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Colonic polyps and ileorectal surgery

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Posted 11/5/2011 4:04 PM (GMT 0)
I have had multiple tubular adenomas for the past 30 years and have had colonoscopies every 2 years where these polyps are removed. The last colonoscopy I had resulted in a perforated colon and subsequent surgery. The surgeon and the gastroenterologist and a counselor from Genetic Counseling have strongly suggested that I have a partial colectomy--removing the colon and attaching the rectum to the small bowel. Has anyone ever had this surgery and if so what can I expect. The surgeon has told me to expect 3-4 bowel movements a day and there will be medications that I can take to curb these movements. I can deal with that amount but have heard some horrifying stories of up to 30 a day. He is not connecting the anus to the small bowel which I was under the impression that causes more BM. Any information is appreciated. Thanks.
Posted 11/6/2011 9:29 PM (GMT 0)
Hi LCDD.. welcome to the forum. Sorry to hear of your perforation and surgery.. not nice :-( I don't know much about this apart from my closest friend has just had a sub-total colectomy for genetic cancer gene. They found cancerous polyps in her colon and removed almost 3/4 of it instead of just a small resection, as it would almost certainly come back. She doesn't have a bag, and still have some of her colon left. It's early days, but so far it's working ok and she's starting to eat. She's on about 6 x per day at the moment but only 2 weeks post surgery .. so as I said very early days. She had her surgery in New York.

In your case they're suggesting an Ileorectal anastomosis - where the whole colon is removed and your small bowel is attached to the rectum. Have you discussed your options with the surgeon? a J pouch would possibly be an option for you - although complicated and multi-step surgery, may have a better outcome. That said, there are peeps on here who have had IA and are coping just fine. Immodium type meds will slow the movements and you may find it's not that bad as you imagine. Although I really don't know as I chose to have an ileostomy bag instead of the total colectomy. Suggest you start another thread and ask for experiences post total colectomy sugery. Good luck.
Posted 11/6/2011 10:10 PM (GMT 0)
Hi Ironmum. Thank you for answering me. From my experience with my surgery (they took out only 4-5 inches of colon) it took a full 4 weeks before I had returned to "normal". Between the antibiotics and other meds given me I think it took that long for my colon to calm down. Your friend having only 6 movements per day and only 2 weeks from surgery I think is excellent. I do hope she drinks plenty of fluid as it will be easy for her to become dehydrated. My surgery will be done at Yale and I have complete confidence in my surgeon but you posed some excellent suggestions. I will google J pouch. My surgeon is planning on doing this laproscopically thus making recuperation quicker. (I hope so). I also was told that those who have had IA have quite a few BM's a day and actually awaken in the middle of the night to go to the bathroom. My surgeon insists this will not happen with IR surgery.

You are young and having a bag would seem to be the best for you as I am sure you have a very active life and this affords you the flexibility you would need.

I wish you friend the best of luck and hopefully if she has children they be tested and have colonoscopies very early in life. There is a FAP gene where polyps show up in the early teens and not taken care of these people will get colon cancer by the time they are 40 years old as per the genetic counselor.

Thank you again for your input.
Posted 11/6/2011 10:19 PM (GMT 0)
Hi LCDD.. yes she does have children and will be getting them screened for sure. She lost her dad, brother and sister to colon cancer, so has been screened regularly herself for the last 5 years. That's how they found the polyps. It's an awful gene and she is pretty scared, but doing ok. She's hoping that gene therapy treatment will be available for her kids as they're only 10 (twins) at the moment.

It does sound like you're in great hands with your surgeon. Wish you well with it all. Keep us posted and ask as many questions as you like! there are some amazing people on here with loads of knowledge.
Posted 11/6/2011 10:51 PM (GMT 0)
Hi again. Thank you so much for your support. I am trying to post the question that you suggested but I don't know under which location I should do it under. There is no location for polyps.

Just curious. Did your friend have colon cancer or were the polyps found precancerous. Please tell her not to be scared. Preventive medicine will keep her children alive and well. The Genetic Counselor told me that it is a 50-50 chance that your child will have the gene. Her children will have to be screened early on and if she has FAP then her sons will be checked very soon. She needs to understand that even if they have this gene, they can be tested every year and should be okay. My daughter (33) just had a colonoscopy and 58+ precancerous polyps were removed. So she will be having colonoscopies every year until she has the same procedure I am going to have. At first she was upset but then realized that she did not have cancer and she is taking control of her health. I am curious as to why the surgeon didn't take the whole colon out of your friend and leave the rectum for her. She then would only have to have sigmoidoscopies, a much less invasive procedure. She is not the first person I have heard of that has had such a strong, morbid history. At least she is taking care of herself and will be around for a long time. My father was diagnosed with colon ca when he was 71 and is now 96, early detection.

thank you again. you are most helpful.
Posted 11/6/2011 10:57 PM (GMT 0)
Hi again. Thank you so much for your support. I am trying to post the question that you suggested but I don't know under which location I should do it under. There is no location for polyps.

Just curious. Did your friend have colon cancer or were the polyps found precancerous. Please tell her not to be scared. Preventive medicine will keep her children alive and well. The Genetic Counselor told me that it is a 50-50 chance that your child will have the gene. Her children will have to be screened early on and if she has FAP then her sons will be checked very soon. She needs to understand that even if they have this gene, they can be tested every year and should be okay. My daughter (33) just had a colonoscopy and 58+ precancerous polyps were removed. So she will be having colonoscopies every year until she has the same procedure I am going to have. At first she was upset but then realized that she did not have cancer and she is taking control of her health. I am curious as to why the surgeon didn't take the whole colon out of your friend and leave the rectum for her. She then would only have to have sigmoidoscopies, a much less invasive procedure. She is not the first person I have heard of that has had such a strong, morbid history. At least she is taking care of herself and will be around for a long time. My father was diagnosed with colon ca when he was 71 and is now 96, early detection.

thank you again. you are most helpful.
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