Disuse rectal colitis

I had a total colectomy with end ileostomy in 2010 for colonic inertia and anismus. I kept the rectum. I have to use warm water enema to get rid of mucus and it's not much mucus if any.

I have had issues the past few months with pressure and smelly leakage. No bleeding that I've noticed.

My gp gave me flagyl and it went away. Now it has returned.

My doctor called me in steroid suppositories and another round of flagyl. 3 days later and still not much change.

I'm very worried that this will just get worse and worse.

Any ideas what else I can do?

Thanks

Did they culture the discharge to see if it was bacteria, and growth studies to see which antibiotics
will work. Or is it diversion colitis.
Oldmike

I face diversion colitis at some point since I have a rectal stump.
Part of it is a lack of short chain fatty acids.
Stool enema soluble fiber enema might work. Of course sounds a bit dangerous,cant poke
through the end of the stump.
Another possible is if you eat enough fruit with soluble fiber, the short chain acids will increase in the
blood,but probably not enough to effect diversion colitis,but with an ileo you mght not even make
short chain acids. Here are some ideas,but not full articles.

https://www.researchgate.net/publication/316568660_a_case_of_diversion_colitis_successfully_treated_with_water_soluble_dietary_fiber

oldmike

Post Edited (Old Mike) : 3/29/2022 4:48:50 PM (GMT-6)

To tell you the truth I don't think they exist except possibly a compound and pharmacy most of what I see is from years ago looks like sodium butyrate sodium acetate and sodium propionate plus other stuff. If I remember correctly they did trials with sodium butyrate for UC and they failed. Again putting anything up into the rectal stump sounds kind of dangerous don't want to poke a hole in it. Old Mike

Post Edited (Old Mike) : 3/29/2022 10:36:44 PM (GMT-6)

I did read about a fecal transplant. I know my husband is healthy and I wonder if that would help. I know that seems disgusting, but I read they had had good luck with it with IC patients.

I continue to have diversion colitis. I Am back on my 4th round of flagyl with steroid suppositories. I see the doctor in January to discuss what's next. I can not be reconnected because I have pelvic floor dysfunction. My symptoms now is a painful and throbbing rectum with some leakage. Anybody find any miracles to treat this? What is a stool fiber enema? Is it made with metamucil? This has turned into a quality of life issue. Ugh.

Well if it is an energy supply problem and butyrate enemas don't work.
There can be a beta oxidation block,possible even genetic.
Another possible solution is to try and feed the rectal cells from the blood supply.,
Sodium beta hydroxybutyrate,I use sodium salt but you may want to use a different salt.
The point is to get more ketones into the blood supply which bypasses a beta oxidation block.
Also acetyl L Carnitine for energy transport of longer chain fatty acids for beta oxidation.

Oldmike