Consequences of Removal of the Ileocecal Valve - RS Hemi

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Lidarose
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Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby Lidarose » Thu Sep 03, 2009 1:20 pm

Hi all...

I saw my surgeon yesterday and since my right-sided hemi-colectomy with removal of the Ileocecal Valve, he told me that I may, for three to six months, experience alternating diarrhea and formed stools, which is exactly what is occurring. What I don't understand is, why when I feel the diarrhea oncoming, I can't control myself at all, and have all of 5 seconds to get to a bathroom, but can control myself when I'm ready to have a formed stool. I've been reading alot of posts whereby people who have had the same surgery as myself, have had their doctors say the same thing, but state that the diarrhea has never stopped, and I'm concerned that I will never be able to go anywhere again without the fear of having an awful, messy accident in some public place!

My surgeon told me that the Ileocecal Valve is responsible for controlling the flow of fecal material from the small intestine into the large intestine and losing it, makes one lose that control. :( I'm also reading on the net (see info below), that without this valve, toxins can build up/back up in your small intestines and make you sick!

This has me concerned.

Can anyone illuminate on this subject? :?

Thanx,
Lida

*********************************************************************

What is the Ileocecal Valve?

The Ileocecal Valve is located between the ileum (last portion of your small intestine) and the cecum (first portion of your large intestine). Its function is to allow digested food materials to pass from the small intestine into your large intestine. The ileocecal valve also blocks these waste materials from backing back up into your small intestine. It is intended to be a one-way valve, only opening up to allow processed foods to pass through. Ileocecal Valve Syndrome

When the ileocecal valve is stuck open waste products can back up into the small intestine (much like a backed up kitchen sink drain) disturbing your digestion and also creating unhealthy toxins that are absorbed into the body. Also, if the ileocecal valve is stuck closed waste products are prevented or constricted from passing into the large intestine.

Unfortunately, this disorder is often overlooked by the medical profession. A dysfunctional ileocecal valve can result in a combination of symptoms.

Ileocecal Valve Syndrome Symptoms

Right shoulder pain
Right side pelvic pain
Low back pain
Pain surrounding heart
Flu symptoms
Tinnitus
Nausea
Syncope / Near syncope
Headache
Bad breath
Face pallor
Dark circles under eyes
Dizziness
Bowel disturbances (diarrhea / constipation)

Causes of Ileocecal Valve Syndrome

Dehydration
Emotional upsets
How you eat (overeating, eating too frequently, eating too quickly, eating foods you are sensitive to, under-chewing your food)
Foods you eat (carbonated drinks, alcohol, caffeine, chocolate, raw foods, hot spicy foods)

Ileocecal Valve Syndrome Treatment Options

Chiropractic adjustments
Applied kinesiology
Homeopathy
Temporary elimination diet (for 2 to 3 weeks avoid:
Roughage foods--such as: popcorn, nuts, potato chips, pretzels, seeds, whole grains
Raw fruits and vegetables--such as: celery, bell peppers, cucumbers, cabbage, carrots, lettuce, tomatoes
Spicy foods--such as: chili powder, hot peppers, salsas, black and cayenne pepper, paprika, cloves, cinnamon
Stimulants--such as: liquors, alcoholic drinks, cocoa, chocolate, caffeine products

References: Systems DC Patient Education pamphlet: Open Ileocecal Syndrome, Consultation-- Dr. K.E. Kirchner, Kahoka, MO.

JAZZToo
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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby JAZZToo » Fri Sep 04, 2009 8:19 am

LidaRose

I had a right hemicolectomy 6 years ago with removal of the appendix, gallbladder and ileocecal valve with 4.5 cm of the ileum. I have not had any bowel problems as a result. The first few months I had several bms a day, no problem with diarrhea and for the last 5 years, usually just one a day, without any urgency and can eat all foods without a problem.

I disagree with your physician's statement - the ileocecal valve does not control the flow of fecal matter. When the intestinal contents pass through the valve at that stage it is liquified. The large intestine is responsible for the resorption of water into the body and that controls the formation of formed stool. This can be affected by food allergies, dumping syndrome (too fast transit time from injestion to ejection), spoiled food, certain medications (e.g. diabetes meds). The muscles around the anus control the ability to hold stool until you can reach a bathroom. The comment that without this valve toxins can build up and back up probably came from one of those "alternative medicine" websites similar to those that claim many pounds of fecal matter are plastered like glue on the intestinal walls necessitating many enemas of whatever brand the site is selling, which you as does anyone who has every had a colonoscopy know is a blatent lie. As far as toxins building and backing up and making one sick - peristaltic waves keep the intestinal contents flowing in the right direction so there is no backing up.

JAZZ

Lidarose
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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby Lidarose » Fri Sep 04, 2009 11:07 am

Happy to hear some edification JAZZtoo!

Only problem with the diarrhea is that one's sphincter can hold in formed stool, but with diarrhea, the stool is liquid, and therefore, my sphincter is totally useless, as far as holding in liquid stool is concerned, i.e., within 5 seconds if I don't get myself to the loo, it simply starts dripping out, and I have very little control. I'm hoping this will change after awhile, but am glad to hear from someone who hasn't had any repercussions of the removal of this valve, as this had me concerned, as you could tell.

I'd be happy to hear from anyone else who has had my surgery, as to what they are experiencing in the way of bowel function, after this surgery.

Many thanks,

Lida :)

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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby mardrobe » Fri Sep 04, 2009 1:20 pm

Unfortunately Linda and I can not give you good news. She is still having problems six years after surgery and her Gastroenterologists are telling her it is probably permanant. She takes Welchol to minimize the Diarhea, but still needs to stay close to restrooms.

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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby Terry » Fri Sep 04, 2009 5:21 pm

Welcome to most of our worlds! Many of us on here have a hard time holding it when we have diarrhea, heck I had a hard time holding diarrhea before my surgery! Only time will tell if it gets better for you. It's been 2.5 yrs since my surgery (a different surgery than yours) and most of the time I can control it but sometimes, even with formed it's a rush to the restroom. I still plan my activities with thoughts to the bathroom.
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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby NWgirl » Fri Sep 04, 2009 6:41 pm

If I have diahhrea, I can't hold it - BUT - I have NO rectum. That said, I am learning the "warning signs" my body gives me. It's kind of like having to go through potty training as an adult - learn all new signals and what they mean - and how much time you have (or don't have) to get to a bathroom. Fortunately, I don't normally get diahhrea. But sometimes if I eat a lot of fresh fruits/veggies - like right now with my garden going full swing - things move throuhg me a lot faster. I may get one "you better go NOW" and if I ignore that, things try to make their way out - which I can pretty much hold in - but not completely.

For those of us with "new plumbing" - it's trial and error and learning all the new signals our body sends us - which are not like the old ones! I'm hopeful that this old dog can learn the new tricks!
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Lidarose
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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby Lidarose » Sat Sep 05, 2009 1:29 am

My main concern is that I will never be able to travel again, which I love. My husband and I love cruising and taking excursions, but many of the excursion buses don't have rest rooms these days, so it sounds like our traveling days are over. I've been wearing Depends, but honestly have no idea if Depends are made for catching urine flow or diarrhea? Does anyone know?

Even wearing the Depends, I'm concerned about odor, as I've noticed since my surgery, shall we say, I'm more odiforous than usual, and I'm afraid if I have an accident, the odor will be very noticable by those around me.

Does anyone have any other options for something to wear that would allow for more confidence regarding diarrhea accidents, as right now, I'm uncomfortable just leaving the house!

Thanx,
Lida :?

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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby garbovatwin » Sat Sep 05, 2009 5:01 am

Hello

I would tend to agree that your doctor misinformed you about having a continence issue without the Ileo valve.

How is your diet?

.....................

The ileocecal valve is a sphincter muscle situated at the junction of the small intestine (ileum) and the large intestine. Its critical function is to limit the reflux of colonic contents into the ileum.[1]

Functionally, roughly two litres of fluid enters the colon daily through the ileocecal valve.

http://en.wikipedia.org/wiki/Ileocecal_valve


Without this valve regulating how much is being allowed to enter your colon to be processed, it is a steady flow into the colon. With the normal processes occuring in the colon, if not regulated, it flows and continues to pass through. NOTE that without the cecum and right colon, you are missing one of the main parts of the colon that pulls water from the stool passing out of the small intestine. Steady flow, subjected to a lesser time passing through a smaller colon can equate to looser stools. Try eating smaller meals more frequently as a means of controlling the flow yourself by timing what you eat. Large meals will more than likely lead to constant looser stools.

SURGICAL REMOVAL OF THE ICV

The ileocecal valve performs two key functions. It physically separates the small intestine from the colon, keeping the bacterial content of the colon from backing up and colonizing the small intestine, and it regulates the emptying of the contents of the small intestine into the colon. By slowing the passage of nutrients from the small intestine, the ileocecal valve helps to prolong intestinal transit time, thereby increasing the time that nutrients are in contact with the mucosal surface. This serves to maximize the absorption of nutrients, fluids, and electrolytes. the surgical removal of the small intestine decreases the transit time of food by physically shortening the length of the intestine, disrupts the normal rate in which food is mixed with enzymes, and shortens the contact time of the nutrients with the mucosal surface. When the ileocecal valve is also removed, bacteria from the colon flow into the small intestine, which can result in bacterial overgrowth. Intestinal transit time is further reduced, since the valve is not there to regulate the flow from the small intestine into the colon. This can exacerbate symptoms like diarrhea, malnutrition, and electrolyte imbalance because the absorption of water, nutrients, and electrolytes is impaired.

Try tweeking your diet and meals and mealtimes.

As far as the urgency issue. If you are ready to have a watery bowel movement. when it gets to the point of feeling the urge, just about anyone is risking having a continence issue if one does not get to a toilet in time. Try timing your toilet sabbatical so you can be on a toilet BEFORE it reaches the 'urge to go' time. This is what I am doing. With all the stuff they have me on right now to loosen and free flow my bowel movements until we totally get my bleeding under control, as soon as i feel 'that feeling' in the sigmoid area I head to the toilet. I have had a few 'accidents' in the past few months because I was waiting until I felt the urge to go.

You can balance it out. No one knows your system and your regularity schedule better than you.

Good luck.

jamiana
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Lidarose
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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby Lidarose » Sat Sep 05, 2009 5:53 pm

Thanks for the additional info, Jamiana.

So - it just sounds like colonic material will be passing through my colon unregulated, in whatever form it happens to take. Unfortunately, I'm in the 5% group of people who cannot take fiber supplements, i.e., Metamucil, Fibercon, etc., having tried them all, and receiving severe left-sided colon pain for my efforts. This is what the surgeon recommended, but it's not possible for me.

However, I shall try to do what you say and anticipate my movements, particularly when I feel they're going to be liquid. I guess that's all we can do, except hoping for the best!

Thank you,
Lida :)

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garbovatwin
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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby garbovatwin » Sun Sep 06, 2009 5:29 am

Lidarose wrote:Thanks for the additional info, Jamiana.

So - it just sounds like colonic material will be passing through my colon unregulated, in whatever form it happens to take. Unfortunately, I'm in the 5% group of people who cannot take fiber supplements, i.e., Metamucil, Fibercon, etc., having tried them all, and receiving severe left-sided colon pain for my efforts. This is what the surgeon recommended, but it's not possible for me.

However, I shall try to do what you say and anticipate my movements, particularly when I feel they're going to be liquid. I guess that's all we can do, except hoping for the best!

Thank you,
Lida :)


Smaller frequent meals spaced apart could help.

The valve acted as a regulator of how much was put into the colon before it would close and prevent more from flowing into the colon, and prevent what was in the colon from backing up into the small intestine. Without that regulator it is indeed flowing steadily with the natural movements created by ones intestines. What is left of your colon is capable of forming stool that is liquid out of the small intestine, but I think perhaps the key might be smaller meals spaced apart.

Pay close attention to how your new 'system' feels. There are always warning signs (feelings) that let you know a bowel movement, be it loose or formed, is getting close.

Have you tried the fiber wafers that so many with an ileostomy use to bulk things up a bit?

jamiana
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Lidarose
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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby Lidarose » Sun Sep 06, 2009 5:36 pm

Nope...what fiber wafers, jamiana? Do you have a brand name for them? Do you know how much fiber is in each wafer? Perhaps they would help if I could tolerate them!

I've found that every 3rd or 4th day, I can eat a large bowl of hot Quaker Oat Bran cereal without repercussions, which has 6 grams of fiber in it, so I try and have a bowel of that to "firm" things up as often as I can stand it. It's also delicious, and actually, I like it much more than Quaker oatmeal! I know 6 grams doesn't sound like very much fiber, but we fiber sensitives, can't assimilate very much without alot of colon pain, and that's just what I don't need, particularly right now, (lol)!

Let me hear back from you!

Cordially,
Lida

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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby garbovatwin » Mon Sep 07, 2009 4:17 am

Lidarose wrote:Nope...what fiber wafers, jamiana? Do you have a brand name for them? Do you know how much fiber is in each wafer? Perhaps they would help if I could tolerate them!

I've found that every 3rd or 4th day, I can eat a large bowl of hot Quaker Oat Bran cereal without repercussions, which has 6 grams of fiber in it, so I try and have a bowel of that to "firm" things up as often as I can stand it. It's also delicious, and actually, I like it much more than Quaker oatmeal! I know 6 grams doesn't sound like very much fiber, but we fiber sensitives, can't assimilate very much without alot of colon pain, and that's just what I don't need, particularly right now, (lol)!

Let me hear back from you!

Cordially,
Lida


There are a few. I have seen Metamucil wafers mentioned frequently.
http://www.metamucil.com/metamucil-fiber-wafers.php
They're available in most larger grocery stores.

I experience a bit of pain in my colon daily, at every bowel movement. I would gladly trade some pain for continence...;)

Thanks for the tip on the Quaker Oat Bran Cereal.

Remember, smaller more frequent meals.

jamiana
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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby Lidarose » Mon Sep 07, 2009 5:28 pm

Freudian slip on the "bowel" of Quaker Oak Bran, jamiana, (lol)! :lol:

Lida

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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby garbovatwin » Tue Sep 08, 2009 3:06 pm

Lidarose wrote:Freudian slip on the "bowel" of Quaker Oak Bran, jamiana, (lol)! :lol:

Lida


Haaaaaaaaaa
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mardrobe
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Re: Consequences of Removal of the Ileocecal Valve - RS Hemi

Postby mardrobe » Wed Sep 09, 2009 12:22 pm

Linda also has problems with taking Fiber as it tends to block her system. The only thing she has found that helps is the Chloresterol drug Welchol which thickens the contents of the intestines and a small dose of Gabepentin which seems to slow down the activity of her stomach and small intestine. Without these she can't be away from a restroom, but she can function close to normal with them. She also uses disposable underwear to prevent accidents.


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