Intestinal longitude
Hmm . . . I’ve been thinking about something of general as well as personal interest, but some aspects are kind of gross. So if body things make you uncomfortable, better move on to another blog. We’ll wait.
For more than a year, ever since my attack of acute pancreatitis, I’ve essentially done without a large intestine. I’m sliced off at the ileum, the southernmost part of the small intestine. The stub of that is turned into an ileostomy, which basically pokes out of the abdomen and empties into a biomechanical reservoir, a bag with a clamp at the end. It has to be emptied every couple of hours, and changed every five to seven days.
(A mundane miracle is the adhesive that secures the thing to the abdomen. It holds for about a week under considerable mechanical stress, but smooths on just like a big round Band-aid [though it’s wrapped in a vacuum pack] and unpeels after a week with very little pain.)
It’s a pain in the abdomen, so to speak. There aren’t any physiological signals for emptying the reservoir, so you have to keep an eye on it. I empty it before turning in and typically have to wake up twice at night to empty it again. Fortunately, I’ve always been a light sleeper. The one time I didn’t wake up, it was about as distressing a mess as you might imagine.
The condition is temporary; the large intestine will be reattached. People who have a permanent condition can nowadays take a more drastic but easier-to-handle surgical solution. For me, the large intestine is just sleeping there, “resting,” until it’s convenient for me to face the hospitalization and recovery period, which will be January. (I could have had it done around June or July, but Europe got in the way, and then teaching.)
What is curious to me is that, inconveniences aside, I seem to be in very good health. So why do people have a large intestine at all? An extra five feet of tissue to have trouble with. If my ileum went straight down to the rectum, my digestive life would be similar to anybody else’s.
Wikipedia says that “the large intestine absorbs water and electrolytes from the approximate 1.5L of chyme passing through the ileocecal valve daily. The colon absorbs vitamins which are created by the colonic bacteria - such as Vitamin K (especially important as the daily ingestion of Vit. K is not normally enough to maintain adequate blood coagulation), Vitamin B12, thiamine and riboflavin.” (Creative Commons)
I don’t take any vitamin supplements, though, and none of the small army of doctors who have passed through my life lately has recommended them. I do eat a well-balanced diet. It does occur to me that my blood may not clot as quickly as it used to. I’ve noticed this but it wasn’t interesting enough to talk to a doctor about it.
So why did the large intestine evolve? Is it just a lurking problem, like an overgrown appendix?
Maybe a human who lived before refrigeration and the other benefits of industrial civilization had more use for the long tube. If you were a hunter-gatherer, you would ingest a lot of vegetable fiber, and when you had meat it might be feast-or-famine - a big meal full of saturated fats or nothing. Whereas most of the meat in my yuppie-fied diet is low-fat chicken or fish, and my carbs tend to be as complex as Whole Foods can make them.
Anybody out there have special knowledge; an informed opinion? Have we evolved beyond the need to have lots of guts?
Joe
For more than a year, ever since my attack of acute pancreatitis, I’ve essentially done without a large intestine. I’m sliced off at the ileum, the southernmost part of the small intestine. The stub of that is turned into an ileostomy, which basically pokes out of the abdomen and empties into a biomechanical reservoir, a bag with a clamp at the end. It has to be emptied every couple of hours, and changed every five to seven days.
(A mundane miracle is the adhesive that secures the thing to the abdomen. It holds for about a week under considerable mechanical stress, but smooths on just like a big round Band-aid [though it’s wrapped in a vacuum pack] and unpeels after a week with very little pain.)
It’s a pain in the abdomen, so to speak. There aren’t any physiological signals for emptying the reservoir, so you have to keep an eye on it. I empty it before turning in and typically have to wake up twice at night to empty it again. Fortunately, I’ve always been a light sleeper. The one time I didn’t wake up, it was about as distressing a mess as you might imagine.
The condition is temporary; the large intestine will be reattached. People who have a permanent condition can nowadays take a more drastic but easier-to-handle surgical solution. For me, the large intestine is just sleeping there, “resting,” until it’s convenient for me to face the hospitalization and recovery period, which will be January. (I could have had it done around June or July, but Europe got in the way, and then teaching.)
What is curious to me is that, inconveniences aside, I seem to be in very good health. So why do people have a large intestine at all? An extra five feet of tissue to have trouble with. If my ileum went straight down to the rectum, my digestive life would be similar to anybody else’s.
Wikipedia says that “the large intestine absorbs water and electrolytes from the approximate 1.5L of chyme passing through the ileocecal valve daily. The colon absorbs vitamins which are created by the colonic bacteria - such as Vitamin K (especially important as the daily ingestion of Vit. K is not normally enough to maintain adequate blood coagulation), Vitamin B12, thiamine and riboflavin.” (Creative Commons)
I don’t take any vitamin supplements, though, and none of the small army of doctors who have passed through my life lately has recommended them. I do eat a well-balanced diet. It does occur to me that my blood may not clot as quickly as it used to. I’ve noticed this but it wasn’t interesting enough to talk to a doctor about it.
So why did the large intestine evolve? Is it just a lurking problem, like an overgrown appendix?
Maybe a human who lived before refrigeration and the other benefits of industrial civilization had more use for the long tube. If you were a hunter-gatherer, you would ingest a lot of vegetable fiber, and when you had meat it might be feast-or-famine - a big meal full of saturated fats or nothing. Whereas most of the meat in my yuppie-fied diet is low-fat chicken or fish, and my carbs tend to be as complex as Whole Foods can make them.
Anybody out there have special knowledge; an informed opinion? Have we evolved beyond the need to have lots of guts?
Joe