Return to high fiber diet two weeks after laparoscopically colectomy?
I had a laparoscopic colectomy two weeks ago, and have eaten a low fiber diet since. Surgeon, his PAs, and nurses have told me to resume my normal diet (high fiber, lots of nuts, raw vegetables) now. I'm puzzled because standard search engine advice is to remain on a low fiber diet much longer in order to protect the anastomosis.
Has anyone received or followed similar advice?
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Go easy, not full fiber all at once…start with gentler fiber (applesauce, cooked carrots) at first, then add fiber very gradually…be gentle with your healing gut.
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1 Reactioni actually had an open sigmoid colon resection 3 weeks ago and was on very restricted diet after hospital. my post sir surgery diet the dr said fiber fiber downer and 10 glasses of water a day along with meticulous… i was surprised as well bu t he insisted… and its working! going to
athro with ease for first time in years , a lot but solid and no strains.. i also
have waldenstroms non hodgkins. colon was removed along with 15 inches of o test
w. good luck.
Hello. I am 3 yrs out (this month) from my laparoscopic robotic-assisted Total Colectomy with Ileo-rectal anastomosis. (TC-IRA). Your question is VERY important. My surgeon told me similarly; eat 35 grams of fiber per day, soluble or insoluble. I began adding fiber gradually, tried various types of fiber supplementation and foods. It didn't work out too well for me and I believe that this advice is thrown out in a cavalier manner. My experience may be different from others as I also do not have a gallbladder so this affects my digestion (bile dumping and the irritation that this causes upon exit). So, I was very keen on "figuring" out my diet. I'm still working on best practices.
The small intestine is now doing the work of the large intestine. This will take time to acclimate to its new job. I tried adding psyllium husks and it slowed things down, but it's very harsh on the small intestine. It turns into a gel and caused me a lot of pain and pressure. Think a scraper rather than a smooth movement. It also binds with medications and supplements and can make them less effective. So, timing and dosage is important. After a while, I stopped the psyllium because I didn't feel well. I have to be monitored due to genetic polyposis issue, and a CT revealed that I had a "blind loop" at the anastomosis. It was confirmed at my annual sigmoidoscopy (even tho I don't have a sigmoid portion, I have annual scopes to check out anastomosis and rectum for polyps). I'm not sure what caused the loop. I read that some TC patients can develop this loop after many years, but mine showed up in year 2. But I suspect it was too much harsh fiber. The blind loop can pool waste at the site and become stagnant stool creating issues like SIBO. I tested negative for SIBO for two years, so I'm happy about that. I also have significant upper digestive issues so have controlled acid reflux and have an annual scope there due to polyp burden. Yeah, I'm a walking polyp farm. (or was until I had my colon removed).
I can't eat skins of fruits or veges, seeds, gassy veges, lettuce or cabbage, heavily seasoned foods with garlic and onion. I peel everything. No more salads. I do gentle fiber such as instant oatmeal, canned fruits, eat meats and poultry, sourdough or white bread, Natures path fig bars, potatoes, sweet potatoes, green beans (canned), pasta and sauce (I cut the acidity a little with cream), peanut butter, eggs. I indulge on potato chips and chocolate. I recently added 1/4 tsp of cholestyramine (a cholesterol medicine powder that causes constipation and is frequently prescribed for slowing things down), but easing into it to avoid a small intestine blockage and timing around medicine intake due to it's sequestering properties. It has changed things a little, but will creep up on the dose. My main concern is the irritation caused by the bile acid malabsorption (BAM) more related to no gallbladder than no colon.
Overall, I'm very happy with the surgery and I do have great control with my movements which allows me to travel, exercise, etc. Basically, I live a normal life. But, I do believe that going very gentle with this process is essential. Try a food, keep a log, be prepared to pivot if it causes issues. It's not just a "eat a bunch of fiber" solution as we've both been told.
I hope this helps. You're welcome to message me with questions.
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4 Reactions@nycmusic good advise! I still watch it 1 1/2 years later!
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1 Reaction@bevjoy very good advise. I was told to eat what I could tolerate, which didn’t work out well.
Going on two years and I still have to closely monitor what I eat.
Go slow and pay attention to how you react.
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2 Reactions@atmarkj I’m very surprised to read this digestive advice from your medical team. The advice I received from my medical team was the complete opposite - to gradually and carefully start adding more fibre back into my diet and check how my digestive system responded.
I am 4 years out from my surgery (including loss of my gall bladder) and I still pay the price if I overdo it. I had terrible diaorhea last night because I had eaten too many pistachio nuts over 2 days. I knew while I was doing it that I was asking for trouble, and I sure got it and regret it.
I still need to be careful about eating my daily food allowance in several small meals spread across the day. While also carefully watching my fibre intake from meal to meal and monitoring how my digestive system is going. It’s now second nature to be aware even if I’m stupid on occasions because I’m enjoying something in excess when I know I shouldn’t!
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1 ReactionI feel it will be a continual way of life. I have to be my own best advocate . I know I will pay the price for eating the wrong things so try to watch it closely.
This information seemed to be sorely lacking from the medical community.
I watch what I eat right down to the way it cooked and what it’s cooked in and try to eat easily digestible food.
I’m it for the long haul!!
Don’t get discouraged.
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