Decided on a right hemicolectomy

[FrankieFredericks]

Hi there all,

The gastro team and surgical team who supervise me have got back to me over the last few days, they definitely want to remove the stricture that I have near the TI, they've decided it has to go..

I'm down for the operation in early October, the surgical team have decided they want to preform a right hemicolectomy..

I am quite confused as to why they would need to take some healthy large bowel..

Would be really interesting to hear how people are finding life after this particular operation, I can't find too many reports on it..

Will I be able to eat a normal diet again for example? Or will I have to stick to a strict one as I do now?

Thanks all, will be interesting to hear from you.

 

[DustyKat]

Hey Frankie,

There are two reasons they need to also remove a small portion of the large bowel, the first then leads into the second:
Firstly they need to ensure that the when they resect the margins of bowel are free of disease.
Secondly is because of the anatomy of the bowel.

The terminal ileum joins to the ileocaecal valve which in turn lies adjacent to the caecum. The caecum is a large pouch at the commencement of the large bowel. You can see from the image the quite considerable difference in size between the ileum and the caecum. It is not possible to anastomose (join) the ileum to the caecum as the size difference is just too great, therefore it needs to be removed leaving the next best option as a join to the large bowel. This usually means about a 8-10cm removal of large bowel, the majority of which is caecum.

Both of my children have had this surgery and although there have been lasting deficits from it there is no doubt that their lives are vasty better for it. My daughter has been in remission since her surgery 9 years ago and my managed 4 years of remission before he started flaring again this year.

It goes without saying that everyone is different and judging by your post I would hazard a guess and say that that your disease type is different to my children’s and as a result you may not have as much small bowel removed.
Do you know how long the stricture is?
Do you have any acute inflammation accompanying it or is it chronic only?

I think you will find that once the stricture is removed you will find eating a variety of foods much easier as the narrowing no longer exists. Some find they can eat anything and everything whilst others continue to find some foods bothersome. My kids can each eat anything really but they have gravitated towards their own preferences, for my daughter a vegetarian diet and for my son something that pretty much resembles a low residue diet.

They both have issues with bile salt malabsorption diarrhoea. This problem seems to be highly individual like everything else with this disease! Some have no issue with it, others have it for a few months and yet others are plagued with it as an ongoing problem. Having said that there are measures you can take to control it and it would likely be dependent on how much small bowel you have removed.

The main thing you will need to vigilant with is your B12 levels. Again, the amount of terminal ileum you have removed will have an affect on this. The terminal ileum is the only area in the bowel where B12 is absorbed. The body can store B12 for up to 5 years so initial good readings are not a indicator of your long term levels hence why repeated testing will be required. The vast majority of people that have this surgery will need to have B12 supplemented by injection at least every 3 months.

Any other questions please don’t hesitate to ask.

Dusty. xxx

 

[FrankieFredericks]

That is great info thanks Dusty,

You have answered all my queries excellently

The surgeon didn't really explain how much of it he will remove, he just said as the stricture is quite small (but obviously narrow) he may be able to simply take it out and rejoin the two healthy bits, but that does depend on A LOT of factors, and he made that very clear.

Just getting a few pre op jitters now, but I'm over the actual "why me" stage of it, I'm a young man at 21, and I want to be able to get over this horrible problem and start fresh with my career.

The thought of biting into a nice expensive burger is one of the thoughts that's keeping me going right now

 

[DEmberton]

My surgery was always referred to as a "right hemicolectomy". As far as I know they didn't remove any of the large bowel, but my surgeon did say something I didn't quite understand about reattaching the small bowel slightly further along.

And I eat completely normally, and have been since the surgery. It's possibly the best thing I've ever done; I've been so much healthier since.

Unfortunately it does seem after a year the disease is fighting back.:thumbdown:

Hope it all goes well for you.