Constant diarrhea after colectomy

[bdungy]

I had surgery to remove colon cancer (left hemi-colectomy) 1 year ago.  Ever since then, I have had problems with diarrhea on a daily basis.  The diarrhea is accompanied by a significant amount of gas.  Prior to surgery, I also had diarrhea issues but not as severe.  My doctor has suggested I try fiber but that seems to have little to no affect.  The onset of the diarrhea is not immediate after eating so I guess it's not as bad as it could be.  I take Immodium on occassion when I need to be out of the house but that basically just defers the attack for several hours.  I have had my follow-up colonoscopy and nothing out of the ordinary showed up.  Is there anything else I can try to control the symptoms or is this just the way life will be post-operative?

[Kevin Pho, MD]

Ruling out infection, colitis or malabsorption syndromes can be considered, with various types of stool tests.  A  CT scan can be done to look for inflammation.  A negative colonoscopy would rule out many of the major lower GI disorders.

If the tests continue to be negative, treatment for irritable bowel syndrome can be considered.  Antispasmodic agents or antibiotics like Rifaximin can be considered.

A referral to a GI specialist can be considered.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[Morecambe]

I'm writing this from the UK - but almost three years ago I underwent a total colectomy for torrential diverticular bleeding and indeed I also experienced frequent watery motions after the surgery.  Gradually their consistency stiffened slightly to what I would describe as a "muddy/sludgy" format.

My surgeon advised me to eat plenty of fibre and maybe the type of fibre plays a significant part in the composition of your motions.  I can recommend incorporating plenty of bran (preferably organically derived) into your diet.  Also fresh sweetcorn and beans are very high in fibre.

Every day for breakfast I eat a home-made muesli incorporating equal quantities of bran + oats soaked in milk (until it looks like "wet cement") - then add grated apple, lemon juice/peel and any other fruit.  This seems to place a significant quantity of fibre in the digestive system so that the day's visits to the toilet have become less frequent (~4 per day) with losse - but not "liquid" - motions.

Good luck.

[daisyearl]

I had a partial colectomy three years ago.  I had a large polyp in the lower colon.  I too have had problems with diarrhea, frequent movements (which causes painful irritation of the skin around the anal area), and gas since then.  I take a calcium with D pill and two fiber (Wal-mart Equate brand) capsules every night.  This seems to have stopped the frequent bowel movements (which caused the painful irritation)and has firmed up the movements so that they are close to being normal (pre-surgery).  From time to time, I still have bouts with diarrhea, which means that I must be within a seconds reach of a restroom, since I don't have nearly the "control" I had before.  But the simple addition of these two things (calcium and fiber capsules) have improved my quality of life.  I still have daily problems with intestinal gas and I am still trying to find something that works really well.  Activated charcoal capsules and probiotic enzymes have helped some.

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