he tries to get the inflamation down.

I started 6mp 2 months after surgery, could nto tolerate it. then switched back to remicade again- now on max dosage.
Posted 10/15/2010 2:31 PM (GMT 0)
I had a relapse 9 years post-op. I had that confirmed via colonoscopy. I wasn't positive I was relapsing, but had a general idea. I felt really tired with some gut pain. If I didn't have Crohn's I would have never gone to the doctor as I wasn't feeling that bad. You just have to listen to your body, if it's telling you something is wrong, listen!
Posted 10/15/2010 4:11 PM (GMT 0)
Mine also returned within weeks after resection. They saw it in ultrasound and confirmed it by scope a little later.
I think my surgeon left some microscopic CD in the same area. That can happen easily.

But my aunt had a CD resection 15 years ago and hasn't been sick since. No symptoms, no diet restrictions, only pentasa. She also had loose stools for a while after the surgery, but I'm not sure how long it lasted.

I'm planning on having a resection soon too, and afterward, I will follow a strict natural diet (no dairy, in case CD is MAP related), meds, and other natural therapies. I suggest you get on CD meds (at least pentasa) and some natural plan or diet to help balance your GI tract and help avoid infection and a new flare up. Probiotics would be a great start, if you haven't already done so. VSL #3 is supposed to be awesome, but I haven't tried it yet.

Hope you have a long remission!
Posted 10/15/2010 5:30 PM (GMT 0)
Had a small bowel resection and colon resection 3 weeks ago, sure enough I have incontinence and explosive Diarreah in the mornings only. Wear Depends overnight and the first I do in the morning is go to the throne.

I eat a small breakfast and go back to the throne. The rest of the day is normal.

A resection will get the intestines "together in the flesh" but the nerve endings are not, so the signals from the upper bowel to the lower bowel are all screwed up.

All this surgery trauma is going to trigger a flurry of scarring activity, Chrons included. It is difficult to separate normal healing from scar and the Chrons.


A Dr that will say to you to come back in 6 months is completely wrong. YOU NEED AGGRESSIVE TREATMENT FOR THIS, I made that mistake and I am paying or it

here is the additional side effects:

Diarreah - Since you have been on a low fiber diet, now you have to reverse course, By week 2 you should slowly crank up the metamucil, first once a day then increase as you reach week 3. The internal anastamosis should be completely healed by then.

If you go with Diarreah for more than 2 days, slow it down with 1 dose of Lomotil or Imodium, but only for one day, then if the Diarreah returns, wait 2 days and back to Imodium.

Potassium - Often ignored, I came many times to 2.5 level which can cause cardiac arrhythmia, make sure your Dr prescribes clinical strength potassium, each of these "horse pills" equals about 8 of the over the counter Potassium pills. Take Magnesium pills which help absorb the potasium.


Ensure - I bow to the "temple of Ensure" This is the wonder drink to get your weigth and strength back. I know of two people that have lived of Ensure ONLY, no other foods !

Walk or ride stationay bike - On week 3 I am up to 2 miles a day, 4 intervals. This helps the bowels realign, get circulation going and bring your energy back.

By the way I also had a drain put in with the live needle going into the belly, they gave me Fentanyl which was 150 times more powerful than morphine...Unbelievable this drug, never seen anything like it !
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