mucus from diverted colon

I'm now 3.5 months post surgery for a permanent ileo and for the most part doing really really well.

I still have part of my colon left inside but it's stapled up and just diverted. My consultant said to expect to pass the odd bit of mucus every now and then - which I have been. But more recently have been getting the odd bit of pain/discomfort (esp on the left side) and needing to pass larger amounts of mucus (and assist it out! - sorry gross). At the weekend I had a spasmy pain in my rectum and had to fish a large lump of mucus out! UGH! My consultant mentioned the possibility of 'diversion colitis' in which case he'd go back in and remove rest of colon. Dont' think it's come to that yet, but just wondering how 'normal' this is?

Dont' get me wrong, it's not a major problem and not at all debilitating but just wondering whether it will continue to get worse? if it's normal? and what to do?

I've heard about irrigation.. what does that involve? Is there any other treatment option?

Rosemary might be able to help here - I think I've heard her talk about this problem too.

Thanks as always for any advice.. Sarah

Hi,

Unfortunately, while ostomies may save and improve our lives, surgeons and other doctors don't always offer complete information before we choose this option or have to get them.

Many folks with a colostomy (which I have) or ileostomy suffer from diversion colitis months after sugery. This has to do with the lack of 3-chain fatty acids which we no longer have in our rectum due to the diversion. Without them, we are subject to inflammation -- a primary symptom of diversion colitis -- and cramps in the left lower quadrant. Sometimes, there is also a small amount of blood that comes with this output of mucous but it's not "dangerous" -- although you should inform your doctor and get a sigmoidoscopy to be sure. My surgeon has recommended the use of Canasa suppositories or Rowasa enemas to deal with the inflammation and decrease the amount of mucous. I'm still a case in process so don't have an answer for you yet. But, it's a common condition that we learn about later -- and I'm living with it for now. Some get rather major surgery for this with removal of the rectum but I'd prefer not to do so. If you go to the General Discussion Group at www.uoaa.org and do a search, you'll find several perspectives on this.

As far as irrigation, only those with colostomies can use this procedure which cleans out the colon. It really has little to do with diversion colitis although sometimes elimination via irrigation may decrease or increase the amount of mucous depending on the ostomate. Again, go to the discussions at www.uoaa.org and see the Forum at the bottom called Gators -- for irrigators. ;) Lots of valuable info at this website. Also, at youtube, if you do a search, you'll find an Australian man (I believe) who describes and shows the irrigation process.

Hope this helps! Good luck to all of us!

Artzfan

Ah, I overlooked the motility issues when I made my response. Makes my advice pretty irrelevant. ;-)

Hi Sarah,

Yes I posted on your other thread about this. I have my colon and rectum suctioned of the mucous about every 6 months. In between I use warm water enemas to get out mucous lumps or strings.

I had in 4 years so far only one case of active disuse colitis this past July. It followed a routine warm water enema that I use only when I feel that there is a lump of mucous in my rectum. I got the lump out, but then for a week I had severe low cramping, in bed two days to make it go away. THEN even though I have an end ileo with no colon/rectum connection, every time I ate it would trigger me "going" rectally and expelling new and old bloody liquidy mucous. It was awful.

My doc said if this did not stop on its own as it did in a week, he would have prescribed anusol HC steroid suppository, some anti inflammatory suppository, I put the name of it in the other post you had on this, and if that did not work he would have prescribed a Butyerate short chain fatty acid enema. The lack of short chain fatty acids which is normally in a used colon and rectum is what makes us have diversion colitis. Hope this helps. The name of the anti inflammatory suppository is down stairs now but I listed it in the other post on this subject. Hope this helps. Rosemary

Thanks Rosemary.. that bout of colitis sounds awful. When you say you have your colon suctioned - who does that for you? is it your doc? or nurse? At the moment I just feel like I've got low grade period pain. Not terrible and I feel just fine, but there all the time. Plus lots of mucus today. BLEUGH! Thanks for the advice. Sarah

mmm.. can't wait! thanks