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How to control loose motions after a hemicolectomy?

Q: I had a hemicolectomy done last year in which 14cm of terminal ileum and 21cm of colon with appendix was resected and then the end of the remaining ileum was joined with transverse colon, as there was a smooth stricture of the proximal transverse colon. After this operation there is diarrhoea (4-6 motions) every day . While the first one or two motions are somewhat solid, other motions are watery. Lopamide tablets are being taken, 1 to 3 tablets/day depending on the number of motions. Stool culture did not show any causal organism. The pathology report is as follows: Chronic colitis with micro-ulceration, sub mucosal fibrosis and vascular changes, features consistent with ischaemic colitis. The problem started nearly 10 years back when every 15 to 20 days I used to have bouts of loose motions containing mucus tinged with ?blood. A year back I fell and had compression fracture of L1 vertebral body. After this fall the diarrhoea became more frequent, sometimes with blood, nausea and anorexia. Colonoscopy revealed a stricture of proximal transverse colon.

A:I am not quite clear what the question is. Perhaps you are concerned about your loose motions. Loperamide can certainly help. You could add codeine phosphate as well. If the question is about ischaemic colitis, I am not quite sure whether this diagnosis is correct. However, the slides could be reviewed so that something like Crohn's disease or ulcerative colitis is not missed.


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