rapid gastric emptying with colonic inertia

Maybe I don't have a clear understanding of your situation, but when you say "they will remove my large intestine & connect my small intestine to my rectum", isn't that the same as a "J" pouch procedure? Didn't he even mention an ileostomy? I would be looking for options.

Yours would be an ileorectal anastamosis (connecting the small intestine directly to the rectum).

The major function of the large intestine is re-absorbtion of water. Nutrients are absorbed by the small intestine.

Your small intestine will adjust in time and learn to absorb water. Be prepared that you will need to be careful to avoid dehydration for the first several weeks/months post surgery.

Cera-Lyte makes a rehydration powder specific for people with intestinal diversion. I have used Cera-Lyte and highly recommend it. www.ceraproducts.com

You may also need to discuss with your MD if you will need vitamin B12 supplementation.

Best wishes to you for a successful surgery.

I would be afraid you might end up with a severe, burning diarrhea since you have rapid emptying and no gallbladders. That will be like battery acid and coming out of your rectum. Yikes. Maybe you could try something to bind the bile salts in your poop???

I have an ileostomy due to colonic inertia and pelvic floor dysfunction. I also have the opposite of you, gastroparesis, slow stomach and slow emptying.

Hi,

This is scary, and I'm glad that you've gone through all the tests. This provides a predetermination as to how things will be. Your gallbladder was removed 2 years ago, I hope that everything has been good with that. Is the rapid emptying because of the removal?

I had severe constipation all my life too. With intense pain and urges, but couldn't go. Surgeon still doesn't know what the cause could of been, not enough blood flow. My colon was ravished with diverticula, had many infections. Like you, I had ileo-rectal anastamosis. I too was told that I could be constipated on my small. But like you said, there are meds for that.

Not knowing what your outcome will be is the most scariest thing to ever experience. I'm glad you found this site beforehand.

Ask doctor about pain management....removal of the colon and manipulation of the small and connecting the two, is really ruff. I was open, wasn't a candidate for laparoscopic. I walked for the first time on day 4. Day 5 is when I had my first bm. Be aware of any changes with your eating and bowel movements. When you can, walk as much as possible, and try to ween the pain meds. I couldn't but maybe you could. Be careful of what you eat, just because it's given to you doesn't mean that it's what you should be eating after this type of surgery. Use better judgement. Some doctors state that you can immediately eat anything and everything!

Also ask the doctor how he will be surgically attaching your small to your rectum. Staples provide more probability of leaking and strictures. Best method is a good hand sew!! I had staples and sutures, and it disconnected.....hence my ileostomy. There is also an anastomotic ring that can be used. It's a ring with piercing edges that will hold the 2 areas together. After a few short weeks, it just falls out in your stool. The surgeon would need to do a rectal scope to see if it did, and see how the adjoining tissue is. This has been recently developed by colorectal surgeons at Mayo Florida. It hasn't any failure rate (aka leaking) and it keeps the connection open too so it has less change of stricturing (risk immediately following surgery.) It's not widely used yet, but it will get there.

Over the years, there were several people here with colonic inertia. I personally keep in touch with 2. One has a permanent ileostomy because of numerous other issues, and one is like you....but he has a slow gastric emptying (gp), always has.

Making an elective decision like this, is one of the hardest things to do. In an emergency situation, that is taken care of for you. Many, like you and I, come to a breaking point. Suffering is relentless. This also helps mentally preparing for surgery. Like you, I couldn't have been more prepared. I was scared, but exhausted of what my life had been. I'm very strong willed, so I did what I needed to.

I haven't gone in for my reversal, because when it detached or leak from surgeries onset, my surgeon had just left on vacation, and the attending didn't care to see my decline. The events that occurred afterwards have changed everything. I survived is all I can say. It's been over 5 years now, and I don't think I can ever muster up going back in. My surgeon even wants it to be in 2 steps....go in and attached the end of my small to my rectum and make an incision 5 feet up my small to make another ileostomy (loop), wait a month, do a rectal scope to make certain the incision is attached and tissue has healed, and go back in to take down the bag by going in through the stoma site and closing the incision in my small. Despite being 2 surgeries, this would be the way to go for me. Maybe one day I'll be ready.

I hope too that you won't be constipated afterwards. I was told the same that I might be. Transit time is hard to determine when the colon is removed. Your assessed on how things were before surgery. By the looks of your case, it might normal/rapid instead. We here can assist with that, as well as prior posts talking about the medical cocktail some have taken.

I hope these next few days/weeks will be great for you. After surgery, it takes time for things to heal, mobility to return, food intake increased, and almost a year for your small to become the function of your colon. I'm sure you will do just great, and look at progress on a weekly basis, not daily.

Some tips post op that I can recall offhand, wipes and some creams for butt burn, soft tissue paper, if you have the urge to go (especially in the beginning) go and don't hold it, incontinence pads in the beginning if necessary so you can venture outside or longer sleep (leaking and accidents are common and will subside with time), and prepare a food journal. Again, look at prior posts, they are a wealth of knowledge on the do's and don'ts of food.

As for me, and I'm sure it will be for you, I had a great enlightenment. After I was on a better level of healing, and realized how I was now as compared to before......I'm so happy to have that diseased colon out of my body. I truly have a new found life!

Hi- I'm glad your gaining the knowledge needed.

The few people with colonic inertia, they were told that it was a mega colon when it was removed. The colon's muscle, and when it's not spasming properly for many years and stool sits, it stretches. Doctors try to access during a coloscopy if it's longer than normal. Some doctors have told the patients during their colonoscopy that its maybe 3-5ft longer. Some doctors are spot on, some are not. Being enlarged, I'm guessing it's then normal that it will push on other organs, in your case, pushing your stomach, and your stomach pushing your esophagus. Sounds like it.

I found out I had diverticulosis when I had my first infection. I was 32, and the infection was in my ascending colon, towards the turn into the transverse. With this being part of the colon that is more liquid affluent, I knew that I was in trouble. GI's never seen a case like mine. I then had a GI scope me, and I had hundreds all over. For the next 3 years, I was fine, until the infections started and had one every 2 months. I stayed on Flagyl until my father died, I was his caregiver and he was in hospice here at home. I scheduled surgery after his death, and after my kids finished school the following month. I researched and had many consults and choose this fantastic surgeon. I was so tired of being bedridden taking care of 2 small children. I wanted my entire colon removed, and the surgeon scoped me beforehand because he wanted to see for himself. As a former president of the Board of Colorectal Surgeons, he never came across a case like mine.

Long story short, he went on vacation day 5. Day 2 I was in alot of pain, so I asked for a breakthrough pain med tramadol, in addition to morphine. This really helped. Be diligent with the surgical residents, you don't want to be in more pain than you need to. And if the residents do anything unjust, call your surgeons office and asked to have him/her paged to complain. The surgeon will then speak to the residents and get you on track. The residents took my morphine from me day 2, and I went into a paralysis. Surgeon was so mad the next morning, yelled at the residents in front of me because they do this all the time.

I was able to get out of bed on Day 3 and was bathed. They removed the foley and NG tube. On Day 4 I started walking the halls. On this day, I had some kind of sixth sense. On Day 5, surgeon told me he was going on vacation. That afternoon, I had my first bowel movement, and I knew it separated. The test I didn't receive was a gastrografin xray. This would have made all the difference. Because of the following sequence of events, I ended up losing a third of my body weight when I was discharged 7 weeks later. I still can't believe that I became that <2% statistic.

It took about 6 months for me to gain my weight back. I healed up quite quickly, took things slow, didn't have high expectations, ate slowly, ate in moderation, some things bothered my digestion right away but didn't a month later. Drink ALOT!! Have alot of salty foods. I drank about 150fl of water for awhile. Until my ileostomy calmed down, then I wasn't dehydrated as much. For you it will be dependent on your bm's. If your eating is hindered when you are discharged, have an ensure and they also have an ensure fruit drink line. You will need to eat and drink for awhile, things that are high in protein for healing.

Post Edited (windy city) : 9/30/2015 1:58:14 PM (GMT-6)

Yes, I was told mega colon when colon was removed also.