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How Long Can I Expect To Recover After Total Colectomy?

Posted on Sun, 29 Dec 2013

Question: I had a total colectomy 7 weeks ago. How long can I expect to recover: normal stools, more energy, etc.?

Answered by Dr. Grzegorz Stanko (1 hour later)

Brief Answer: 3-6 months. Detailed Answer: Hello! Thank you for the query. Total colectomy has caused lack of large intestine in your digestive tract. And large intestine is the place where water is absorbed. So without it, you get diarrhea. If the colectomy was done with J-pouch creation the chances to get back to normal are more possible. Without J-pouch you may not get normal stools ever. Usually it takes from 3 months to half a year for intestines to get used to new situation. So this is the time after witch you should get similar to normal (less watery stools). 7 weeks is for sure too early. Hope this will help. Feel free to ask further questions. Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Grzegorz Stanko (37 minutes later)

I am not sure about the J-pouch, so I must not have had that? Please explain. Also, I still have days with no appetite along with diarrhea so much that I have to work to stay hydrated. Is gatorade a good help for this? Is Boost recommended? My incision (small because I had laproscopic) got infected in a small area of it. It drained a purulent discharge, and on the second visit back, the doctor trimmed the edges and cleaned it out. It has since continue to close and heal, but now it is beginning to open and drain in another section (mostly clear except when it bleeds a little). I clean it with an alcohol swab and cover it loosely with gauze. The doctor has not seen this last problem with the incision, but I have an appointment in 5 days.He did not seem concerned with the first infection and said it was somewhat common after colectomy, I suppose when the large intestines is removed through this incision? Is this common? I only had intestinal issues for a year before the surgery. I rarely got constipated. But, had terrible abdominal pain and cramping, nausea, weight loss and saw a gastroenterologist for this year leading up to my surgery. He ran many tests, radiographs, and the last being the Sitz Marker test that showed that nothing was passing past my small intestines. It was only the last 3 months or so that my colon just stopped 'working'. Why does this happen? I know that he repaired, removed, or 'fixed' some adhesions during my colectomy. Why did I have adhesions and were they adding to my problems and discomfort? And, also, could they have been a result of abdominal surgery 6 months before all my problems began? It was a back surgery where the doctor went in from the side of my abdomen for part of the surgery. I would not blame adhesions on the neurosurgeon! but I was wondering just how one gets adhesions and if they added to my discomfort. I know there are several different questions here, but would you please try to answer them all? Thank you very much, XXXXX

Answered by Dr. Grzegorz Stanko (36 minutes later)

Brief Answer: Detailed below. Detailed Answer: 1. There should be mentioned about surgical technique (J-pouch) in your discharge documents. Please take a look in it and check it. J-pouch is a kind of reservoir made from small intestine which helps with diarrhea (makes your stools less frequent). You may have it even if you do not know about it. Your surgeon knows it for sure. 2.Gatorade is very goods. Same is Boost. The most important is diet which helps decrease diarrhea frequency (see this WWW.WWWW.WW . 3.Your problem with incision is probably caused by stitches left under the skin. Some people do not tolerate such stitches well, what causes discharge from the wound due to tissues irritation by the stitches. Infection 7 weeks after surgery is rather hardly possible if the wound were closed before. So the first thing your surgeon should do is to try to find this stitches. Ultrasound might be helpful to rule out any fluid collections. Large intestine wound is treated as infection by intestinal bacteria, but this gives discharge few days after surgery and usually does not last for so long. 4.Colectomy is done usually because of Ulcerative Colitis. This is an inflammatory bowels disease which affects only large intestine. The main symptom of it is bowels obstruction what most probably has caused your symptoms. You should receive a hystopathology report of removed intestine. The main diagnosis should be in this document. 5. Any abdominal surgery can cause adhesions. Adhesions are kind of stripes which can narrow intestines and cause its obstruciton. But for sure there is no adhesions which could cause total large intestine closure. So this was not the reason of your symptoms. During your last surgery, adhesions were removed for sure. But your last surgery has caused new adhesions creation. So you can not blame any one for your adhesions. It just happens after every surgery. And I dont think adhesions are causing any problems right now. Otherwise you would gate similar cramps, gas obstruciton and vomiting. Hope this will help. Regards.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar