My experience has been complicated but in general, I am able to manage the diarrhea to a few hours when I wake up but I have to be very careful with what I eat.
I had a bowel resection 2 years ago that removed a total of 3 feet of small intestine, the ileocecal valve, the ileocecal artery, and some large intestine. At first I had watery diarrhea and large amounts of fatty material. I was prescribed a bile acid sequestrate, cholestyramine. I lost the fatty stuff but developed pain and realized that cholestyramine contains sorbitol. I do not tolerate sorbitol so switched to colesevelam. I have been able to stop the colesevelam a few months ago. I started taking Imodium daily after the surgery and continue to take it but more about that later.
I continued to have pain and occasional vomiting and weight loss. The surgical oncologist nor the gastroenterologist could not find the cause until I was hospitalized with a bowel obstruction. No one had considered an obstruction as the source of my pain and weight loss. I started on a very low fiber diet (8 grams per day) and have slowly added a little more soluble fiber. It is still a low fiber diet.
My diet is complicated with food allergies and sensitivities. I am lactose intolerant but can eat aged cheddar, no wheat (except in small amounts) triggers migraines, no soy, and some other foods. So my diet is very limited but now I am able to talk walks and exercise. I have added some soluble fiber like peeled apples, avocados, sweet potatoes.
So lessons that I have learned and that may help someone is:
1. If you are taking a new medication (prescription or over the counter) and you are experiencing problems, read the ingredients. I learned that most formulations of Imodium contain lactose and now take Imodium Multi-Symptom Relief. Even the gastroenterologist did not know about the lactose. And switching from cholestyramine to colesevelam eliminated the sorbitol.
2. After surgery, I talked with 5 nutritionists and found limited help. I had to use trial and error because of my personal sensitivities. It was suggested that I take chewable vitamins (not gummies) for quicker availability in the intestines. But I don't remember any one talking about calcium. I now have osteoporosis with a high risk of spinal fracture because I do not absorb calcium from my diet or calcium supplemented foods. I now am trying powdered calcium citrate and upping my calcium intake to 1800 mg, which is 1.5 times the recommended amount.
3. The calcium citrate and higher amount of calcium had slowed the movement in my intestines and I now often can have softly formed stool. So including the soluble fibers and the calcium I am slowly gaining a pound or two so I hope that I can also absorb the calcium.
4. I am slim and did not eat a lot before surgery. I have not decided if I can eat too much food that encourages the intestines to move things through quicker. I try to think of eating nutrient dense foods and not the bulk like the rice and potatoes.
I am thankful that I am now see the medical providers at Mayo. I have complications that I feel better about having a team of experts that my location medical center was not able to handle.
Best wishes to all of you. I have struggled but keep finding new information and approaches.