MYSTERY:How does Rectal cancer cause ongoing diarrhea??

[Bob_Weiss]

Diarrhea results when food moves too quickly through the colon, and the water cannot be adequately absorbed by the colon. I was treated for rectal cancer, with surgery and radiation which did not involve the colon-although I did have a temporary ileostomy. It has been 5+ years since my ileostomy has been reversed, and I still get occasional watery stools, which causes an urgent need to get to the toilet ASAP (or sooner!). When the stool is solid, my rectum functions normally and the urge to "go" can be delayed for a while when there is no toilet immediately available.

It seems mysterious to me that treatment involving the rectum should have resulted in this apparent permanent change in the functioning of my colon, while my rectal functioning seems back to normal. Perhaps the temporary ileostomy caused the problem?? Has anyone come across articles/research on this question??

[PGLGreg]

My theory (I've no evidence) is that the diarrhea and gas after surgery for CR cancer are a consequence of the surgical removal of many lymph nodes during the operation. I realize this is vague, but I have the intuition that all those lymph nodes must have been serving some useful function, which is lost when they are removed.

[Jachut]

I've wondered this too. Diarrhoea was not a major problem for me after surgery, but it was a symptom. I ignored easily explained away symptoms for literally years but when I'd sneeze and bloody diarrhoea run down my leg, and when I was having leakage of liquid stool, that's when I'd had enough. Why would I have diarrhoea due to a tumour in my rectum? What was there should have been solid.

By the same token, why did my temporary ileostomy not settle for the whole 9 months?. Boy oh boy, it produce litres and litres every day. Nothing we did ever stopped it. I gained 5kg the night of reversal simply from rehydration.

[Lee]

My 2 cents. Sorry if this offend a certain population. God created man (and throw in evolution) . We are born with a certain amount of colon. It is what we need to process food food correctly . The perfect machine (ie colon). Now take some of that away (surgery), colon is now much shorter butt expected to work the same load prior to radiation, surgery, etc . Body says I'm doing the best I can under the condition you have just given me .

We are not the same now as we were prior to our diagnoses. Butt our colon is expected to do the same as was prior to diagnoses .

Just my 2 cents.

Lee

[Nik Colon]

I cannot answer neither, but when reading, any colon/rectal issues can cause weird issues like these. It doesn't make much sense to me either, but our bodies sometimes seem to change when things change, like cancer, surgery, etc. I can only assume it has something to do with how our body reacts to these changes. I wish I had a better answer and feel your pain (although we all experience it somewhat different). Best wishes

Wanted to add, when the rectum is involved it changes the muscle structure/control. Your rectum should be able to hold a full load of fecal matter, but with surgery that would change that. That's all I can think. I had my sigmoid removed and from what I believe it doesn't have that holding area, therefore goes directly down and changed my frequency and ability at times to determine if it's gas or not. I still have occasion small accidents.

No matter what I have done I can't seem to get back to normal. Some days are better than others tho.

[tarheelmom]

I was just thinking about this very topic (in addition to clustering) because my take down surgery is less than 2 weeks away. Here's my theory:

1. The colon removes water from the waste and aggregates the waste into stool that is stored in the rectum until it's excreted.
2. When a significant portion of the colon is removed, there is not as much length (and hence time) for the waste to move through and hence not as much water is removed causing diarrhea.
3. Also without the length of the entire colon and no rectum, the waste doesn't have time to aggregate into a larger stool which causes the clustering.

The part of my theory that is missing is why clusters sometimes and diarrhea at other times.

[Jachut]

All true but the function of the rectum is to hold already solid stool - I didn't lose significant colon, I still had almost all of my sigmoid colon. And as expected, I never had diarrhoea - only before when I had my whole colon. Now I have my colostomy there's less colon to work so you'd expect softer sools - nup, Its hard hard hard most of the time.

[Lee]

. . . Now I have my colostomy there's less colon to work so you'd expect softer sools - nup, Its hard hard hard most of the time.

Any chance you are not getting enough water or liquid on a daily basis?

Lee

[Abadrock]

This is a great question. I think it has to do with nerve damage from radiation or chemo that affects the motility and transit time through the bowel. In the course of a couple of weeks I can go from diarrhea to constipation without changing anything about my eating or activity levels. I've finally figured out a regimen of Metamucil, probiotics, and Miralax that keeps things relatively balanced, but if I vary it even a little, I am messed up again.

Diagnosed 12-2011, T3 M0 N0
LAR 4-2012
Xeloda, Radiation, pre op 28 sessions
Xeloda post op.... With horrible hand and foot!
Temp. Ileostomy, takedown 12-2012
So far, so good!

[pabl]

I have the same issue every week or so. It seems that something I eat hits my stomach and doesn't react well, and soon after, I get diarrhea and it seems like it triggers my entire system to empty. I have been to a GI doctor who speculated that it was because of the radiation---that it changed the ability of my intestines to operate properly or something. Still don't know for sure. But I wonder if I were able to build up my biome better, would that help cuz maybe the radiation killed the bacteria that is needed to process. But why would it work sometimes and not other times?