Post-surgery / Diarrhea - Bile salt malabsorption

[alebeau4106]

Hello,

As I posted a few weeks back, I'm 23 years old and had a small bowel surgery in mid-April of this year (about 6 weeks ago now), having approximately 12 inches of my terminal ileum removed. While pretty much all of my initial worries have sorted themselves out, I am still suffering from diarrhea. Last I went to the doctor, about 4 weeks ago, he told me he was actually surprised to see me having such issues with bile salt absorption and in fact, ordered me to take two packs of Questran per day in addition to a bentyl tablet before each meal. Following his advice, I began to experience some very discomforting bloating and gas, and believe it or not, saw no improvement in going to the bathroom until a day or so after stopping the Questran. (That is, if I took Questran on Day 1 and 2 but stopped completely on Day 3, by Day 4, without having taken anything, my stool would be very soft and mushy but still kind of "normal"). In other words, if I continued taking the Questran without pause, the diarrhea would continue.

Wondering why I was feeling so bad, I decided to give up the Questran and bentyl and began feeling immensely better. Not only that, but I also noticed an improvement in my diarrhea (with respect to my initial post-surgery diarrhea stage), though, in all fairness, it wasn't as good as the day or so after stopping the Questran (say, "Day 4" in the above example), if that makes sense.

My question is this: For those having had a small bowel resection, how long did your diarrhea last? Did it ever get better? Having glimpsed over a few threads talking about the same thing, I'm beginning to think this may be a lifelong thing that I may have to life with - which, of course, I'm completely OK with. I'd just like to know if this is normal, and if anyone knows if my body might eventually "return to normal" (in the digestion of food, at least)?

I deeply appreciate any light on the matter and look forward to your response.

Best,

ADL

 

[24601]

Hi!

It seems to be a consensus on the forum amongst those of us who've had bowel resections that 6-8 weeks is the sort of timescale at which you can hope to see good progress with recovery - so starting Questran when you did (2 weeks post-op?) seems a little early. Your gut will still have been doing a lot of adjusting after the surgery. And you're still in that time period when you can see a lot of improvement quickly.

I had my 4th small bowel surgery last summer and after that I talked to my doctor about the diarrhea that I was experiencing and discussed bile salt malabsorption as a possible cause. I was told that I could try various meds for it or I could wait and see - and my doctor told me that for up to 2 years post-op your bowel may be adapting to perform in its new configuration with parts of your remaining bowel learning to do the job of the section(s) that were removed. So there is definitely hope that this is not a lifelong thing for you - even if you see this continue past the early-ish post-op recovery period which I think you still might be in.

There are a lot of people on the forum who have experience of this and have found ways to manage - and hopefully they'll be by to let you know what has worked for them. What I think I see in their experiences is that, as with everything, it's a bit of trial and error to see what works. Some people do well with questran, others with something else, some just take immodium or lomotil to control it. There's also a thread here with people doing really well with psyllium husks.

So there are options and there is most definitely hope that you will either not continue to have this problem or that you will find a way to successfully manage it.

 

[alebeau4106]

Dear 24601,

I cannot tell you how appreciative I am for that extremely elucidating, prompt response. Thank you for pointing out that I am still in the initial post-surgery period, and even after then, that my intestine might just need a year or so to take over the task that the removed part was doing. Perhaps it was just pure naïveté on my part.

I'm certainly going to take a look at the threads that you posted regarding alternatives for the diarrhea.

Thank you so much. You've given me not only answers but hope for my future.

My deepest appreciation,

André L.