My dad used hot vinegar and honey I think, but I can’t bear vinegar.

Sometimes exercise helps, but mostly it doesn’t have any effect.

First, let me preface this by saying that I am not yet a full blown gastroenterologist, nor am I a surgeon. I am a doctor doing what you would consider a residency programme in the US. I deal with patients with ulcerative colitis frequently in day job (and this is my particular area of interest).

First let me summarize what I think happened to you based on the story you told us. Please correct me if you are wrong. You said you were diagnosed with ulcerative colitis (UC) for the last month, but how long before that did you get symptoms? UC doesn’t tend to present suddenly. It is very likely you had been having diarrhoea, or bloody diarrhoea for a few more weeks preceeding your diagnosis. I’m guessing you were started on steroids (prednisolone or hydrocortisone) as well as other immunosuppresive drugs (i.e. mesalazine, azathioprine) during this period as well? However things didn’t quite settle right? Did they also try ciclosporin just prior to surgery, but that failed to right? So I’m guessing the surgery was either because you developed toxic megacolon, or perforated something, or because of the failed therapy. So far so good?

You have a total colectomy right? Not a hemicolectomy, or a proctocolectomy? I’m asking because I want to know if there is still bits of colon and/or rectum left. This has implications of potential recurrence of the disease, especially if there is rectum left.

Ok, here’s the (ugly) truth:
1. As you just had major surgery, you shouldn’t really be doing anything strenuous. NO VALSALVA/BRACING type moves for at least 8 weeks. The reason is that you want your abdominal muscles to heal properly.
2. When you do recommence, start slow. Start VERY SLOW. Use light weights, for reps. Just do planks for core type stuff – progress these VERY slowly too. Maybe start with sets of 10s
3. Considering that you have a further surgery in 6 months, (is this a reversal of the colostomy?) my suggestion is to do light activity – when you can- until you had that. Then you can start rehabbing back again. It’s like taking two steps forward, and one step back
4. Don’t rush into it. You got the rest of your life to get back the mass. Besides, the reason the mass was loss, is because your body was catabolic from the inflammation due to the UC man.
5. If you still have a rectal stump/rectum, and or bits of colon left, AVOID red meats, and eat a lower fat diet. This is because these foods seem to have a pro-inflammatory effect on the bowel. Some omega-3s are fine. But I would prefer you took these as a supplement, and do not overdo these. 1g EPA/DHA should be more than enough.
6. As you are recovering from the surgery and the UC, EAT!! You need to put some weight back on (not too much), especially before your next surgery. Because of the inflammatory state you were in (i.e. post-op + UC), you are likely to put fat, especially visceral fat when you do gain weight. Don’t worry about it for now. You can lose it all again after you have fully recovered. This is only a blip in your life.

That’s all I can think of now. But if you need more advice email me at jin dot lim at mac dot com. I’ll do my best to help a fellow fitness enthusiast.

P.s. Kevin: One thing I find that helped a lot of my patients with constipation is steady state cardio (especially running), as it seems to affect the parasympathetic system. This is only an anecdote, and an observation I made.

I recently had my stomach removed via a laparotomy and thoracotomy and went from a formidable 210lbs to a scrawny, hospital patient looking 170… Doctors orders are ‘no heavy lifting’ for 3 months (for fear of herniating through the lovely 20cm incision in my transverse abdominus) and after 6 weeks I’m still struggling to get enough food down over the course of a day to maintain my current weight let alone put any back on.

From my own experience so far, my advice would be embrace the fact that you’re alive and loosing a few pounds is really not that important in the overall scheme of things. As much as you don’t want to hear this (cos I hate hearing it) just focus on healing and getting through your surgeries in one piece. This new chapter of your life is going to be scary as hell but in time you’ll learn to live with your new self, your new scars (which chicks dig by the way), and the adjustments you’re going to have to probably make for the rest of your life (don’t think I’ll ever be able to drink beer again..).

Stick in there mate and you can put on all the weight you want once you’re 100% back on your feet.

Cheers,
Geoff
p.s. feel free to email me through GrizzlyPT.com if you want to chat/vent!