DEAR DR. GOTT: I am a 66-year-old male who has undergone two small bowel resections in the past year to free up adhesions caused by a previous colon resection for diverticulitis. I am worried my system may never get back to normal. I went from 240 to 200 pounds after the first procedure and from 200 to 180 pounds following the second one. I think I am suffering from malabsorption because I am very low on energy and my thyroid medication (Synthroid) needed to be increased despite the weight loss.
I have also become very lactose intolerant which I have read can result from small bowel surgery and antibiotics. I think probiotics are a good idea to repopulate the gut with good bacteria after being on any type of oral antibiotics. Do you feel it is necessary to take a probiotic daily or would I get the same results if I take one every other day, as the better brands are very expensive? It seems to me that once you reseed the gut with good bacteria, it should then be able to maintain a level on its own.
DEAR READER: Briefly addressing your low energy level, my guess is that your age, two surgical procedures, a weight loss of 60 pounds, and your hypothyroidism have all made a contribution. I would hope you now have your Synthroid dosage regulated. If not, simple lab testing should allow your prescribing physician to properly control that portion of your care and post-operative time and weight stabilization will level off, as well.
Adhesions are areas of scar tissue that form between two surfaces inside the body, causing them to stick together. Most adhesions in the abdomen and pelvis occur because of a previous surgery, While some cause no difficulties at all, others can cause chronic pain. Most are found during exploratory surgery. Once adhesions form, they can increase in size and the risk of them forming is definitely increased following a repeat procedure. Intestinal obstruction can result in severe pain, cramping, constipation, vomiting and abdominal bloating. Generally speaking, most people who undergo the procedures you did recover completely and are able to perform activities such as hiking, gardening, sports, and the like within a reasonable period of time following surgery.
In a healthy individual, the cells that line the small intestine produce an enzyme known as lactase. This enzyme attaches to lactose molecules in the foods a person consumes, ultimately breaking the molecules down into two simple sugars that can be absorbed into the bloodstream. In your case most of the lactose in your food passes into the colon unprocessed, resulting in gas, bloating, diarrhea and the condition known as lactose intolerance that occurred because your small intestine decreased lactase production following surgery.
While the recommendation for lactose intolerance is the avoidance of dairy products, you may be able to digest cultured milk products such as yogurt with live cultures because the bacteria used in processing produce the enzyme that essentially breaks lactose down. Or, you can purchase lactose-free products that are becoming increasingly available in most grocery stores. Then there is Lactaid, Dairy Ease and a number of other over-the-counter products that may help you digest dairy products. It will do no harm to consider probiotics if these recommendations fail to bring success.
The human body normally contains about 400 types of probiotic bacteria that help maintain the natural balance of organisms by reducing the growth of harmful bacteria, but only specific strains have been found to work in the digestive tract. When your physician put you on the antibiotic, you received a double whammy. The drug killed the good bacteria in your body along with the bad bacteria that caused the initial problem.
There is evidence to prove that probiotics can help eradicate diarrhea, prevent digestive tract infections and assist inflammatory bowel disease. And, research is ongoing to determine if probiotics might be beneficial with regard to colon cancer, irritable bowel syndrome (IBS) and skin infections. More research is necessary, however, before a blanket endorsement can be made for their use when they relate to children, the elderly, and for those with a compromised immune system.
I suggest you speak with your physician to determine his or her views on this supplement and your possible malabsorption. In the interim, read labels, eat well, consider eating yogurt with live cultures daily and try a probiotic every other or third day to give your body the boost you feel it may need.
Readers who would like related information can order my Health Report “Irritable Bowel Syndrome” by sending a self-addressed, stamped, number 10 envelope and a $2 US check or money order to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
