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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Will Indigestion Of Diabetes Medicine Be Possible After The Removal Of Colon Part?

I had part of my colon removed a month ago. My oncologist told me that taking B12 by capsule would no longer be effective because the part of my colon that was removed was in charge of digesting and disbursing its benefits. I m noticing in stools that I think the metformin capsule I take for diabetes may not be digesting. Is that a possibility?
Tue, 15 Nov 2016
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General & Family Physician,  's  Response
Hi & Welcome.

Used in the treatment of diabetes, Metformin is absorbed from the upper parts of the intestine (duodenum and jejunum). So, colectomy (surgical removal of all or part of the colon) therefore does not impair its absorption and hence there is no possibility of it being excreted through the feces.

However, Metformin interferes with the absorption of vitamin B12-intrinsic factor complex in the terminal ileum, and vitamin B12 deficiency can occur after many years of Metformin use. Hence vitamin B12 is supplemented along with Metformin to prevent its deficiency.

Now, since the part responsible for the absorption of vitamin B12 has been removed (colectomy) so vitamin B12 will not be absorbed, hence you will have to take the injectable form of vitamin B12 like Methyl cobalamin to prevent this vitamin deficiency.

Hope these answer your query.
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Will Indigestion Of Diabetes Medicine Be Possible After The Removal Of Colon Part?

Hi & Welcome. Used in the treatment of diabetes, Metformin is absorbed from the upper parts of the intestine (duodenum and jejunum). So, colectomy (surgical removal of all or part of the colon) therefore does not impair its absorption and hence there is no possibility of it being excreted through the feces. However, Metformin interferes with the absorption of vitamin B12-intrinsic factor complex in the terminal ileum, and vitamin B12 deficiency can occur after many years of Metformin use. Hence vitamin B12 is supplemented along with Metformin to prevent its deficiency. Now, since the part responsible for the absorption of vitamin B12 has been removed (colectomy) so vitamin B12 will not be absorbed, hence you will have to take the injectable form of vitamin B12 like Methyl cobalamin to prevent this vitamin deficiency. Hope these answer your query.