Right Hemicolectomy

[Willowcat05]

My son had a right hemicolectomy in october last year taken out 35cm of small intestine, 10 cm of colon and appendix. The question I have is he is still having very loose stools and going 3 to 5 times a day is this normal? He doesn't seem to be flaring at the moment.


Meds
Methotrexate injection 15mg
Folic acid 5mg

 

[Kaevata]

I am sorry your son has had to go through this at such a young age.
I am afraid it is fairly common after this type of surgery to have frequent loose stools, I am in double figures but I have had nearly all my bowel removed.
There are some medications and things he can do to help which his Dr can perscribe and other things to concider.

The job of colon is to suck the last of the water back out of your poo and that job is reduced by the removal of some of it. The small bowel also helps this job sucking out the nutrients, vitamins and minerals too.
I see you son is on methotrexate and Folic is he also on something like Pentsa?

One of the problems with losing so much of the small bowel is malabsorption, there is not enough left to do the job properly. Nutrients, vitamins and minerals can all run low and lead to other jobs in the body not being done efficiently.
Your son is very young any deficiency he may have is worth picking up early for his long term health for instance, Vitamin B12 is only absorbed in the terminal ileum, the part of the small bowel that he has had removed.
Vitamins and mineral play a big part in how we function and some of the loose stools could be due in part to some of these vitamins and minerals not being absorbed or indeed being lost due to frequent loose stools.
As he is on methotrexate he should be having regular blood tests, I would advise you to ask your Dr to do a full blood count along with his next bloods.

I hope this is helpful, Good Luck

 

[Willowcat05]

Thanks Kaevata, your reply was really helpful he has bloods to be taken on Thursday so I will ask for full blood count to be done , he does not take any other meds . Im going to phone his ibd nurse tomorrow and see if they can give him something to help with the loose stools.

 

[Kaevata]

Oh good timing then.
I kind of would have expected to see more than the one medication and a supplement, given the length of bowel removed. Are you seeing a consultant gastroenterologist at your local general hospital?
If so you could ask for a referral to the top gastroenterology unit near you if you have one although I think it would be Edinburgh.

I am seeing my gastroenterologist at the local hospital on Monday but I also go to St Mark’s in London about 40+ miles from me. It is the main gastrology teaching hospital and is a national and international referral centre for intestinal and colorectal disorders. I am very luck to be near it but people come from all over to it.
I see each of my consultants every 3 months, the local just for check up but London for all the clever stuff, changes and any procedures.


http://www.stmarkshospital.org.uk/consultant-staff/jeremy-nightingale/46

He is my consultant at St Marks and writes a lot of interesting stuff if you Google him.

Good Luck Thursday

 

[DustyKat]

It is not uncommon for this to happen following this type of surgery.

The area of ileum that was removed means that where bile salts would normally reabsorbed from the bowel and into the body is missing. This means that the bile salts are dumped into the large bowel. Normally what would happen in the large bowel is that the body absorbs the excess water out of the large bowel and it is this action that firms up the stool. The presence of bile salts in the large bowel means the opposite happens...water is actually drawn back into the bowel (the effect of osmosis) and so the stool becomes overly loose.

There are a couple of prescribed medications that cane be used to alleviate this problem, Questran which is a powder or Colestid which is a tablet. My two kids both have this problem and use Psyllium husks, they work the same way as the prescribed meds by binding to the bile salts and so firming up the stool and reducing the need to go. You can buy them in the supermarket. Also eating things like bananas and apple sauce help too.

Dusty. xxx

 

[Terry]

I also had a right hemicolectomy done in April, they took about 26cm of my small bowel. I was still having problems with loose motions between 3 to 5 times daily, I had read on the forum about malabsorbtion after this surgery, I spoke to my GI and he started me on Questran powder. It has made a big difference, so talk to your sons Dr I'm sure they can give him this powder or something similar to help. Good luck to you both. Theresa.

 

[twokatmew]

I had a right hemicolectomy done in May 2005. It took me a few years before my body adjusted to having a shorter bowel. I still have periodic diarrhea, but for the most part, stools are normal. With no terminal ileum, we can't absorb B12, so injections are necessary. I do my own every two weeks (1ml, 1000mcg/ml). I was diagnosed in the summer of 1975 (age 13) and was in St. Bartholomew's Hospital. They literally saved my life. I'm living in the US since 1977, and I'll be 53 in November. I've got a long list of supplements and meds that I take but no time now to elaborate. Good luck to you and your son.

 

[oakey3132]

I had a right hemicolectomy (18 inches removed) in May and am also having similar issues which was starting to cause me a little concern; the above posts have put my mind at ease - thank you.