Living without a colon can bring about some unique challenges, especially when it comes to managing symptoms like severe gas, cramping, and bacterial imbalances. Here's a look at one person's experience and some advice that might help others in similar situations.

- This individual has been living with an ileostomy for six years after previously having an internal pouch. They are currently dealing with extreme cramping, gas, and stomach pain.

- Their functional-medicine doctor and nutritionist suspect that Small Intestinal Bacterial Overgrowth (SIBO) and "colon-type" bacteria might be present in the adapted small bowel. The aim is to rebalance the gut rather than completely eradicate the bacteria, as some are necessary for immunity.

- They are reaching out to others who have also had their colon removed to see if they experience similar issues and how they manage them.

Additional background information includes:

- The individual has no colon, so a reversal is not planned. They have also lost their gallbladder, ovaries, and have had a total hysterectomy.

- They previously tried the BCIR (Barnett Continent Intestinal Reservoir) but faced complications such as severe pain, gas, pouchitis, and pouch prolapse, which required further surgeries. Eventually, they returned to a conventional ileostomy.

- Their first ileostomy was in 2004 due to pelvic-floor dysfunction, which was later reversed but symptoms recurred by 2008.

Here are some suggestions and insights that might be helpful:

1. To soothe gas and cramping, try drinking chamomile tea or using over-the-counter Beano (alpha-galactosidase) to reduce gas.

2. Support your gut microbiome by adding probiotics and prebiotics to encourage a healthier bacterial balance.

3. For symptom control and improving quality of life, medicinal marijuana (where legal) has helped others with pain and gut discomfort.

4. Without a large intestine, expect looser output. While you can thicken the output through diet, fully formed stool is unlikely since the colon is the main site for water absorption.

5. Long-term options include:
- A conventional ileostomy reversal is technically possible even without a colon, but it may result in very loose stools and a higher risk of diarrhea due to bacterial imbalance.
- The BCIR remains an option for some, particularly those with ulcerative colitis or Crohn’s in remission for over a year. However, complications such as pouchitis, slipped valve, need for revision surgery, extended hospitalization, and hernia risk have been reported. Palms of Pasadena Hospital in St. Petersburg, FL, is noted for its experience with this procedure.