How long until bowels become normal after surgery?

Hi,

I've had Crohn's disease for about 15 years I am very lucky as I was in remission for about 7 of those years. I had surgery in July to remove 30cm of Crohn's affected bowel, best decision ever! My question is how long until my bowel movements become normal? I'm not taking any medication only probiotics.

If anyone has any advice to offer it would be great!

Thanks

Michelle

Hi Michelle,
I think it depends on what is removed. If it includes the ileocecal valve I don't know that you will ever be normal again. That was my first surgery and was never 'normal' from that point on.

How are your bowels behaving now? Are you more on the constipated side or loose? What is your diet like?

A couple of weeks to go back to normal but if your surgery was July that's a really long time.

As DJW has said, if you have had your Terminal Ileum resected then it varies greatly. Some people seem to return to normal bowel habits quite quickly, for others it takes months and for yet others it never returns to normal, or close it, without taking something to help firm the stool.

My children fit the last category. They have both had ileocaecal resections of vastly different proportions and yet neither has normal bowel motions without help. My daughter’s resection was 8 years ago and she had 68cm of bowel removed. I do believe there has been some natural take up over the years but nothing significant. My son had surgery 3.5 years and had 28cm of bowel resected, he too needs to take something to reduce the amount of times he goes a day.

All this is due to the fact that this type of resection results in the malabsorption of bile salts. The Terminal Ileum is where bile salts are reabsorbed back into the body, when this doesn’t occur the bile salts get dumped into the large bowel. The function of the large bowel is to absorb water back out of the bowel and so firm stool up, the presence of bile salts in the large bowel means that the opposite occurs. Bile salts have the osmotic effect of drawing water back into the bowel and that results in loose, frequent bowel motions.

You can be prescribed medication like Questran, it is a powder that you mix into water/juice etc. It binds to the bile salts in the small bowel and in doing so firms up the stool. This should then result in firmer, less frequent bowel motions. Others find Lomotil/Imodium helpful but I don’t know if this would be recommended as a full time long term solution.

What has worked for both of my kids is Psyllium husks, it works the same way as Questran does. My daughter has found it far more palatable than Questran and it has the advantage that you can add it to cereal, soups, gravies, anything moist really and you can cook with it as well…slices and so on. Chia seeds have a similar action but I am not overly familiar with their use in this instance. This thread has loads of members experiences with Psyllium:

http://www.crohnsforum.com/showthread.php?t=13856

If you do go down this track please be aware that both Questran and Psyllium do have time restrictions as to when you take medication in relation to them.

Dusty. xxx

Sorry, to clarify on my comment if you had certain parts removed you may not go back to your before normal. So while it takes a few weeks for normal to return it may be a new normal. Over time though the body has been known to adapt in terms of absorption and even the small intestine can act a bit more like the colon after a while n

"Normal" as in, as if you don't and never have had Crohn's - quite possibly never. "Normal" as in, when your bowel is healed from the surgery - my surgeon has always told me to wait six to eight weeks to heal from a major bowel surgery. Plus the effects that come from removing specific parts of the bowel, as mentioned above.

But my own experiences imply something a bit different: my bowel movements return to what will at that time be my "normal" after a few days, and that includes what happens since I've had a stoma: my stoma output normalises a few days after surgery.

But often medications can help improve particular symptoms, and dietary changes may help too, so you needn't assume that the problems you're having now are always going to continue, even though your bowel should have healed from the surgery by now. Plus it's possible you have symptoms now which may be being caused by active Crohn's or from a complication that can be treated - without more details it's impossible to say, but if you're concerned it may well be worth talking to your surgeon.