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Gastroenterology (Expert Forum)
Re: Life on TPN due to inability to find effective treatment for post-op diarreah
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Re: Life on TPN due to inability to find effective treatment for post-op diarreah
by HFHSM.D.-ym, Jan 01, 1995 12:00AM
Posted By HFHSM.D.-ym on August 23, 1998 at 22:02:55:
In Reply to: Life on TPN due to inability to find effective treatment for post-op diarreah posted by Donna on August 22, 1998 at 08:04:45:
I have been on the medical-merry-go-round for 21 years. Nineteen of them with UC, the past two after total proctocolectomy with ileal pouch anastomosis, with unending crampy, urgent diarreah, 20-25 times a day. No reasonable answer other than a severe motility problem leading to malabsorption has been offered. I have been evaluated all over Philadelphia, and have consulted with the Cleveland Clinic and Mt. Sinai in NY city. NADA. I suppose there is worse, the TPN IS keeping me alive, however if I don't explore every avenue open to me, I may miss an oportunity for help. This is really very frustrating for myself and my doctors of many years, any comment would be appreciated!
Dear Donna,
If the ileoanal pouch surgery is causing too many problems (diarrhea) and you are requiring TPN, have you considered an ileostomy? Although you may still lose fluid and electrolytes, at least you will not have the bad diarrhea sensation. If indeed you had ulcerative colitis (and not Crohn's disease) your inflammatory bowel disease should be cured after proctocolectomy with ileoanal pouch anastomosis and your current symptoms are most likely secondary to pouchitis. I don't know which anti-diarrheal agents have been tried but that is also an option to consider. Pouchitis can also be treated with an antibiotic called metronidazole (Flagyl). I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you want to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: ulcerative colitis, proctocolectomy with ileoanal pouch anastomosis, pouchitis, total parenteral nutrition
In Reply to: Life on TPN due to inability to find effective treatment for post-op diarreah posted by Donna on August 22, 1998 at 08:04:45:
I have been on the medical-merry-go-round for 21 years. Nineteen of them with UC, the past two after total proctocolectomy with ileal pouch anastomosis, with unending crampy, urgent diarreah, 20-25 times a day. No reasonable answer other than a severe motility problem leading to malabsorption has been offered. I have been evaluated all over Philadelphia, and have consulted with the Cleveland Clinic and Mt. Sinai in NY city. NADA. I suppose there is worse, the TPN IS keeping me alive, however if I don't explore every avenue open to me, I may miss an oportunity for help. This is really very frustrating for myself and my doctors of many years, any comment would be appreciated!
Dear Donna,
If the ileoanal pouch surgery is causing too many problems (diarrhea) and you are requiring TPN, have you considered an ileostomy? Although you may still lose fluid and electrolytes, at least you will not have the bad diarrhea sensation. If indeed you had ulcerative colitis (and not Crohn's disease) your inflammatory bowel disease should be cured after proctocolectomy with ileoanal pouch anastomosis and your current symptoms are most likely secondary to pouchitis. I don't know which anti-diarrheal agents have been tried but that is also an option to consider. Pouchitis can also be treated with an antibiotic called metronidazole (Flagyl). I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you want to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: ulcerative colitis, proctocolectomy with ileoanal pouch anastomosis, pouchitis, total parenteral nutrition
