Hi everybody:

As some of you already know (or you can see my profile), I had my J Pouch in 4 steps. In the first one I had the sub total colectomy. The surgeon removed the bowel except the rectum, but also removed 4 cm (about 1.5 inch) of terminal ileum. In that time I had an end ileostomy and never had any nutritional problem. However now that I have my pouch I was told those 4 cm are critical for absorbing some nutrients like A vitamin and folic Acid... I wonder how true is that, specially since as I said, I didn't have any problem the whole year I had the end ileostomy (I could recover my weight, I had hemoglobin=18, and no skin disorders). However this became concern since I after J Pouch surgery I have been losing slowly weight, although it's said because lack of exercise (when I don't go to the gym for a long period I lose weight).
What do you think?

No, not true. The terminal ileum is essential for absorption of vitamin B12. Vitamin A and folic acid are absorbed throughout the small intestine, mostly the jejunum. The terminal ileum is more than 1000 cm long, so the loss of 4 cm would have little to no impact on nutrient absorption. However, if you have chronic pouchitis, that basically puts enough of your ileum out of commission, and can affect your B12 levels that way. But, since your body stores 3-5 years worth of B12, it would take that long for a deficiency to become apparent.

And, yes it is true that if you lose muscle mass, you will lose weight even if your clothes fit the same. Muscle is more dense than fat.

Jan