How Much Colon Can Be Removed Without Major Issues?

how much of your colon can be removed? and still go thru a reversal with out ending up in dialises and or the other option i was told is that if the colon was  to short even tho not on a bag i would know of every bathroom, outhouse,do to colon being short it would be no different then being on a bag but with out a bag or end up with a ileostomy and relocation of were my stoma would be move to  if they go thru with the surgy i have already lost 30 inches between the surgries i have had do to hurshsprung  

i will talk to you all later

I knew a couple of people years ago who had their entire colon removed and part of their small intestine as well and had the reversal done successfully.  Keeping in mind, the colon or large intestine can be 6-8 feet long in an adult and the small intestine anywhere between 20-30 feet in length....as I was always told by my surgeon.  They tried a reversal on me as well, but I ended up with another bad Crohn's attack and my reversal went out the window.

Weewee, there are a couple of things going on here.  First you can have all of your colon removed and a reversal done using a J pouch, if your anus is still intact, mainly the muscle.  Many people having this done find they use the bathroom maybe about 6 times a day. This is after about  1 year of your body getting used  the J pouch.

In some cases the colon is removed, however the rectum or rectal stump as some doctors call it is intact and not deased (sp) is left in place.  If that is the case it gives much more storage capacity than just the J pouch alone.  A person can with the help of Imodiam or Lomotle (sp) get to about 2 to 3 times a day diet permitting.



I found it is very hard to get reliable information on this subject.  I have yet to find a doctor that gives the whole story both up side and down side and side effects.  So many things are learned the hard way and after the fact.



Ask lots of questions, know exactly where this thing is taking you.  Be relentless about your questrions.  Don't let the doctors shine you on with a short explanation.



Good luck



Rick.....

Hi. I have had my entire large intestines removed, including the rectum (it is sewn up). I have also had most of my small intestines removed aswell......It last count there was approx 3-4 feet of the small bowel left. My Ieleostomy is permanent. A j pouch was not an option because I have Crohn's.  i have heard good and bad about reversals. i would think that it would be a discussion between you and your doctor and getting all the info. BTW....You wondered about dialisis?? Do you mean Dialysis? That is a treatment when your kidneys have failed. Good luck.

thanks guys for your answers i just got back from camping WOOT what fun and yes the doctors dont want you knowing anything and do give you short answers i dont take it from them i get more info from everyone on this site and go to bat with that overpaid A$$ lol and he gets a dumb look and then i might get some answers close to what everyone says they like the maybe world not the real world to much

talk to all soon

Words of Encouragement from Ostomy Advocates I Hollister

  



OK, so I"M a dumb Bunny (been called worse but I keep hearing about this J POuch, is this something that is inserted into the abdomen, or another external Pouch, enquiring minds wants to know

J" pouch:

Usual candidates are those who have had their colon (large intestine, large bowel, all the same thing) removed due to UC or Familial Polyposis. The anal sphincter must be free of disease and competent. A pouch is created from a portion of the small intestine to make a holding vessel for stool, and connected to the rectal stump. Stool is liquid and enzymatic as it is basically a "continent" ileostomy, no pouch. Stooling frequency varies from person to person, diet, competency of sphincter, volume the pouch can hold which differs, etc., but average is 5-9x/day. Continence varies also depending on sphincter control, diet, and how your individual intestine reacts. Most folks have slight stool seepage at night. Perianal skin protection and using a pad is common. How long you can "hold" stool prior to seeking a restroom is individual.



Diet control, Imodium or Lomotil, sometimes even Metamucil or bran can help slow down the stool frequency and thicken it up.



Statistically, satisfaction with lifestyle after a year whether you have an ileostomy or a J pouch appears to be pretty equal. J pouches have a higher incidence of re-surgery, potential pouchitis; some have to be "taken down" (removed). I have had a couple of patients have their pouches removed as continence was poor. If Crohn's disease, one is not a candidate. Occasionally what biopsies and presents as UC has later been found to be Crohn's, and pouch was taken down. Much as some may have continence issues, others may have strictures and require re-surgery or dilation to keep things open in the rectal stump. In all, the upside is maintaining your anatomy and no external pouch. Psychologically this is very important to many and they opt for the J pouch. The surgery may be done in 1, 2, or 3 step process depending on the individual medical condition and surgeon. Takes a bit longer to get back to normal lifestyle than conventional ileostomy.

Comparing with an ileostomy: Upside: Faster and simpler surgery, less reoperation, lower complication rate. Stool is contained in an external pouch (we hope!!

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a little ostomy humor....). Frequency of emptying and need to slow down the stool flow is about the same. Skin is protected by the appliance. Downside: there can be containment issues (!!) Food blockages from what I have experienced with patients can be more troublesome, so diet restrictions may be a bit more, depending. Having a pouch on the abdomen can be difficult to adjust to for some.



Some folks have the small intestine sewn directly to the rectum without a "j" pouch; some still have good continence but more frequent stools and have to watch their diet more carefully.



Medical condition, age, and other factors may influence your surgeons or your own decision of what is the best operation for you. I say "for some" as everyone is an individual with their own sets of thoughts and circumstances. I couldn't say that one procedure is "better" than the other; that is for the individual and their physician to decide what is most appropriate and risks or not they wish to take.



There is a good web page: www.uoaa.org with explanations of both. Look on the left, the menu I think says ostomy info. You can read or download info on all types of ostomies and continent procedures.



Hope this helps.

Well I've always wandered since I heard the term. I had asked my surgeon about the possibility of having a reversal and in his nicest way told me I could ask any questions I wanted but in the end I would have to make that decision alone. When I told him I have constant diarrhea, would I have the same after. END OF STORY, I keep the pouch. Also, my sister, who worked in Emergency Rooms for many years, told me of many horror stories she had come across in the ER, so she says Ed get that shit out of your head, You're dealing with this much better than I thought you would. SO FORGET IT. OK, yeah OK, and I did.