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When one has an end ileo, I read that they gain all the weight back that was lost during UC. Why is this the case? In either scenario, the food goes through the end ileo? With the colon, it just goes through additional absorption (albeit rapid for UC patients). Without the colon, it just ends at the end ileo. My sincere apologies if I am stating any of this incorrectly or do not understand something.
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Two reasons:

1) often during a severe flare patients voluntarily limit their diets because more food or more varies food tends to mean more pain. Most patients are able to eat a wide variety of foods freely with an end ileo.

2) downstream inflammation can cause fast transit upstream. In other words, colitis can cause food to pass through the small intestine too quickly, leading to decreased absorption of the food you eat. Transit time tends to slow down to normal speeds with the end ileo.

Hope that helps. Anecdotally I didn't gain back all my weight with my end ileo, but I gained about 25 lb pretty easily (as compared to stuffing my face during my flare trying to maintain my underweight size)
In addition to the above, there is massive protein loss from the diseased colon during active UC. This is why removing the colon results in a reversal of the weight loss, as long as there isn't also ileal disease in a sufficient quantity. There is about 20 feet of small boweo to absorb nutrients (its primary function). Very little nutrient absorption occrs in the colon. The colon's primary function is water absorption.

Jan Smiler

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