Can your bowels grow back?

03 October 2017

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Question

Can the bowel grow back after you have some of it removed, for instance, if you had a colectomy procedure?

Answer

Consultant physician Gareth Corbett took on this gutsy question...

Gareth - The bowel does not grow back after you’ve had some of it removed and, obviously, there’s lots of different bowel operation that you can have. Some people have a bit of bowel removed and then they’ll have the two ends connected back together again. And some people have a bit of bowel removed and they’ll end up with a dreaded stoma bag, which a lot of people worry about. But we have fantastic nurses which help look after patients and get them used to it, and the vast majority of people with stomas live with them very well. So it’s not really something to be afraid of or worry about, it’s a consequence of an unfortunate condition you might have had to end up having that surgery.

What we do see though that is interesting is in patients where they have a limited amount of colon left. For example in the condition inflammatory bowel disease conditions you sometimes have large amounts of bowel removed and then the small intestine is reconnected to a small bit of colon. You do see that the small bowel almost turns itself into colon - there’s changes in the appearance of it. It still does maintain a sort of cellular architecture like a small bowel, but when we look at it endoscopically you get the sort of muscular appearance like it’s almost reforming and it helps people store stool longer basically. Because the large bowel’s a stool storage mechanism so we’re not continually having to rush to the bathroom and if you lose some of your colon then you will go the the loo more frequently. But the body does adapt to help that change over time after you’ve had such an operation.

Chris - Because people can actually get by with having quite a lot of it removed, can’t they?

Gareth -  You can live without any consequences without any of your colon at all, so people who have had to have the whole lot removed are fine. In terms of your small intestine, that’s not quite the case. You can lose substantial amounts of small intestine but you do start to have nutritional consequences for that. People with super short parts of gut can start to have liver disease as a result of that. So losing small amounts of small bowel is quite serious. Again, going back to the inflammatory bowel disease conditions, such as Crohn's disease or Ulcerative colitis that people might have heard of, people with Crohn’s tend to have quite significant numbers of operations and bits of small removed, and we do get to a point in treating people like that where we say, that’s enough small bowel removed. We need to try and preserve as much as possible because they do end up having consequences in terms of getting food into them properly.

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