Ruptured Appendix & Bowel Resection

[raisungirl29]

Hello.  I'm hoping someone has had a similar experience and can help me understand what the longterm prognosis and implications might be in this scenario.

My brother had emergency surgery this week for a ruptured appendix.  The surgeon estimated that the appendix had actually ruptured almost a full week before he went to the ER and she operated.  She basically said that if it weren't for his young age (he's in his early 20s), he would not as made it as far as he did.  During the surgery, she removed almost 1/2 of his colon, including his ileocecal valve (valve that connects the small intestine to the large intestine).

Obviously, we are so thankful that he is still alive after the close call we now realize that he had.  Our main concern right now, as he is only a few days into recovery, is that he heals well and there is no further spread of infection (they left his incision site open after the surgery to drain).  Once he gets past this initial recovery hurdle though, I'm curious about the longterm implications for him of the bowel resection.  Does anyone have experience with having this much of the colon removed.  All the surgeon has really said so far is that he will likely have more frequent and looser stools as a result of losing that portion of his colon.

Thanks in advance for your experiences-

[boron]

Surgeon was right. Lose stools is pretty much all, what he can expect. Colon is more or less only a storage place for the stool, for gut flora (normal intestinal bacteria), and is the site where a part of water is absorbed. Most of water is absorbed in small intestine anyway. Now the rest of the colon can adopt the absorptive power of the resected part, and from this lose stools depend.

Due to removed ileocecal valve, he might build a small intestinal bacterial overgrowth (SIBO) - colonic bacteria move upwards in small int. This would be experienced like bloating, and possibly diarrhea. Bear that in mind, since many doctors don't. It can happens anytime. This can be diagnosed with a breath test, and treated with antibiotics.

[Morecambe]

Hi - as you may have seen from my other postings, I underwent a total colectomy four years ago for torrential diverticular bleeding.  Indeed after the operation there were significant changes in my bowel habits.  These were:-

- increased frequency (6-8 times per day and 2-4 times per night).  However, after some months these declined to ~4 times per day and 0-1 times per night.


- the stools composition was semi-liquid/watery.  To avoid anal soreness from the more corrosive nature of one's stools, I suggest that after wiping with toilet paper, another (i.e. the last) wipe is made with soapy toilet paper.  If you are away from home, take very mild baby wipes with you for this last "wipe".  Then there are steps that you can take to cause your stools to become more "muddy/sludgy" rather than watery.  Eat plenty of fibre in the form of pulverised fruit and vegetables.  I found that home made muesli (made with organic oats, plenty of organic bran, grated apple, grated lemon/lemon juice, nuts etc all soaked in milk so that the mixture looks like "wet cement") causes your motions to "bulk up".  In other words the effect is a bit like cleaning up a liquid spillage on the kitchen floor by sprinkling sawdust on it.  Organic bran can also be added to yoghurt to enhance the absorbative effect.

A total colectomy/partial colectomy is a "big" operation and it may well take a few months before your brother feels 100% again.  I am now 62 and it took 4-6 months before I felt able to go back on the tennis court.  However, after the first few weeks you can live semi-normally (ie.e. a quietish life at home but going for short walks rather than being bed-bound).

In the immediate aftermath of the operation, do watch out for abdominal pain associated with an increased temperature.  After any intestinal operation there is always a slight risk of leakage from the point of the join (anastomosis) which can cause peritonitis.

Good luck to your brother and I'll watch out for any further questions you may have on this thread.

Morecambe

[thegrinningcat]

Morecambe and the others, this was very helpful. I would like to add blueberry juice as a remedy which made me constipated and my mom, who is the one with the short colon, "normal". You have to experiment h the amount, as it also made her constipated finally, and don't eat the plain berries as they cause soft stool. They also blacken the stool so I thought I was in for colon cancer due to the stress, until my D ad told me  the bulk of blue berries he had picked and we had been turning into shakes were the reason. I crushed them with a blender alongside some strawberries and mixed them with soy milk and some grape juice for sweetening which is delicious and despite the creamy consistency,  it still worked despite my knowledge of the effect. Later I found this in a book as an anti-diarrhea measure when you have a surgically shortened colon. And yes, do invest in those baby wipes, we didn't think of them, and nobody ever looks at that part until I did and it looked horrible, sore and already blistered after all those harsh frequent toilet paper wipes.

After the first colon sugery, the diarheea gradually subsided after ca. 3 months, now we have been at it for over 4 months.

To save money, you could also keep some baby cream handy and dipp the the tp sheets into the cream before each wipe.

Don't forget to take it all with a sense of humor...