This is beyond the scope of my knowledge, however I have a couple of cousins who have had their colon's removed due to ulcerative colitis and it really hasn't improved their quality of life due to continued complications.

Anecdotally from blogs and podcasts within the paleoshpere I have heard of people facing a colectomy correct their conditions via diet.

Having your colon removed should be an absolutely last resort, save your life, measure.

I highly recommend that you not only sort a second opinion on your condition but track down a paleo friendly doc and functional medical practitioner to work with to resolve your condition without resorting to irreversible surgery.

You could perhaps try the Paleo Physicians Network as a place to start looking.

Best of luck.

Try GAPS. You don't want to remove your intestines it's a life long sentence guaranteed to make you miserable, increase stress, and shorten your lifespan.

If you want to heal your large intestine than your going to have to commit to eating very easily digestible foods for at least several months.

I'm going to look like a nut job but about 3 months ago I used a fecal transplant and it cured 7 months of post-partum (heavy antibiotics from a failed induction and cesarean) constipation. Nothing else helped. I used my 100% breastfed infant's stools with the saline water from a fleet bottle and held it in for 6 hours. I just did it twice and since then any hint of constipation is easily managed with a little magnesium and/or coconut oil. It was amazing. Also I was drinking home made broth 2=3 times a day with meals and taking a good probiotic, but the real change was the transplant.

Perhaps you haven't exhausted every option you have yet.

I feel for you, especially so young - I am the same age. I think this is really a question of the least worst option. I guessed from you question that there would be a history behind this, surgery is usually a last ditch option.

Your colon is important for a range of normal functions.

However colonic inertia and really chronic constipation can be very serious. If it turns out in the end that surgery is the only option that can solve the problem then it may be better than doing nothing. I would treat it as the very last option, major abdominal surgery is big undertaking. I don't know how a post surgery diet would need to change.

If the muscles in your colon are not working, if you suspect hypoganglionosis, then most of the normal cures will probably have little effect as they still rely on your colonic muscles pushing the stuff out.

One idea though:

Fecal Transplant (also called Bacteriotherapy) is something I would think about trying before surgery if you can stomach the idea. It's not like you have anything to lose.

Bacteriotherapy using fecal flora: toying with human motions. Also on pubmed.

There is one mention in that paper of a case report of resolving chronic constipation. It usually involves cleaning out everything in you colon and replacing all the gut bacteria with new ones from a healthy donor. Usually under the supervision of a gastroenterologist, if you can find a helpful one. It is growing in interest for serious colonic infections and I noticed that you said that it began when you became sick with serious abdominal pain and diarrhea.

This blog Cooling Inflammation has a number of posts on the subject.

See some comments here: http://www.medhelp.org/posts/Gastroenterology/Large-Intestine-Removal/show/316355

I would try alternative medicine before - orthomolecular and homeopathy. Those are untoxic and safe, and if those do not help, at least they wont harm you. If you didn't try it yet, go full paleo diet, withoug grains, gluten and other notorious intestinal chemicals.

I think its very important. Removing part of large intestines is probably similar in many ways to removing substantial amount of microbiota with antibiotics with obvious difference that fungal proliferation will not happen. There is big possibility for vitamin K and B deficiency so if you do it make sure you supplement it.

THere is possible post operative complication you should be aware of: Anastomotic Leak. This means that choice of surgeon is very important. Poor wound healing and infection are other cause and if you do it, make sure you start vitamin C megadose ASAP [talking about it, you may find vitamin C flush helpful].

== EDIT ==

Since no laxatives work for you, I think you should try vitamin C flush. After few tries you will learn about correct amount of C so that you don't finish with severe bathroom runs. Not eating is not going to help you. So lets see, finally, what do we have after everybody answered and you extended the info:

1. Probiotics. Since transplant is expensive and fiber didn't help I would go for some ultra quality ones and pop them like crazy. Watch for number of strains and number of bacteria in capsule. The more the better. I would suggest you to use huge number of them per day. Kefir, yogurt or other fermented stuff should help. If you could make your own kefir that is probably the best as kefir contains massive amount of fungal and bacterial probiotic cultures.

2. Supplementation:

   • Vitamin C - Flush to try to solve constipation issue. The only adverse effect will be flatulence. I think this is the safest laxative out there but determing dose is dynamic process - it could take from 10 to 100g of powder per day to get it depending on stress level.
   • Multivitamin - you should supplement your diet since you avoid eating. See supplementation threads on the forum. You need strong one, for body builders for instance, not regular low dose ment for young healthy people. See my other post.
   • Vitamin B5 - Improves peristalsis. It has role in the production of intestinal acetylcholine. 100 - 2,000 mg per day.
   • Vitamin B1 - It is involved in improvement of the muscle tone of the intestines. Constipation is one of the symptoms of vitamin B1 deficiency - 100 - 500mg per day.
   • Magnesium - Impaired contraction of smooth muscles can create constipation. Lack of magnesium may create constipation because it regulates and keeps the bowels alkaline and prevents gas from forming in the alimentary tract. Milk of magnesia or epsom salt could also be used to cause diarrhea.
   • MSM - It is known to improve chronic constipation. Take 1000mg twice per day.
   • Piracetam - peristalsis by smooth muscle in the gut is controlled by the parasympathetic nervous system, which uses muscarinic acetylcholine receptors to activate it. Piracetam is muscarnic agonist so you should start taking it, from 4-10g per day with lots of Choline [Soy lechitin, shiitake, egg yolks]. There is no actual research about it, some people even get constipation on it, but it makes sense and you should probably try it. In the clinical setting, constipation following muscarinic antagonist therapy is often reported as one of the classic muscarinic adverse events. Also, choline alone is known to improve constipation so if you decide not to use Piracetam, at least use choline.
   • 5-HTP - Serotonin deficiency causes constipation. 5-HTP is better then tryptophan, whose conversion to serotonin in the gut is limited by feedback control mechanisms. The most common side effect from 5-HTP is gastrointestinal motility. This effect exists with Prozac also. Eat cashews. 15-50 mg should be a good dose.

3. Drinks: Caffeine, green/black/white tea, water and rakia all help constipation. Drink lots of water, especially if you do vitamin C megadose.

4. You may be suffering from carbohydrate malabsorption (starch, sucrose etc..). If you didn't try it yet, test this possibility by removing fruits and starches and eating hi fat, moderate protein diet with vegetables and nuts as only source of carbs.

All those interventions shouldn't be expensive and supplements are non toxic and safe. Just be aware that you will be using therapeutical doses of some of them, information regarding healthy human supplementation is of no relevance to you. You cold get all of it for around $100 - $200 for several months.

Sounds like an insane way to approach constipation. What do you actually eat in a day? What have you tried to remove? You avoid eggs, right? There is plenty of potential for constipation under the vast umbrella of "paleo." Have you tried a high fruit, high starch diet? I can't imagine a diet that consists of plenty of berries, sweet potato, white potato and rice resulting in constipation. Throw in a bit of meat and organs here and there and it's a perfectly healthy diet.

There simply has to be another option.

That's huge! I sure hope it works out for you!

In my family a condition pops up from time to time called Hirschsprung's Disease. It's a developmental issue where the very last bit of the fetus (when at the early fish state) doesn't quite weave the neural matrix all the way to the end. Later on this part becomes the colon. My father had it, and had part of his lower colon removed when he was 25. It skipped me but daughter had it and she had similar surgery when she was just two days old. I'm still astoundingly grateful that we - by luck of the draw - had a world-famous surgeon work on our daughter (we saw this guy on TV later, doing open-heart fetal surgery...)

Anyway, the primary symptom is extreme sluggishness - because of no nerves there is no peristalsis and stuff just backs up. My dad had to have almost daily enemas and eat a special diet for years until the operation. The surgery itself is very benign. My daughter was SO much better immediately. My dad went on a 20 mile bike ride the next day.

The lingering effect though is that it's difficult to control when stuff comes out, since there's a structure at the end that holds 'stuff' until it's potty time, and also lets us know we need to 'go'. And it's always a little messy. WAY better than a colostomy bag (one of our options) but it's something to live with and deal with forever.

I honestly can't say there are nutritional issues. My dad seems relatively healthy still in his 80's now, and my daughter is fine that way (if ONLY I could get her to eat liver!) In her case they took out about 2/3 of the descending colon - not the whole thing - I'd think that the more one took out the greater risk of problems later.

Not sure if any of this is relevant, but perhaps somewhat useful.

Oh - the way the surgery works is that they detach the colon at the anus, then pull it through taking biopsies every inch or two. They keep pulling until they find nerves then reattach. Maybe more info than y'all wanted, but we're all grown-ups here :-)

Robb Wolf talks frequently about how close he was to a bowel resection and how paleo reversed all the symptoms that were plaguing him. I don't know about you but I'm going to do my damnest to hold on to each every part that I evolved to have. I just don't see how living without a large intestine could be a good alternative to anything. Are you paleo now?

BTW, I've been reading a lot of material about Thyroid lately, and sluggish gut is a classic symptom of hypothyroidism. Whether or not your numbers are bad or good (and get the full panel, not just TSH) it sure wouldn't hurt to try a thyroid supplement for a little while. If you can convince your doctor, try something that contains T4 AND T3 (probably Armour) since you don't want to depend yet on your colon for its role in T4 -> T3 conversion.

It's worth a try and it's not permanent like surgery. Low risk high reward as they say.

Hi Marty,

I dont know where are you from, but I recommend considering with your doctor the use of a home-made fecal transplant. It is relatively easy to do, you just need healthy stools, a couple of commercial enema materials and a blender. You can adapt the protocol used here for treating Clostridium difficile:

Success of Self-Administered Home Fecal Transplantation for Chronic Clostridium difficile Infection

From the symptoms you write, any dietary measure to modify gut flora seems to be useless.

It's important but that doesn't mean you should ignore your doctors. Respect them and they'll respect you. My advice is to mention that you are very averse to the surgery and ask whether it is absolutely necessary. If the answer is yes, then seek a second opinion. If it is still yes, then go for it.

I have a cousin who had the ileo-anal pull through after colon removal and she's done great. It's been decades since she had it.

I hope that all other causes have been eliminates if you are considering something so drastic. Causes for constipation can be numerous, everything from too much fiber to magnesium deficiency to gluten or lactose intolerance can cause it. I hope you get well!

Read the book "Wheat Belly" by Dr. William Davis. Sounds like a problem one of his patients had. Cured by cutting out all wheat.

this might be VERY outside the box, but if u haven't been already, go to gutsense.org. the author is a little too colorful at times but his logic is impeccable. i read everything on the site (which was alot) and bought his book, which made even more sense. going zero-low fibre and carb is probably what u should look into. initial constipation with going cold turkey on fibre is usually normal (with less fibre or no fibre the size of stools passing in u reduce in size by a lot so triggering less "sensation" on colonic nerve endings but when stools do come they will be smaller). try the site (just don't buy his supplements lol)

and be careful of surgeons. the sad truth is that they really don't know what else to do other than to butcher people. i know someone who had some of her intestine removed, not a pretty picture in her daily life.

and yes u NEED every organ u were born with

Personally, I like to use sex as a comparison in these types of decisions. Can you live without it? Yes. Would you want to live without it? Noooooooooo!

My grandma had to have some of her large intestine removed and lived with a colostomy bag for the rest of her short rapidly deteriorating life afterwards. Not something I would recommend if you can at all avoid it.

Removing organs because of constipation sounds like madness to me.

However, you could probably live well without it. My fiance's father had a large part of his colon removed around age 60 due to advanced colon cancer. He lived to age 85 in excellent health, looked much younger than his age and was lean (had a fatal heart attack while in the middle of a long walk going uphill). His favorite food was polenta with tons of butter.