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Probiotics and supplements for life after colon

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Posted 4/15/2013 3:32 PM (GMT 0)
I was curious as to peoples' thoughts on this topic.

Vitamin K sounds like something worth supplementing after losing a colon, as it is absorbed there , from my understanding. There may be others. As for probiotics, my concern is in minimizing the risk of future crohns (a worthy goal even with a totally "certain" UC diagnosis, because such certainty will never be total- 1 in 10 "certain" UCers find outnit was crohns post surgery sometimes years later) as well as other possible issues such as c.difficile, SIBO, etc that could become problems in the small gut that remains. There are studies that show VSL3 can not only help reduce pouchitis incidence and severity in jpouchers, but also help prevent or dampen ileitis.

The small gut has, I think , something like 1/100th the amount of flora for a given area of the gut lining- which still means an awfully lot though. It is much more an environment for lactobacilli and much less so for the bifidobacteria that predominate as probiotic flora in a healthy gut.
Posted 4/15/2013 4:33 PM (GMT 0)
I only took probiotics for a short time before surgery, because of a C Diff infection, and have not taken any since. Currently I take a chewable multivitamin and a calcium supplement every day. My surgeon said there really isn't a huge need for extra supplementation. She says that in time our bodies adjust to the new way of functioning, and all of what we need should be absorbed through the small intestine. She also said that if I would like to, after a few months she can do blood work and what not to see where all my levels are and that would give us an idea of how my body is adjusting. For now I choose to take the multivitamin because I figure it can't hurt and the calcium I take because I have been on Prednisone for so long.
Posted 4/15/2013 5:51 PM (GMT 0)
I take folic acid, a multivitamin, Vitamin D, and chewable calcium (Tums). My folate, Vit D, and calcium levels have been low since pre-surgery due to the flare, malabsorption, and prednisone/methotrexate use; at last check they were normal but on the lower side of it. My GI thinks that I physically could go without supplementation at some point in the future when I'm totally healthy and healed, but for now I choose to supplement since it's easy and it helps.

My surgeon tells me not to bother with probiotics until after takdown. I know VSL has been studied for treating pouchitis but I'm not sure if it's been studied for pouchers to take on an ongoing basis for pouchitis prevention. I mean, it makes sense that it would do something, I just don't think they've looked at it. I do eat a lot of Greek yogurt with active cultures -- doesn't pack the punch of a real probiotic but I think it helps to some extent.
Posted 4/15/2013 6:23 PM (GMT 0)
I hear ya, Liz. Still, I think that docs are generally way behind the curve on probiotics just as they are now behind the curve on the larger surrounding science of the Microbiome (which, were it more developed years abo would probably have negated the need for us to face and do surgery). So rather than wait another 10-20 years for them to come around to thinking probiotics might be great idea for crohns prevention in remaining gut, post colon, I'd rather be proactive. Granted, mountains of probiotics havent helped me avoid deciding on surgery in the end, but for better or for worse they did dampen my UC symptoms and reduce flare frequency, for years. And I remember all too well how pretty much all my GI's, until the past 5 years or so when the articles started hitting the GI publications and conferences, dismissed probiotics as a gimick.

I am keen to start getting into healthy homemade fermented foods post colon (not just homemade yogurt though I miss that, as I learned to avoid dairy the last few years), now that I should be able to expand diet more from my fairly retricted version of paleo I settled on, but am a bit nervous re. whether some will create too much gas for my ostomy. But I guess the's no harm in trying, esp. at home where I can easily burp the bag.
Posted 4/15/2013 9:16 PM (GMT 0)
Maybe acidophilus and l-glutamine for the SI? And I would do the ferments as well. Look at the pickl-it fermenting jars. They're supposed to produce the most lactic acid which is great for the gut. They're also supposed to be the most tolerated for people with gut issues from what I've heard. I'm trying to figure out how to get them sent here (they're in the US so you shouldn't have any issues).
Posted 4/15/2013 9:44 PM (GMT 0)
Kill- can't you just drive down to Buffalo and pick some up? Surprised you cant fund those somewhere in TO though. Like i say, my only worry with ferments is whether they will be too gassy for an ostomy (well, same issue for a jpoucher really). But It may be something to enjoy at home at least, if not at work.
Posted 4/16/2013 12:17 AM (GMT 0)
I have been tested for lack of Vitamin K and 12 years out; my Vitamin K levels are okay WITHOUT supplementation. I take probiotics and I eat a lot of healthy yogurt. My B-12 levels are normal without supplementing. The only things I take are Vitamin D, because my levels were low, and Calcium because I am a woman over age 35. I would be wary of just supplementing for the sake of supplementing. At your annual doctor visits, just ask to have these levels tested. Just because we are lacking a colon does not mean we aren't getting all the vitamins and minerals we need.

Sue
Posted 4/16/2013 2:27 AM (GMT 0)
Good points, suebear. I do have some decent baselines going into surgery. I have always been low in certain things eg vit D, absent supplementing it that is.
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