Community Forum

My name is Sam I am a 21 year old male and I have had ulcerative colitis for almost five years now. After I was first diagnosed, I was doing great and had been in remission until this past April. Since then, I have been in and out of the hospital where I have spent a total of two months as an inpatient. I am still having problems with my colitis, mostly including many irritable bowel movements a day and occasionally bloody stools. It affects my life so much, I cannot go to school, get a job, or even hang out with friends.  I have tried every medication possible but another clinic has suggested I could try one last medication called methotrexane. However, after my doctor told me about the side effects, I decided I would rather get the surgery. My question is what is life like after getting the surgery the IPAA surgery? From what I understand, my doctors have told me I would be having multiple bowel movements (anywhere from 4-8 per day) and may have problems with malnutrition since I would not be able to absorb as much nutrients without a colon. Any replies would be greatly appreciated; I just don't know what to do.

Thanks

 Reply posted for vande713.

Methotrexate may cause an increased risk for infertility. Low sperm count has been seen in some men using methotrexate. Most of these men were using high doses of the medication, as well as other medications used to treat cancer. Sperm levels returned to normal after the men stopped using methotrexate. There are no reports suggesting that men who use methotrexate at the time of conception are more likely to father a baby with a birth defect. However, due to general concern rather than actual risks, some health-care providers recommend that men wait at least 3 months after stopping methotrexate before trying to conceive.

 Reply posted for vande713.

Thanks for all the replies. I have tried every medication possible for my colitis but nothing has worked. My next question is about a medication I am going to start taking. I have been told by my doctor at Mayo Clinic in Minnesota that methotrexate can cause birth defects in children when taken during conception. But I was wondering if men taking methotrexate can cause birth defects. Although I live in an area with very good colorectal surgeons, I do not want to get surgery. Any replies or words of advice would be greatly appreciated.

Thanks,
Sam

 Reply posted for vande713.

I had the surgery completed almost two years ago now and my advice to you would have to be to do your research before the surgery.  You will still be on some kind of medication for the rest of your life, just a different kind.  It will be to slow down your bowels to mimic a colon.  Although I don't know if all patients do that I know most do take some sort of anti-diarrheal multiple times a day and a lot of people are unaware of that. 
Make sure you have a good surgeon, I don't want to tell you my story suffice it to say my first surgeon was inept.  As with any surgery there are risks, and if you've been able to manage your UC with any meds I would try to stay on that as long as possible, explore all your other options first because once that colon is gone you'll never see it again.  It is definitely less painful than a flare, but you will still be going to the bathroom often.  Be sure to stay hydrated, as without a colon, hydration is always an uphill battle.  I was 21 when I had my first surgery, and these are the things I wish I knew.  I know it can get difficult physically and emotionally having IBD, I hope you have the support you need to make this decision and that you have a healthy future ahead of you.  Healthier, anyhow.

 Reply posted for vande713.

getting the ipaa surgery as you call it helps a lot of people. if you know dennis from ucvlog he has had a functional j pouch for a while now. with the surgery you will live with an ileostomy for a few months while the j pouch is healing inside. to complete the whole process of ipaa surgery is about two or three surgeries depending on the surgeons ways. you wont have any problems with absorbing nutrients such as fat, carbohydrate, protein, vitamins, and minerals, but because you wont have a colon hydration becomes an issue (the colon main function is to absorb water). so you may need extra water or pedialtye to stay hydrated especially if you are exercising. with a j pouch you will have more bowel movements since you colon is gone, but this should be a lot better compared to a flare of uc.