I am a 52 year old lady who is considering having all or part of my colon removed for severe constipation which began when I started taking medications for chronic pain/fibromyalgia about 24 years ago.
I’ve seen 2 colon surgeons who both think surgery (laproscopic) is warranted. One would remove my entire colon and join my small bowel to my rectum. The other one would leave 6 – 8 inches of my sigmoid colon. Do you know which of these is most often done for colonic inertia? Is one more effective than the other?
In addition, the one taking my entire colon would join the small bowel to the rectum at a right angle. The other one would attach the small bowel going straight down into the sigmoid colon. Do you know which of these techniques is best? It seems like going straight down would be but I’m not sure.
The options available are subtotal colectomy with ileorectal anastomosis and proctocolectomy with ileoanal anastomosis.
In the former the rectum and part of colon are left behind whereas in the latter rectum is also removed.
Both are equally good. But a few studies have shown that the latter is better.
when coloectomy is done for ulcerative colitis or FAP then total removal of colon and rectum gives a better result (but removing complete colon and rectum means ileum is to be joined with anal canal which requires a pouch construction from ielum which is difficult and has its own problem, but we dont want to leave any part of colon or retum in above said conditions so this procedure is preferred thogh difficult) but in your case i.e. inertia of colon (motility disorder) I feel leaving some part of rectum/ colon would be wise coz it will make the surgery easy/ less of fecal soiling problem lateron/ less chances of leak from anastomosis.
Dr Tewari (India)
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.