This topic is about concerns regarding the absorption of the medication digoxin in someone who has had a proctocolectomy with the creation of a Kock pouch. The person is dealing with atrial fibrillation and is worried that their unique anatomy might affect how well the medication is absorbed, potentially leading to lower than needed levels of digoxin in their blood.

Here are some helpful insights and advice:

1. Keeping steady blood levels of digoxin is important and can be challenging with a Kock pouch.

2. The person is also taking Xarelto for atrial fibrillation and plans to discuss medication options with their cardiologist.

3. Medications in tablet form might pass through an ileostomy or Kock pouch before they fully dissolve. Crushing hard tablets and mixing the powder with liquid or soft food can help improve absorption.

4. It’s a good idea to ask the prescribing doctor or pharmacist if digoxin, or any other important medication, is available in a liquid form. Liquids generally absorb more reliably than whole tablets.