My Story
I didn’t realise what a silent, steadfast warrior my gut had been for me… until they took part of it away.
In 2020, while the world was grinding to a halt in the midst of the COVID-19 pandemic, I was undergoing a more personal crisis of my own: the discovery of a tumour in my abdomen that led to a bowel resection and a one-way trip to life after gut surgery.
There’s a lot that nobody tells you about gut surgery, and I had to learn a lot of it myself.
The Diagnosis & Surgery
A gentle touching of the abdominal area – a search in vain for the abs I hoped were building there – revealed a firm mass. After it didn’t resolve itself in a few days, I sought a medical opinion and rather quickly found myself in a maelstrom of diagnoses, specialists, tests, and surgery dates.
At first they thought it was cancerous, and it seemed like I was in big, big trouble. Thankfully, a biopsy revealed that the tumour was benign. The spectre of cancer removed from the equation was welcome news, even though it could not diminish the enormity of the operation I had to have.
The surgery itself was swift and clinical: a resection that removed not only the large, fibrous desmoid tumour, but around 80cm of small intestine and the ileocecal valve itself – a seemingly small structure that would later prove to have a disproportionately-sized role in my everyday life.
The Surgery: What They Knew, What I Didn't
Like many similar surgeries, they couldn’t fully know what to expect until they went in. I knew they would remove the tumour, and I knew it was likely I would lose some of my intestine. I didn’t know how much, or what else might have to be tackled while they had me under. This left a great deal of uncertainty for me, and a whole pile of questions I couldn’t begin to answer until I woke up on the other side of it.
I was admitted to hospital in August, 2020. In my case, it was very much a non-trivial surgery. The tumour itself was the size of a small rockmelon – around 17cm in diameter and remarkably spherical. Wrapped inside it was my appendix, which was also removed, and its intimate contact in no less than three locations to my small intestine meant a bowel resection was necessary. All up there were three keyhole entry points and a huge abdominal incision. They removed the mass and 80cm of my small intestine, as well as the ileocecal valve, connecting my small intestine directly to my large. I still carry a large, 15cm scar running vertically down my torso.
I struggled through challenges during my twelve days in the hospital: a nasogastric tube due to developing an ileus – a blockage that prevents food passing from the stomach into the digestive tract, significant pain and discomfort, incredible fatigue, being awoken at all hours for nurse checks or pain relief, and a wholly unsatisfying re-introduction to bland hospital food that did nothing to nourish my recovering gut. Hospitals – in Australia, at least – do not seem to prioritise good gut health in their post-surgery menu.
Fortunately for me, I had a loving partner who was there through the entire thing. She would visit each day whenever she was allowed, during COVID times where only one designated visitor was permitted for the entire duration of my stay. She gave me tremendous love and care, and helped see me through the entire experience. I am forever grateful for how she held me through that time with such tenderness.
Leaving the hospital was a relief. But I quickly discovered that the real recovery was only just beginning…
Life After Surgery
I spent a total of 12 days in the hospital. I’ll be honest, there were a lot of trials, and I found myself at an extremely low point. Mindfulness and years of on-again-off-again meditation definitely helped me remain focused and present throughout, but it was incredibly difficult and painful. If you find yourself reading my story due to needing to have or having had a bowel resection, take heart: my case was on the extreme end. Many resections are done with keyhole surgery, and do not require the kind of invasive surgery I did. The tumour is what complicated it for me.
Regardless of the individual circumstances, there is a lot to learn about your digestion and your gut after a resection. You don’t fully appreciate that your digestive system is an incredibly hard worker – it is working for you 24/7, without breaks (unless you’re into fasting, but even then it finds maintenance work to do), every single day of your life. I have never felt such a deep gratitude for my gut than after surgery, when it was no longer able to perform at the same level of operation I had become accustomed to.
Learning to Eat Again After Gut Surgery
I took a simple but educated approach to food after surgery, prioritising foods that were easy on my gut and avoiding processed foods as much as possible. In a serendipitous turn, in the year prior I had read several books on the gut and digestion, uncovering a part of my health I had not deeply considered previously. I started with Gut by Julia Enders and, finding the subject matter fascinating and ripe for improvement in my own life, followed it with The Secret Life of Your Microbiome by Alan C Logan and Susan L Prescott. Between these two books I felt armed with the knowledge that I could supercharge my gut and give it a helping hand.
As soon as I was at home in my convalescence, I took my diet into my own hands. I would eat Japanese rice with some leafy greens and some eggs, and sip on a miso soup on the side. I cooked potatoes for their starchy stickiness, topping them as I might. If I ate bread, I aimed for wholemeal or sourdough, and I avoided caffeine and chilli for a few weeks until things settled.
How My Body Reacted Without the Ileocecal Valve
I was on the toilet up to eight times per day. The gut is a sensitive soul, and being sliced, diced, and stitched back together again definitely gives it cause to feel a little upset. Like the rest of us, it was still recovering. And that ileocecal valve I mentioned earlier? It’s responsible for the transition of food from the small intestine to the large. Bile reabsorption happens at the terminal ileum, a part of this valve, which slows down digestion and re-absorbs the bile your stomach introduces so that it doesn’t disturb your gut further on. Without that valve, things move extraordinarily quickly. I still remember the first sip I had of a caffeinated beverage – a green tea – and I swear to you there was less than 10 seconds between that first sip and being seated on the toilet.
My scar slowly healed, and eventually the staples were removed. I would walk a little longer each day, balancing my energy levels and the pain in my injury to push myself little by little back to wellness. It was a time of pain, discomfort, rediscovery of my bodily functions, and learning how best to live with my shortened and stitched-up bowel.
Road trips and hours in the car had me intimately familiar with the location of the nearest toilet (hint, McDonalds are always a reliable, if not always clean, toilet stop), and life was dictated somewhat by my bowel movements. When I needed to go, I needed to go now. That urgency does reduce somewhat over time, but for a period there it definitely felt like my gut ruled my life. These days it’s more of an advisor, and one I can ignore for a while, at least most of the time.
The period from surgery to being fully settled into the new normal was around 6 months for the major changes, and up to 18 months for the smaller, slower changes to reach equilibrium. Firm stools are largely a thing of the past, though some of the tips I will share with you can help with that.
What Helped Me
I experimented a lot with various tools and foods to help me with my gut. I saw a Chinese doctor and took a course of herbs to help my digestion get back to normal. I tried various foods, some more successful than others. I tried a variety of supplements all designed to help the gut. All of these things helped to some extent, but it made something abundantly clear to me: all the nutritional support in the world can never replace the natural mechanism my body had in the ileocecal valve.
If you have an ileocecal valve – and most of us do unless you’ve had a resection to remove it – take a moment now to express your gratitude for it. Trust me, it’s doing wonders for you. I went through some grief understanding that my gut would never be the same again, and no matter what I do I cannot fix that key mechanical issue.
I explored various foods and played around with what worked. Oats and starchy, gummy foods such as boiled (especially cooled) potatoes, white rice, and pasta all help slow things down a little. Chilli, caffeine, and excess fat can have you board the fast train to the nearest toilet bowl, or cause pain and discomfort while going to the toilet.
The Role of Psyllium Husk and Gut-Supporting Foods
One day, I met my digestive hero: Psyllium husk. Oh boy, can this guy help you – not only does my life have a before and after bowel resection surgery, it also has a before and after I discovered psyllium husk.
Psyllium husk became my superhero, something I put into my body each morning before any solid foods. Without it, stools are much looser and more frequent, and with it, everything just functions a little more smoothly. Eventually I discovered my optimal breakfast – oats with fresh fruit and various additions – that helps set my gut up for success each day.
I learned that if I start the day with a greasy breakfast, I’m not setting myself up well for the day. Pair that with a coffee, and things aren’t looking super rosy – I’ll be spending some time on the toilet, probably having to go back multiple times. That hangover bacon and egg roll doesn’t look quite so good anymore.
Seek your own answers, don’t just rely on doctors
My surgeon did an amazing job of my resection. I am extremely happy – and very grateful – that he was able to address my issue with the best possible outcome. Surgeons are experts in their field, and we rely on them to look after us when we're under sedation and undergoing a surgical procedure. I have tremendous respect for what they do and the knowledge they have in their specialisations.
I also want to say that they do not always have all the answers – for your body. I told my surgeon I thought my tumour was getting bigger in the months between diagnosis and surgery, and he dismissed me saying that was unlikely, that it was slow growing. After it was removed? It was larger than the initial scan by a significant amount. People make mistakes, and that's OK, but remember that your body is just that, yours – and what you feel happening quite possibly is.
This one experience didn't teach me that doctors and surgeons should never be trusted – they absolutely should. It taught me that sometimes they don't know everything and they see dozens of patients all the time. Each one of them is unique, and some are outliers.
Be your own scientist, don’t take their word as the only gospel, and do your own research. I don't mean throw the baby out with the bathwater and discard medical science altogether. I mean that you should look beyond the common body of medical knowledge, approach things with a skeptical and open-minded view, and try a few dietary changes yourself. Get a blood test and check in on your nutrient levels. I feel it is better to be proactive about your own health than to wait for a problem to rear its head years down the line.
Finding support through the process
Aside from the physical and dietary changes, nobody who has not been through this knows how it truly feels and what the impacts are. I found it helpful to speak to people who had been through a similar surgery. What I wish I had been told is that you will be OK, you will find a new normal, but also that it won’t necessarily be smooth sailing. You will lose a chunk of your day to toilet needs. You will need to be thoughtful of what you put into your body, otherwise you may suffer for it. I can still drink 3 coffees if I really want to, but the hell that unleashes on my colon – and the toilet bowl – is quite the trade off.
I learned that you will have good days and you will have hard days, and that it is not always easy to predict. Sometimes you do everything that seems to work and things won’t run as smoothly, and sometimes you will do all the things you know will cause issues and your digestive system runs along without a hitch – it truly can be unpredictable. Still, consistency wins the day: the more you can take consistent actions to support your new bowel, the more comfortable and fulfilling your daily digestive life will be.
It is also critically important to remember that no person’s journey will be the same as anyone else’s. I had my own complications; you might have an easier set of circumstances, or you might have a worse set. You will uncover your own learnings and it is important to do what works for you, no matter how much someone insists their method or tip will change your life. Keep an open mind, and keep a notebook – customise your strategies to suit your life.
Why I Started Absorbing Life
At the inception of this site, it has been five years – almost to the day – since my bowel resection.
Prior to the surgery, I faced a lot of uncertainty, not all of which could immediately be alleviated. There’s often a lot of ‘wait and see’ with digestive surgery, and my case was no different. For example, I have malabsorption issues and need to supplement with Vitamin D, Iron and also received regular B12 injections. The surgeon didn’t expect this would be an issue, but here we are. I had to discover this on my own through blood tests, as I imagine many who undergo similar health issues do.
Through the past few years I have learned a lot about my body and how best to support its new normal. I’ve also had to confront the challenges that come with a long-term health issue, and the mental and emotional struggles this can bring.
I want to share what I have learned with you, and I want you to know that you are not alone. Many of us have been through these struggles, and it is often hard to find real world experiences and a human touch when so much information is on medical sites.
It is my hope that through this offering you find support, an honest account of the experience, and some useful tips that might help you, whatever stage of the resection journey you might be on.
Ready to dive in? Start here, or check out some of my favourite posts.
Have you had a bowel resection, or are preparing for one?
I’d love to hear from you. Feel free to leave a comment.