Surprise Sigmoid Colon Abscess: Questions before my resection

Posted by lucy155 @lucy155, Nov 30, 2022

Hello.... my story has a few spin offs, kinda related, so I'll try hard and make it concise. It started with a right hip replacement surgery September 27, a successful, uneventful 3-day stay. At home, 24 hours later, I had severe urine retention, and what I thought at the time excruciating bladder pain due to UTI, which I get five times a year. My PCP sent me to emergency, where they removed 550 cc's of urine, but no infection??? A CT Scan uncovered a perforated sigmoid colon with abscess, caused by Diverticulitis. The surgeon would not operate because my total hip replacement was so new that the fear of an infection in the new artificial joint took precedent over the colon resection surgery. Hip revisions are a terrible, bed ridden, months long process, so it was determined that the first action would be to pound me with IV antibiotics and a clear liquid diet. I was also diagnosed with Sepsis. My resection surgery was put on a back burner until the hip had time to heal. Five days later I was released with a regimen of 875 mg of Augmentin 2x day for the next 30 days. Infectious Disease doctors indicated antibiotic regimen "until resolved." My follow up three week CT Scan showed the abscess had increased in size. The perforation had healed, but the antibiotics were not affecting the abscess. I then had an emergency X-ray guided probe to drain the abscess. It was aborted because the doctor placed the probe in the wrong spot! My abscess is still there.
It's now three weeks later and with a Diverticulitis flare, the pain is back, not sleeping, back on high dose antibiotics waiting for resection surgery date December 14. I went all liquid diet yesterday to see if pain would subside. It did. I ate a half bagel with cream cheese this morning.
Now for questions for you....
1. Can anyone share their "safe" diet pre-op with me. I am afraid of another perforation, but I must say I miss eating!!
2. Has anyone been on high doses of Augmentin for several months??? Any bad side affects? C-Diff? I am eating Activa most days and taking a probiotic.

Thank you all. I'm glad I found this site. Like all of you, I have a lot of healing to accept. I must be patient.

Interested in more discussions like this? Go to the Digestive Health Support Group.

@lucy155, I'm tagging members @suziq52 @thull @anniegk @ppat4pr @fdixon63 @speedbird @bbarbiee, who you've connected with in this related discussion:
- Seeking support for recovery from diverticulitis surgery https://connect.mayoclinic.org/discussion/seeking-support-for-recovery-from-diverticulitis-surgery/

@sue6408 and @johnbluffside have experience with Augmentin that may be relevant to your story.

Lucy, You're asking good questions before surgery re diet and what to prepare for. I know fellow members will be able to offer their tips and suggestions.

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I stuck with clear liquids because my blockage due to diverticulitis was so bad. Clear broths, jello, and Boost Breeze, which is clear and has 9 grams of protein. I was on cleats for over 30 days. Not fun, but I did it. It was tough because it was over the Christmas holidays and that sucked. I got the Boost Breeze on Amazon.

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@thull

I stuck with clear liquids because my blockage due to diverticulitis was so bad. Clear broths, jello, and Boost Breeze, which is clear and has 9 grams of protein. I was on cleats for over 30 days. Not fun, but I did it. It was tough because it was over the Christmas holidays and that sucked. I got the Boost Breeze on Amazon.

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Thank you for sharing your experience and the information about your diet. I was on the jello, broth, sherbet diet for four days while in the hospital. Lost 8 pounds in 10 days between the hip surgery and the perforated colon. For you, 30 days on clear! Wow, that had to be a tough time. How are you feeling now, a year later?? I've tried a "soft" food diet the last couple days.... Activa yogurt, to try and add back the good gut bacteria , soups, with a pancake or toast once a day. With soft food and antibiotics, I still have steady level 4 pain. I will definitely get some Boost Breeze. I'm diabetic, and my readings are higher than usual, so I'll need to check the sugar. Yes, this next month, with Christmas gatherings, will not be about food!

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I didn’t have diverticulitis, but I did have a colon perforation. I started out with a tumor in my sigmoid found during colonoscopy. I had been having pain but thought it was a kidney stone. I had a resection (actually two) and developed a leak. I had a second surgery about a week later. Three months later an obstruction, surgery, then a month later developed a fistula. Ultimately that caused the perforation and I became septic after surgery. I was in ICU for five weeks and in a coma. I was put on TPN, which gave my body high doses of calories to heal and helped me gain weight all while my colon healed. I also did twice daily shots of octreotide (spelling?) and stayed on TPN (nothing by mouth except ice) for two months. This helped my colon heal. I was on augmenting and flagyl multiple times over a six month period. I had no adverse effects from it. This was three years ago and I’m not done.

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@lisag03

I didn’t have diverticulitis, but I did have a colon perforation. I started out with a tumor in my sigmoid found during colonoscopy. I had been having pain but thought it was a kidney stone. I had a resection (actually two) and developed a leak. I had a second surgery about a week later. Three months later an obstruction, surgery, then a month later developed a fistula. Ultimately that caused the perforation and I became septic after surgery. I was in ICU for five weeks and in a coma. I was put on TPN, which gave my body high doses of calories to heal and helped me gain weight all while my colon healed. I also did twice daily shots of octreotide (spelling?) and stayed on TPN (nothing by mouth except ice) for two months. This helped my colon heal. I was on augmenting and flagyl multiple times over a six month period. I had no adverse effects from it. This was three years ago and I’m not done.

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You have certainly had a challenging journey. Hopefully the surgeries will be done, and you will find a peaceful normal. I have had gastro problems for as long as I can remember. I LOVE to cook and I LOVE to eat. It will be a major adjustment if I need to drastically change the way I eat for a long period as you have had to do. I guess we do what we have to do. Thank you for your time and reply. It was helpful... Acceptance of what is to come.

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Boy Lucy, you have been through a lot! I also have taken high doses of Augmentin twice a day for 20 days when I had flare ups. This summer with my last flare up, the Augmentin did not resolve it, which led my new GI to recommend surgery because I might be developing a resistance to the antibiotic. And in my case I cannot tolerate Cipro or Flagyl. I did test positive for c diff after that flare up, but it was not active. No one in the medical field seems greatly concerned about it, and I have no idea if another course of antibiotics will cause the c diff to take off on me. So I am really trying to eat anti inflammatory foods and take probiotics. In hope that the good bacteria will eventually repopulate my gut. Before my surgery I went on a low fiber diet for a few days, and then a clear diet the day before surgery as a part of my prep. I was also given about ten small bottles of a high protein Ensure. I was instructed to drink two bottles a day up to the day before the surgery. The surgeon, and nurses who were a part of my prep really stressed drinking these to make sure I had plenty of protein before surgery because it promotes faster healing. You may want to check into this with your surgeon. I will try to include a photo of this stuff below. Also, I called my surgeon many times with questions before the surgery. I was lucky to have a really approachable surgeon but even so, I think they have to answer your questions. My surgeon relayed many of my questions to his RN who was really nice and helped me a lot.

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@suziq52

Boy Lucy, you have been through a lot! I also have taken high doses of Augmentin twice a day for 20 days when I had flare ups. This summer with my last flare up, the Augmentin did not resolve it, which led my new GI to recommend surgery because I might be developing a resistance to the antibiotic. And in my case I cannot tolerate Cipro or Flagyl. I did test positive for c diff after that flare up, but it was not active. No one in the medical field seems greatly concerned about it, and I have no idea if another course of antibiotics will cause the c diff to take off on me. So I am really trying to eat anti inflammatory foods and take probiotics. In hope that the good bacteria will eventually repopulate my gut. Before my surgery I went on a low fiber diet for a few days, and then a clear diet the day before surgery as a part of my prep. I was also given about ten small bottles of a high protein Ensure. I was instructed to drink two bottles a day up to the day before the surgery. The surgeon, and nurses who were a part of my prep really stressed drinking these to make sure I had plenty of protein before surgery because it promotes faster healing. You may want to check into this with your surgeon. I will try to include a photo of this stuff below. Also, I called my surgeon many times with questions before the surgery. I was lucky to have a really approachable surgeon but even so, I think they have to answer your questions. My surgeon relayed many of my questions to his RN who was really nice and helped me a lot.

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Hi Suzi, I will call regarding clarification on what to eat now during my current flare. I ate turkey, meatballs and fish over the Thanksgiving holiday. (Eeek!) I was in pain by Sunday night. Couldn't sleep. Scared straight, I went on clear liquid on Monday. I was able to sleep on Monday night. Tuesday I started just soft food. No meat. Protein came from yogurt, chicken broth. I think I'll try and stay from any meat in addition to the other no, nos. The surgeon did give me the same type of drink, but I can only take one a day because of all the sugar in the drink. I'll keep up with high protein yogurt, until prep for colonoscopy/surgery starts. Thank for sharing.

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@lucy155

Thank you for sharing your experience and the information about your diet. I was on the jello, broth, sherbet diet for four days while in the hospital. Lost 8 pounds in 10 days between the hip surgery and the perforated colon. For you, 30 days on clear! Wow, that had to be a tough time. How are you feeling now, a year later?? I've tried a "soft" food diet the last couple days.... Activa yogurt, to try and add back the good gut bacteria , soups, with a pancake or toast once a day. With soft food and antibiotics, I still have steady level 4 pain. I will definitely get some Boost Breeze. I'm diabetic, and my readings are higher than usual, so I'll need to check the sugar. Yes, this next month, with Christmas gatherings, will not be about food!

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It was tough to be on clear liquids over the holidays! I cried on Christmas because I could not have any of the yummy food. It should have said clears, not cleats! Dumb auto correct. My surgery was in 2019, so quite a bit of healing has taken place. Dr wants me to up my fiber intake now, but have to do it very slowly. Still feel the best on Low residue diet.
Hope you find ways to enjoy the holidays!

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I will be able to identify with having a "not-so-pleasant-eating" Christmas. I'll just be 10 days post surgery this Christmas. From the comments posted, the recovery isn't slam dunk. I'm bracing for the worst, praying for the best. Thank you for your reply. ...Better holidays for all of us!

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Well, I'm 6 days post op, still in hospital, and back on clear liquid diet. I have a "post op illias" blockage which caused lots of pain and extreme bloating. Can't go home until I can eat soft food. Im feeling frustrated. Miss my dogs, my home. This illias thing came out of no where right when I was getting ready to go home. Has anyone else had to deal with an illias? How long did it take to resolve?

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