I suffer significantly from slow transit constipation.
Today my surgeon informed me that he would like to totally remove my colon attaching the ileum to the rectum (subtotal colectomy with ileo-rectal anastomosis) and maybe (awaiting the outcome of one more test and responsiveness to physiotherapy) bypass the rectum entirely (stoma).
This is huge. I am only young and up until becoming very sick in June last year an avid sportsman. I wonder how this will change my life?
Researching the surgery I found this:
This particular surgery would spare the cecum. I know it is only a very small section of the colon, but it is still some right? Is it worth pushing my surgeon for this? From my readings at Evolutionary Psychiatry, Hunt Gather Love, PHD etc. it seems the colon is an enormously important organ and it would be wise to keep as much as I can. The study also links to psychiatric condtions appearing in those patients post-colectomy. Probably a gut flora thing. Worrying.
Also, I wonder how my diet may have to change post-surgery?
Kindest thanks to any response.
Thank you everyone for your responses, I'm absolutely blinded by the genuine warmth and help offered and the general spirit of the paleo community. I will try and exhaust all options before agreeing to colectomy. One option that was offered was sacral nerve stimulation. Unfortunately this is not covered by Medicare or my insurer and is quite pricey. (It is covered for faecal incontinence). My surgeon said it was hit or miss anyway. I am very interested in bacteriotherapy however $12-15k is not an option:
I will phone these guys regardless as I am Australian and it may be covered in some capacity but I doubt it. I do not know where else this type of treatment is performed?
Constipation has been kept under wraps from a young age with high grain fibre. I had an episode of bad constipation at 4 or 5 which led to metamucil. A bowl of weetbix and bran was sufficient daily to move my bowels. If I skipped this breakfast I would know. However it worked fine right up until June last year - I (more or less suddenly) became sick with abdominal pains and was having roughly 8 bowel movements of loose stool a day. Stool samples came back negative for the usual suspects. Colonoscopy came back clear apart from one or two polyps. Endoscopy showed esophagitis, unsymptomatic. GI told me 'eat more fibre (impossible I couldn't be eating enough at this stage) it is just IBS' and provided me with Nexium for the esophagitis.
I ditched fibre after reading gutsense and further research exposed me to to PaNu. I adopted this diet very strictly. 5-10% carb. Continued dairy after trialling no dairy for a while.
A new GI requested Lactulose breath test which came back negative for SIBO. MRI showed only constipation as did X-ray. At this stage I did not know I was constipated. I though I was fine as I was having regular stools, however impacted. I told my GI I had given up grains, he was shocked and requested I start eating them again immediately. I and the GI figured the constipation only arose out of my change in diet. He requested I take laxatives and everything should be fine. 'You're just constipated' This didn't explain the pain I was suffering before I was constipated or when laxatives had an effect. His lack of concern led me to a new GI.
This GI investigated the possibility of hirschsprung's at my request. Biopsies came back negative. This was after a colonic transit study showed 'significant colonic inertia' with 85% retention of 'test meal' after 72 hours, normal being less than 3%.
I moved to a more Perfect Health Diet around Christmas (20% carbs approx) which I continued until very recently. I have followed the protocols of various other paleo figures re: constipation. Nothing has made a shred of difference.
Laxatives lost their punch very quicky. Now I am entirely unresponsive to microlax enemas, movicol (miralax), dulcolax. I am having very limited effect with picoprep which is painful. Home administered water enemas are useless. I have had one colonic which helped but was painful and expensive. Because I cannot defecate, I have quit eating. I am now on water, bone broth, some rice and potatoes (very little), some fruit. Probably 350 cals a day total max. This is why the surgeon probably wants to operate sooner rather than later. I have quit work. Pain is worse some days more than others.
I had thyroid blood test done, which must have come back normal as I haven't heard anything. Multiple blood tests showed only high cholesterol (statins were talked about). Last monday I had an Rectoanal inhibitory reflex which suggested hirschsprung's. This was already ruled out but another biopsy will be taken next week - full thickness looking for short segment. My mother notes that my stool as a baby was always very small hard lumps. Before June last year, boxing and surfing was my life. I think about surfing every day.
Sorry for the info dump. I am grateful and thankful for all the responses so far.