Constant diarrhea post-surgery?

[jackbeth58]

I was diagnosed with Crohn's in 2006 from a little pain I had. I had no further symptoms for the next 4 years. Then there was more pain and more investigations which revealed inflammation and a narrowing of the terminal ileum. It all got worse in 2012 when I was on and off immune suppressants and steroids then in November 2012 I was admitted to hospital with an abscess on top of the inflammation. I was treated with high dose steroids and antibiotics and was home in 3 days. Things settled down in early 2013 then in May I got the pain again and it was decided that I should have the inflamed bowel removed which I did do on 7 June. About 7 cm was removed and the bowel rejoined. Ever since the operation I have had constant diarrhea, practically liquid most of the time, far worse than pre-op. I've seen my specialist and been back to the hospital but they are not giving me any answers. I take Imodium which doesn't work as well as before and have been on Questran Lite which helped initially. I am at the end of my tether with it all as I never know if I can go out safely or be at work without fear of an accident. I also have wind which I didn't before which I can't control. Please can anyone tell me if this is normal after surgery and if it will settle down or any idea why it is happening, what I can do to settle it down. My last blood test was good and as I don't get the pain any more I've no idea if the disease is active at the moment. This really is preventing me living life to the full at the moment.

 

[bobisacrohny]

Sounds like the bile acid binder was doing something so it could be an indication of bile acid. Bile salts also have a role in the process but I am not sure how. From what I have been reading the portal vein in the ileum absorbs the bile acid and recirculates it to the liver. Not an expert or even a medical person, so I could be way off, but I wonder if the surgery stimulated the bile acid to overproduce or if it is not recirculating for whatever reason?

 

[Grumbletum]

Hi, sorry to hear you are having these issues :-( Did they remove your IC valve and cecum? That can cause issues with D. There are quite a few people who have had great relief from taking psyllium husk. Although not as severe as yours, I have had more issues with D post surgery than before. I find if I avoid fatty foods and a lot of refined sugars, my bowels are a lot more settled.
Hope that helps.

 

[jackbeth58]

Thanks bobisacrohny and Helen for replying. As far as I know only the diseased bowel was removed, I will check at next hosp visit though. All seems to point to bile salts from what I've researched but I can't understand why the specialists can't give me any answers, they must have other patients with similar post-op problems. My friend at work had a bowel cancer op three months before me and she's been battling diarrhea since so it must be quite a common problem I would have thought. Anyway I am really going to persevere with Questran, seems to be the only thing giving me relief at the moment. I think a custom made cork would help too if it were possible !!!! Got to laugh or I'd cry.

 

[Aussie]

How much questran are you on?

 

[jackbeth58]

4g sachet twice a day

 

[Aussie]

You could increase the dose if you tolerate it well. Also, ask for a faecal calprotectin to ensure that your diarrhoea isn't due to a flare of Crohns. Also, with all the antibiotics, make sure you also check for stool infections including c diff. Might also be worth asking to be tested for small bowel bacterial overgrowth as well. I would also suggest that you see a dietician to work on your diet to try and control your symptoms.

Best wishes.

 

[jackbeth58]

I had a stool sample tested a few week's ago and it came back ok for blood, infection, parasites etc. I have seen a dietician in the past, pre-surgery. I still don't know what sets me off in a flare-up and a couple of days on just warm water seemed to settle things down again. All I was told at the beginning was not to eat dried fruit or anything fibrous in a flare-up. Since surgery I can't tolerate fresh orange juice and to begin with I just ate 'safe' foods. I wasn't given any guidelines re eating at the hospital, seems like as soon as you are recovered enough you can pick anything off the menu. So I've pretty much had to be my own keeper day by day and see how I go. I'm trying to vary my diet a bit now because I love salads, veg, wholemeal bread etc and if I stay on the safe food for too long I get so as I don't want to eat at all through boredom and get phobic about trying new things. I'll see how I go for the next 3 weeks then I'm back to the hosp again for another review.
Thanks for your advice.