Living with half a bowel

Hi Nicnak72 That’s a really interesting question. I do worry that food sometimes goes through me so fast that my body can’t be absorbing all the goodness? 
Have you thought about copy and pasting this onto the Ask a  Nurse page perhaps?

 Ask a Nurse 

Take care

Karen x

Hi Nicnak72,

I very warm welcome to the board. Pleased to hear you’re through your operation and gearing yourself up for the next stage.

I had the equivalent of a right hemicolectomy in July 2022. This was due to complications after my ileostomy reversal in March 2021 due to leakage. This formed scar tissue at the join which lead to a blockage. (My original surgery was a lower anterior resection in Jan 2021 followed by chemo).

The operation entailed my caecum, appendix and ileocecal valve being removed, but I still have most of my ascending colon. At the time I was told by the surgeon that my body could manage perfectly well without these organs and no proper follow-up was arranged. Ummm!

However, I suffered from severe diarrhoea and urgency so bad that I couldn’t leave the house. To cut a very long story short I have severe Bile Acid Malabsorption (BAM) which means the bile produced to metabolise fat cannot be reabsorbed (which normally happens in the ceacum) therefore too much bile enters the colon. It took me a long time to get a firm diagnoses and in the meantime I was left to diagnose myself. I control it by following a very strict low fat diet (less than 3% a meal) with no more than 15g fat a day to keep the amount of bile produced to a minimum, together with my medication – this has been a game changer.

Due to the above I need Vitamin B12 injections every 3 months for life, our bodies can’t make vitamin B12 and we have to get it from foods from animal origin, as I can’t eat much fat I do not get enough Vit B12 from regular sources.

I have regular blood tests to check on the levels of everything else. I was referred to a dietician, but to be honest the consultation wasn’t any help and I knew more than she did.

Along with taking Cholestergel (to bind the bile acids) and Loperamide, I take a multivitamin tablet daily and try and drink water with squash and if I feel I need it I will take Dioralyte daily (or you can make your own similar St Marks solution).

I hope this helps and fingers crossed you won’t suffer from BAM so won’t need to worry about your fat intake. However, for warned is for armed and hopefully the other information is useful.

Please ask if there’s anything you want to know.

Very best wishes

Net X

Hi Karen,

That’s a good idea! I’ll hive it a go xx

Hello Net,

Thank you so much for taking the time to respond and sharing your experience to help. I very much appreciate it. This is really useful and important information for me so that I can take it forward to my surgical consultant as my oncologist sort of fobbed me off with a vague and illogical answer .

I’ll look further into the condition and wish you well xxx

Nic x

Hi net and Nicnak. I too had a right hemicolectomy this year where 35cm of disease was removed (crohns disease for 33 yrs). Histology came back as confirmation of bowel cancer and spread to 3 lymph nodes. 3.5 months of tough chemo followed. Once that concluded & had dealt with the side effects of that, within a week of finishing landed back in hospital with severe diahorrea,  unable to keep any food/ nutrition in me. Actually  had sepsis as so ill with it, heart rate through roof, etc, very scary. They eventually also diagnosed me with BAM( bile acid malabsorpbtion), which had never heard of or been warned could occur but can  following resection. They commenced Cholestagel medication & saw dietitian ( also nothing new, insightful already re nutrition/ low fat needed, given load of high calorie supplement drinks). Within another week the severe diahorrea kicked off again so back in for 8 days of tests/ monitoring and gastroenterologist upped Cholestagel 625mg to max daily dose along with loperamide but in the 'melt' form as was not absorbing any medication either. Thankfully,  this has worked well now,  no longer need to take loperamide unless get a crohns flare which did this month , due to see gastroenterologist week after next. Think we need to be mindful of absorption following what we've been through,  take good supplements ( take loads now and feel well daily), and keep well hydrated always. It's a lot to manage but it does settle when on the right regimes and being very mindful of intake/ supplements needed. Good luck both xx