Question 1

is colectomy is the last choice for treatment ulcerative colitis ? is colectomy a bad thing to patients ?

Accepted Answer

Not a simple answer: This is a complex issue beyond the scope of a 400 word answer. If you have tried all the usual treatments including biologics (humira for example) and immune modulating drugs (imuran (azathioprine) for example) and have non or poorly responsive disease, then a colectomy is generally a better choice than a life of being a slave to your colon inflammation.

Question 2

if patient had total colectomy with ileostomy placement, can they have a surgical procedure involving ileum to sigmoid/left colon several yrs later.

Accepted Answer

YES: if one performs a left colectomy, even extending the dissection below peritoneal reflection, as long as there is a rectal stump, 1-2 cm above the levators, proximal bowel can be reanastomosed.   One can creates a pouch from the proximal bowel to make anastomosis easier and have the pouch act as a partial  reservoir for the liquid feces in the ileum that will be used for anastomosis

Question 3

if a patient had subtotal colectomy w/ileostomy placement resulting in short bowel syndrome for over 13yrs, could they have their ileostomy reversed?

Accepted Answer

It depends : This is a difficult question to answer without more data. Assuming they had some sort of small bowel resection and truly has "short gut," then reconnecting to a rectal stump will likely not improve the condition, as the rectum does not provide adequate nutritional absorption (mainly just water resorption). This needs to be discussed with a general surgeon along with radiographic evaluation.

Question 4

to clarify. high grade (flat/invisible) dysplasia in random colonoscopy biopsy (uc patient). is colectomy only option cause this type of hgd is so deadly or cause it's not resectable (being invisible)? if latter, could chromoendoscopy offer any hope?

Accepted Answer

: Colectomy is indicated for preventing death from inevitable colon cancer.

Question 5

what would be the reason for having a patient who's had subtotal colectomy with ileostomy placement undergo a fluroscopic single contrast enema test?

Accepted Answer

Many reasons: If it was subtotal colectomy with anasthomosis to rectum and protective iliostomy then most likley it's to check the anasthomosis prior to  iliostomy closure

Question 6

surgeons: if a patient who had a subtotal colectomy w/ileostomy placement 13yrs ago, resulting in short bowel syndrome & frequent loose bowels, but was wanting an ileostomy reversal, what would do & y?

Accepted Answer

Difficult question: to answer without knowing much more details. Why was that surgery done? What is the remaining anatomy? Remaining colon or rectum in place? Reconnecting an ileostomy  after 13 years might not be well tolerated with resulting frequent diarrhea, poor anal muscle control, anal irritation &amp; the surgery would not correct a short bowel condition. Need many more details to try to answer this question.

Question 7

how long is the survival rate of an 88 yo patient, who underwent partial colectomy due to stage 3 colon cancer without chemotherapy?

Accepted Answer

: All depends on many other things like his general health, co morbidities, grade of tumor. It is very difficult to predict. Wish him/her a long survival and good health.

Question 8

post colectomy instructions...diet, sex, return to work?

Accepted Answer

Variable: But assuming you had an abdominal incision of some kind, i usually tell my patients 6 full weeks before sexual activity and strenuous exercising. I usually treat for 2 weeks post op with a low fiber diet and then at first post op visit if all is well, advance to an unrestricted diet. I am assuming you have no ostomy. Please discuss with your surgeon as they should have the final say so for all of.

Question 9

can i take in protein powder? as i can only have low fibre diet due to i had done a total colectomy(large intestine).

Accepted Answer

Yes: A pure protein powder has no fiber at all.
There are many types of protein powder. If from soy make sure it is non-gmo soy. If whey try to find one from grass-fed cows not given hormones or antibiotics and processed at low temperature such as whey cool by designs for health. Protein powder from hemp seeds is another good choice though make sure it is a pure protein powder without fiber.

Question 10

how can i doctors control pain after a colectomy?

Accepted Answer

Multiple ways: Intravenous patient controlled anesthesia is most common with narcotics. This can be supplemented with Iv Tylenol (acetaminophen) or Toradol with good results until oral meds can be initiated

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Doctor answers about:

Diet for colectomy patients

A member asked:

Is colectomy is the last choice for treatment ulcerative colitis ? is colectomy a bad thing to patients ?

A member asked:

If patient had total colectomy with ileostomy placement, can they have a surgical procedure involving ileum to sigmoid/left colon several yrs later.

A member asked:

If a patient had subtotal colectomy w/ileostomy placement resulting in short bowel syndrome for over 13yrs, could they have their ileostomy reversed?

A member asked:

To clarify. high grade (flat/invisible) dysplasia in random colonoscopy biopsy (uc patient). is colectomy only option cause this type of hgd is so deadly or cause it's not resectable (being invisible)? if latter, could chromoendoscopy offer any hope?

A member asked:

What would be the reason for having a patient who's had subtotal colectomy with ileostomy placement undergo a fluroscopic single contrast enema test?

A member asked:

Surgeons: if a patient who had a subtotal colectomy w/ileostomy placement 13yrs ago, resulting in short bowel syndrome & frequent loose bowels, but was wanting an ileostomy reversal, what would do & y?

A member asked:

How long is the survival rate of an 88 yo patient, who underwent partial colectomy due to stage 3 colon cancer without chemotherapy?

A member asked:

Post colectomy instructions...diet, sex, return to work?

A member asked:

Can i take in protein powder? as i can only have low fibre diet due to i had done a total colectomy(large intestine).

A member asked:

How can i doctors control pain after a colectomy?

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