Removal of Large Intestine

I need to know about what to expect following a large intestine removal.  (I will not have a colostomy.)

I have severe constipation that they've been unable to relieve.  My autonomic nervous system is effecting my digestion.  My small intestines were also damaged during a surgery to place mesh when the doc neglected to anchor it fully and it wrapped around my intestines and severely restricted them for over 16 months.  (I told her the instant I woke up that something was wrong but she ignored me.  We went to Mayo Clinic for my correction surgery, bless them for keeping me alive!)  The surgery has given me chronic acute pain unrelieved by over 11 surgeries now, I'm now on extended release and short-acting Oxycontin which causes more constipation.  

It's been a year now and nothing helps.  I don't have bowel movements without suppositories or enemas.  My doctor's hope is that by removing my large intestine I will finally have regular bowel movements given that the majority of fluid is reabsorbed by the large intestine.  

I'm leaving in a few weeks for Mayo Clinic...can anyone tell me what to expect?  How is the recovery and what nutritional changes can I expect?  I feel a little lost and dazed, they never even mentioned this as a possibility and then dropped it on me, "We'll give it two weeks on the new medication and if it doesn't work we'll go ahead and remove your large intestine."  Uh, what?

I'm 35 with three young children, help?  

[Morecambe]

Just over six years ago I underwent a total colectomy for torrential diverticular bleeding and, in response to another Medhelp patient's question, I posted my experiences of this operation on:-

http://www.medhelp.org/posts/show/523166

My surgery was fully invasive (i.e. surgeon's hands inside the abdomen) whereas there may be a possibility that your operation could be performed laparoscopically.  Do ask.

You may like to print off the above 523166 posting and show it to your surgeon and ask whether his/her expectations of your forthcoming surgery would be expected to mirror my own.

I don't live in the USA but I believe that your Mayo Clinics are hospitals-of-excellence for gastro complaints.  I am also assuming that your surgeon is a specialist G.I. surgeon performing intestinal resections "all day and every day" rather than a general surgeon who carries out only occasional total colectomies amongst hernias, ingrowing toenails and such like.

Do come back if you have any questions.

regards
Morecambe

[kbjeeb]

Wow!  Thank you so much for being so detailed, it's always good to hear what to expect from a real person rather than an article.  

My surgeon at Mayo does only GI surgeries.  I'm returning there rather than staying closer to home with a less experienced doc.  Do you know how it is determined whether the surgery will be laparascopic or open?

Did you have any trouble with the anastamosis to the rectum?  It's likely that I will develop an ileus given my nervous system issue, again, I appreciate all of the information, you were very detailed and that is much appreciated.  

One final 'odd' question, is there anything you wish now that you would have asked your surgeon about?

Thank you for your response, it is very helpful.  I'm glad that you are doing well...

kbjeeb

[Morecambe]

I believe that the choice of operation ("fully invasive" or laparo) is determined by the surgeon based on his/her appraisal of the geometry/acessibility of your intestines prior to the commencement of the operation.  Even if the surgeon decides to attempt a laparo procedure, he/she may well say "I'll start out this way but I may have to switch to fully invasive if the laparo procedure is proving tricky".  Maybe all this is "covered" in the "consent form" that you will have to sign beforehand....??

I was fortunate in that the rectal anastomosis (i.e. suturing the far end opening of the ileum to the near end opening of the rectum did not result in any "re-working".  I think the surgeon must be super careful about the integrity of the joint because any leakage could cause peritonitis and require a second operation to seal shut any leak.

The only "surprise" I experienced was the development of the ileus after the surgery.  

Good luck and do let us know how you are getting on.

regards
Morecambe