Hi, Teresa. we all appreciate your initiative on the impact of surgery on our digestive tract, especially on how to deal with nutrition that comes mainly from what we eat and drink. I don't think my experience will be widely useful, given my unusual surgical escape from colon cancer.

The surgeons removed most of my colon, starting with its beginning where my appendix was, up my right side, across the top of my abdomen, and down my left side to within six inches of my rectum. As a result, I lost almost all of the large intestine where foods not already digested in the small intestine are harvested by a crowd of bacteria and absorbed from them into my metabolism. In short, I lost a lot of nutritional material that used to be collected in my colon, and the customary waste that remained was clogging what was left of my colon and in my rectum. Over more than a year of recovery, it became clear that fiber-bearing foods were a major factor in the poor mobility of a digestive system that had no colon to handle it.

I found relief last month from a expert nutritionist. To deal with the bulky and fibrous foods, we cut high-fiber cereal from my daily breakfast and other carbohydrate food. Then we spread my meals out to four per day, reducing each to about two-thirds of their former size. She recommended that I make special effort to chew my food more to make it easier to digest in my stomach and small intestine. And starting each day with a glass of water and adding more during the day, along with nutritious drinks, has helped move the digesting food along more readily. And maybe most important, more exercise at a moderate rate for longer periods encourages everything to move along as it should.

On the whole, the content of my diet is not markedly different than before, just less fibrous, more spread out, and more liquid. Martin