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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have An Ileostomy, Rectum Closed. Have IBS, Had Non Hodgkin S Lymphoma. On Humira And Rituxan. Why Is Kidney Suffering?

I have an illostomy (7 yrs) resectioned 2 yrs ago amd have developed short bowel syndom. My rectum is closed. The output is pure liquid and any thing I ate or drank goes thru to the pouch within 15 minutes. My gastrologist know has me on TPN with no solid food. e had me on Humrari but I had a TIA and he stoped the Humari. I had non hodgekins lymphoma 4 yts ago but am fine after treatment with Retoxin. My Dr wants to put me on Gattex. OH my left kidney is at about 60%. I am a 65 year old male.
Wed, 20 Nov 2013
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General & Family Physician,  's  Response
Hello there!
thank you for asking. I read your query and i want you to know that the age of 65 with so much morbidness and surgical interventions and use of Rituximabs and adalimumabs the monoclonal antibodies for IBS and non hodgkins lymphomas makes you very vulnerable to electrolyte imbalances resulting in deranged renal perfusions, Addedd by old age of 65 as after 40 years onwards renal functions themselves decrease by 1- 3 % a year.

Your gastro enterologist is right you need a TPN total parental nutrition and a very strict monitoring for electrolytes and intake out put records as slight derangement can fry the kidneys. SO all the picture of decreasing renal functions and your troubles are explained.

I strongly recommend to stay in constant touch with your gastro enterologist, with dietitians and with nephrologists to monitors your renal functions. It will need alot of endurance and i am sure you would be able to make it by playing your role. Follow your doctor to every bit you advice he give to you.

I wish you very good luck. You are in safe hands. Cheers

regards
Dr S Khan
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Have An Ileostomy, Rectum Closed. Have IBS, Had Non Hodgkin S Lymphoma. On Humira And Rituxan. Why Is Kidney Suffering?

Hello there! thank you for asking. I read your query and i want you to know that the age of 65 with so much morbidness and surgical interventions and use of Rituximabs and adalimumabs the monoclonal antibodies for IBS and non hodgkins lymphomas makes you very vulnerable to electrolyte imbalances resulting in deranged renal perfusions, Addedd by old age of 65 as after 40 years onwards renal functions themselves decrease by 1- 3 % a year. Your gastro enterologist is right you need a TPN total parental nutrition and a very strict monitoring for electrolytes and intake out put records as slight derangement can fry the kidneys. SO all the picture of decreasing renal functions and your troubles are explained. I strongly recommend to stay in constant touch with your gastro enterologist, with dietitians and with nephrologists to monitors your renal functions. It will need alot of endurance and i am sure you would be able to make it by playing your role. Follow your doctor to every bit you advice he give to you. I wish you very good luck. You are in safe hands. Cheers regards Dr S Khan