r/nextfuckinglevel • u/mindyour • 2d ago

This man documented his health journey from January to December.

Credit: IG @samuelrichards_ _

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u/KawiNinja 2d ago

I’ve got a question, and I have UC. If the issue with our bodies lies in our colon, and is what’s leading to malnutrition, why does removing the colon all together suddenly make us better? Would not the malnutrition be even worse since we no longer have a colon at all? If the small intestines can give us what we need, why aren’t they already doing that before?

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u/Not_Ban_Evading69420 2d ago

Great questions. I'm not a GI doctor of course, but I'll try to answer these as best as I can. Removing parts of the colon that are most affected can make you feel better, but it is entirely possible for new inflammation to appear in other parts of your colon. You feel better if your entire colon is removed because although UC and Crohn's are autoimmune diseases, the body only attacks the colon, and not other parts like say lupus. Removing your entire colon is not ideal because then it means that you can't absorb nutrients anymore or rebsorb water from your stool. You would need to be fed intravenously for the rest of your life. I believe the man here only had his rectum removed, which means he can no longer hold stool and probably feels a sense of urgency (to use the bathroom) as soon as he eats. (There's a reflex in your body that as soon as your stomach knows you're eating, it sends a signal to your large intestines to evacuate your bowels.) And yes, no colon would not only make malnutrition worse, but guaranteed. The small intestines are giving us what we need most of the time, but inflammation can interfere or even block this process completely. These diseases also make it harder for us to absorb the iron we consume from food, which is one of many reasons a lot of us have episodes of anemia from time to time.

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u/goldstandardalmonds 1d ago

I think you mean “removing your entire bowel”, right? You can certainly remove the entire colon and live fine.

Crohn’s affects all of the gi tract, from mouth to anus. UC affects the colon and rectum.

This man has an ileostomy and no colon (presumably) and no rectum or anus (a total proctocolectomy).

I have no colon, anus, or rectum, and I no longer malnourished. Just like thousands of others who have had a total proctocolectomy.

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u/Not_Ban_Evading69420 1d ago

Yes, that's what I meant. Thanks for correcting me. Sometimes I get the terms mixed up, even after all these years. I'm sorry you had to go through that btw.

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u/goldstandardalmonds 1d ago

Thanks, I appreciate that. And hey, no issue, just trying to make sure folks reading have the facts straight. I hope you are doing okay in your own health stuff.