I'm not going to bore everyone with my story, but I have absolutely zero colon. It's gone. Lost it at age 24 in 2009. I'm 29 now and have a J-Pouch (aka my small intestine was reconfigured to act as a large intestine).
I was afraid it would derail my life as a lifter...but I can thankfully say I'm stronger now than I've ever been in my entire life. But leaner and more defined? No. At one time, yes. After my final surgery when my body was basically in super-compensation mode, I was absolutely ripped. But after that brief period, it's been all downhill. I'm still very lean by normal American standards (about 13% BF), but as a fitness enthusiast, I obviously wish I could be in the 9-10% range and also keep on muscle easier. I also struggle with energy levels that are about 8 times lower than they were before losing my colon, but that's another thread for another time...
What's changed with my diet? Everything. Here are some key things I've had to adjust with what I like to refer to as my "new body":
Caffeine is a no go. I finally accepted this one recently, to much chagrin.
I'm Gluten Free.
Vegetables are INCREDIBLY hard for my gut to handle. I'm to the point where I won't even risk it anymore. Health benefits? Great. Doesn't outweigh an entire morning and afternoon in the restroom 4-10 hours after consumption, though. I'm referring to cooked vegetables, for the record. Raw vegetables and hardly chewed nuts/beef jerky are the absolute #1 biggest no no's.
Red meats are very limited. I can handle them once in awhile, but they have to be fatty and fresh off the grill/oven/stove.
Seafood and eggs risky. I'll only do Salmon if I do seafood.
Very acidic foods, like pasta sauces, are an absolute no.
I have trouble using powdered supps, at least ones with tons of weird ingredients. I also have trouble with supps because as someone with no colon, I'm not supposed to take in a lot of liquid at one time, even if it's water. I'm supposed to take small sips throughout the day to get my water in. So a lot of these supp protocols, like the ones on this site? I simply cannot tolerate the heavy liquid intake.
Lactase enzyme has been an incredible addition to my diet, so now I'm more able to handle dairy, like whey isolate (a couple times a day). Cheese (particularly melted cheese) is also very good to my gut when on lactase enzyme. And yogurt's always been good to me, so I try to eat quite a bit of Greek Yogurt throughout the day.
I'm hungry enough to eat 6-8 meals a day, but whenever I eat, I know that means more frequent restroom trips...so I try to only get in 3 or 4 meals and no in-between snacking unless absolutely necessary.
I try to do a modified version of the nutritional guide my surgeon's and doctor's gave me (for people like me with no colons). They essentially advise child like diets:
Highly refined, starchy carbs (like white bread, white rice, Chex cereal, etc.)
Obviously those foods are not very "aesthetic" friendly. I try teetering the line between healthy eating and this list...but at the end of the day, foods like the ones directly above are the only ones that I can have confidence in. When I try going super healthy, that's when I run into problems.
So this is my lot in life. What do I need? Some strategizing? I don't even know for sure. I'm just looking for any opinions and thoughts on the matter. A lot of people would suggest to suck it up, but that's easy for people who aren't stuck for hours in the restroom if they make one wrong move with what they eat. It's incredibly frustrating. It's even more frustrating being with family and friends for Holidays like Thanksgiving and not being able to convey why I can't eat a lot of things without it going into really embarrassing territory.
I struggle with eating enough to stay optimally muscular, lean, and energized (furnace burning, that whole bit)...but when I do try to make sure I eat more, I can only do it with foods my body can handle....which aren't aesthetically optimal.