Alan’s nearly 2 years Post IL. I think he’s doing really well apart from a couple of things. One is that he continually has phlegm/mucus in his chest that irritates him but he finds difficult to move. The other is diahorrea. 7 weeks ago we came back from a few days in Spain. He had a tummy upset. Eventually went to GP who took a stool sample and found he had Campylobacter. He was given antibiotics and it cleared up. On Friday we returned from a few days at my daughter’s and Alan has had diahorrea ever since. He seemed a bit better yesterday but this morning it’s back again. Does anyone else who’s gone through the same thing have similar experiences? Maybe his immune system is poor after chemotherapy that finished 18 months ago (post IL), however I’m a teacher, surrounded by kids who have all sorts of colds and he’s never picked up a cold since his diagnoses 2.5 years ago. And I had the flu in February and he didn’t get that. He had had the flu injection but so had I.
Alison
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AlisonStobart
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Hi Alison, I am 8 years post op and I still have bouts of diarrhea. I don't seem to travel as well now and always have an upset tum the day after. I think we all have different digestive problems, but I think we learn to live with them. Sorry this probably isn't much help
Edwina xxx
Sometimes it can be the bacteria in the gut that can easily get out of control, partly because there may not be the same amount of stomach acid to combat the bad bacteria (possibly because of a side effect of Omeprazole etc). I think I would contact the specialist nurse at the unit where he had the surgery, on both counts. There may well be a gastroenterological clinic that they would refer him to, and some medication they normally prescribe for it.
I suffer from the same thing periodically and I think it's caused by the body rejecting some types of food.
I was prescribed Loperamide tablets by the Specialist and they do clear it up, but not the root cause. I am nearly three years post op.
Just in case it helps your chap you can actually buy it in the supermarkets quite cheaply nowadays. When I discussed it with the specialist he told me that this particular drug stays within the digestive system and can cause no harm as all it does is remove water from the system effectively. However you do have to take care as with any medicine.
The active ingredient you look for on the box is 2mg Loperamide hydrochloride.
Loperamide (Imodium) is an opioid from the same family as Heroin and Morphine.
The only reason that it is available OTC is that immediately it leaves the intestines and enters the blood stream it is removed and de-activated completely by the Liver. Thus there is no residue circulating and available to affect the brain and so to become addictive.
However that removal process does impose a processing load on the Liver.
BUT whilst within the intestine Loperamide does have the effect of paralyzing the smooth muscle layer which is responsible for the rhythmic contractions of peristalsis, the process by which food is squeezed along the GI tract, from one end to the other.
Sure diarrhea is reduced or even stopped dead as long as the paralysis lasts. Clearly this is dodgy if a meal bearing toxic bacteria is frozen in transit. Yes the increased transit time will afford greater potential for the stool to be de-watered thus reducing it's liquidity but is this desirable, given that diarrhea is the body's defense mechanism for ridding itself of a poison rapidly?
Also, Loperamide is "addictive" to that smooth muscle which becomes habituated. Hence many frequent users find that they must take a rapidly increasing dose in order to achieve the same level of inhibition.
In short, if you are assailed by Delhi Belly and need to get on a plane to come home then by all means pop the pill to buy yourself 48 hours peace of mind but it is not a long-term solution. In my opinion, it is inappropriate as lazy prescribing for IL sufferers simply because the NHS does not bother to undertake the detailed investigation necessary to diagnose the underlying cause and so restore a reasonable quality of life.
Hydrochloric acid production in the normal stomach serves 2 critical functions. Firstly to bring about the breakdown of Protein, to make that life-sustaining nutrient available for absorption. Secondly (via the same functionality) to passivate the majority of the billions of bacteria which enter the GI tract with every meal, some of which species are highly noxious and life-threatening.
In the IL patient this function is impaired due to (1) the reduced surface area of stomach tissue remaining for secretion of acid after the pull-up procedure (2) the inhibition of acid secretion due to a reduction in messages from the brain owing to the unavoidable severing of the vagus nerve (3) the further inhibition of any remaining acid secretion by the action of PPI and h-blocker drugs.
In this scenario is it any wonder that we are prone to opportunistic bacterial infections as well as impaired digestion leading to malnutrition?
Thanks very much for the information it is much appreciated, although I must admit to taking Loperamide regularly in the past, nowadays I only take it if I have to as you say. And after the information you have given me I think I will be much less likely to use it in the future.
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