How well do we metabolize food/meds?

Sally,
According to my surgeon, 'if you are gaining weight then you are absorbing'...rather simplistic but a basic truisme...we all tend to have similar deficiencies such as fat soluble vitamins (A & E), The B group and certain trace minerals as well as Iron.
The fact that we don't have a colon means that our circuits are shorter but the colon mostly absorbs liquids from our stool and not nutrients.
Now, if you have short gut syndrom, some sort of disease remaining in your bowel, a faster than normal digestion or another problem (pouchitis, cuffitis...) then things may go through too quickly althoughter and not get absorbed at all. (think gastroenteritis).
Of course time released meds, coated pills and a whole lot of other meds developed for coloned people can be a no-no too.
Sharon

Sharon, you described that very simply. Thank you. I hope you are feeling better. I am. Sally

Sharon, I told my doctor that administers Zoloft to me about my small bowel being shortened, so he increased my dosage and I seem to be doing a little better mentally. Sally

So, here is my "broken record" reply:

It depends and varies individually, and there is no general rule.

Each of us has our own transit time, which can be a factor, plus, if you have pouchitis or other upper GI disease, that can affect your absorption. These things may or may not have anything to do with your surgery (particularly if you actually have Crohn's and it is active).

For myself, I have had no problems absorbing every calorie that passes my lips. Sometimes I think I absorb them by just looking at them or thinking about them! Medications too, have been no problem, even delayed release. But, my small intestine has not been shortened (just my colon and rectum removed), so that is not an issue for me.

So, I think it is just one of those "proof is in the pudding" sort of things, and you have to try and see what works and what doesn't. Your absorption may have nothing to do with your need for more Zoloft. It may just be that you metabolize it faster than typical. What matters is figuring out that you need more and finding what works.

Jan

It also depends on what it is you are consuming. I had a whole conversation with my Doc about whether he should prescribe regular Ambien or Ambien CR, as he felt it was questionable whether I might excrete out the extended release pill while it is still releasing. However sleeping meds like Ambien slow me down dramatically and I found that both Ambien and Ambien CR worked well for me.

As for vitamin D, there is a wide spectrum on how it is absorbed. Take a blood test and your results will tell you whether you are not absorbing enough of it. And as Jan has mentioned in the past it is another "chicken or egg" issue as to whether the IBD causes the vitamin D metabolism issue or lack of vitamin D worsens the IBD.

There are no general rules, you have to figure out what makes you tick, how fast you tick and then set the time accordingly.

Thanks . . . that all makes sense. I am arming myself with questions for my next g.i. appt. I don't think he is sophisticated in the area of j-pouches, but he's better than nothing. I feel better than I have in ages since taking a month of antibiotics and Rowasa. I thought my leakage, butt pain, etc. was just run of the mill. That's the unfortunate part of not having insurance. Again, your information is invaluable to me. Thank you all so much. Sally

Having only 5 feet of small bowel (read your profile) is a challenge for sure, since most of us have around 20-25 feet! Sure hope you don't need any more resections, or you will be in real trouble! 5 feet is right around the bare minimum to sustain life, and that is assuming it is all functioning well! They are making some strides in intestinal transplants, but you have to have complete bowel failure and no longer tolerating long term TPN (like serious liver damage).

So, take care of what you have, Sally! Fingers crossed for you.

Jan

Thanks Jan and CT. Jan, I know what you are saying. I have been pretty frightened for the last month since I found out about the corrosion in the small intestine. The physician's assistant (it turns out) agreed over the telephone today to give me a prescription for the VSL3DS, for which I am extremely grateful. I am now being super careful about what I eat, following more of an anti-inflammatory diet. When I had my last obstruction a year ago, the surgeon told me that my pouch was just wrapped around and around, and that it was inevitable for me to have another obstruction. I can only pray and do what I am doing. Thank you for your thoughts. Sally

When I was on Oxycontin for my pain management I would literally pass them whole when I had a bowel movement and because I have a reoccuring fissure on the right side of my anus about an inch or 2 going up my anus it felt like I was passing a foot long shard of glass .I don`t have to say how incredibaly(sp)painful it was.Thank God I am now on Morphine instead of Oxy`s and don`t have any issues passing the morphine tablets.