Iron Deficient Anemic post colectomy

I had bloodwork done due to not being able to lose weight after having a trainer for a year and a 5 months (6 weeks post op from colectomy) and doing some intense cardio. Additionally, I am having undigested food and watery stool still. My trainer's concern was that I may not be processing my nutrients.

I got my bloodwork back yesterday that indicates I have iron deficient anemia. I was a 14 and the low end normal range was a 44. Also, my BUN was elevated but my creatinine levels were normal. I also had elevated liver enzymes (ALT and LDH). This would indicate that my body is not absorbing/processing nutrients especially proteins which is not helping me lose weight. Has anyone else experienced this problem? What can be done to change this? Will the Ferrious Sulfate help me if I am not absorbing nutrients (will my body absorb the iron supps?)

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Hi Heather,

What your describing is fairly normal for everyone who has had intestines removed. I have lived with Short Bowel Syndrome for 12 years now. I live with chronic pernicious anemia. I get B12 shots biweekly. with me the other you described went away on its own.
Don't fret, you will be ok. be sure to discuss this with your Doctor. They can give you b12 and iron shots if the iron levels are way out of whack. good news it can be treated.

Terry

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Hi. I'm waiting til the end of the month to discover whether my iron deficiency anemia was just a post surgical thing or whether I need an iron infusion. My hematologist said that often after surgery there is some iron deficiency. Pills wouldn't work for me, as I have no colon to absorb them. Six months post op, though, sounds like a long time for it to be a post op thing. You might do well to include soy or rice protein powder into things like cream of rice cereal, even mashed potato or pancake batter. Or make yourself a protein shake (Boost or Ensure) with an added scoop of protein powder, blend with some ice. I like to thin my Boost because I don't like the thick consistency, with 8 oz skim milk. I use the vanilla flavor add a tablespoon of instant coffee, lots of ice, and I have a great tasting, very healthy iced coffee, which I love. The undigested food indicates to me that you are probably eating some high fiber foods which don't always go well with less intestine to process them. I don't know whether you have a colostomy or ileostomy. If the latter, high fiber foods like fruits, vegetables, whole grains, nuts, and seeds should be on your list of foods not to eat, or you're flirting with an obstruction. I always advocate keeping a food diary, noting your reaction right after you've eaten, 24 hours later, and 48 hours later. I spreadsheet mine and have a column for calories, as well, though my problem is getting in enough calories to maintain my weight while trying to wean off TPN. You might find it a useful tool for weight loss. Sounds like you're in good shape, and certainly getting enough exercise to lose weight, but I found that after my ileostomy, my caloric needs dropped. I needed only 1600 calories/day to maintain weight, so perhaps something like that has happened to you, too. Good luck.
Love and Light, Candace

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I just got my lab reports to take to the Gastro on Friday. I have a high BUN/Creatinine ratio, elevated liver enzyme ALT and LDH and my iron results were : UIBC High (437), Iron, Serrum Low (11), Iron Saturation 2, ferritin, serum 5, and transferrin High at 416. I have done alittle research on the internet and I am finding a lot of information on GI bleeding with high Bun/Creatinine and iron deficient anemia. I have had bright red blood quite a few times in the watery stool (like a pool of bright red blood) but it has been a few months since I have seen blood in toilet.

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heatherpyle, I hope you find some answers soon and get all the answers you need along with a plan to get you better!!!

I had my colon removed in April and I am having a lot of undigested food come through as well. I am waiting to have some blood work done, giving my body a little more time to sort itself out as I have had a very slow healing since surgery so I imagine that everything esle is going slow to adjust. I was severy anemic before surgery as well as having low magnesium, low potassium, low B12 and some other low levels that I can't remember. In the hospital those levels dropped even lower and with the help of IV infusions and TPN i was able to get those levels within the normal range. I had some bloodwork done about 3 weeks after surgery and at that time the levels were on the low side of normal, but with all the fatigue, and loose BM's I'm thinking that they are not within the normal range anymore.

I'm nervous to "complain" to my docs. I feel like I am always bothering them, but I guess I have to. :)

Hugs!

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Oregonnative,

I am so sorry to hear your having issues. Please don't be nervous to speak up as I am 1.5 years post op and just now speaking up. I know the watery stools have caused the High Bun/Creatinine levels (which is dehydration)- being dehydrated from the numerous watery/loose stools still. I didn't realize how low the ferritin and iron saturation is until I googled and did some research. All of this if due to the lack of large intestines :( I just need to find a way for my poor body to absorb nutrients and get back on the healthy side. I know I will feel better that is for sure. I am constantly tired and sleeping and at times my insides just plain hurt. Please don't be afraid to speak up...as I am learning...the sooner the better!

Hugs!

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Hi! I also had a problem with anemia after my subtotal colectomy. It was discovered through blood work during a major sinus flare up this past fall. My hemoglobin level went down to 6.8. I had to get a blood transfusion and then went through 8 weeks of iron infusion. Unfortunately, I was still having trouble with constipation so iron pills or injections were not an option.

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I am headed to the Gastro tomorrow and I am hoping they will be able to get me straight. My high Bun/creatinine is from dehydration I am assuming from still having watery, diarrhea like stools. I am afraid the pills will not work if I am not absorbing nutrients. I fear a needle but I think an iron infusion would probably be the way I go. I am hoping my levels are low enough to qualify for it. I am tired of being tired and sleeping all the time, cramping all the time, being irritable, being lightheaded and dizzy, and having the desire to suck on rocks all the stinking time :) In retrospect, I cannot believe I have been training hard 6 days a week, dieting since Feb 2012, and doing 2-45 minute sessions of cardio daily and I haven't passed out or anything...lol

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I went to the Gastro today and he suspects pouchitis which he said is very common with people with Colectomies. He also suspects Celiac. He is doing a endoscope to check out the stomach and a colonscopy. He also drew blood for the Celiac and I have to give a stool sample.

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