Hi Doc..I have 3 questions to ask you (I hope you don't mind). First of all, 17 years ago I developed chronic, daily, constipation. Because I have IBS, being constipated was very painful. So, I took laxatives every day to get relief. After about 11 years of that, I needed to use Ducalax rectal suppositories as well as the laxatives to expell the fecal matter. Then, about 2 years ago, the rectal suppositories stopped working. As a result, I can't get the fecal matter out of me, even if it turns to diarrhea. Tests have shown that I have colonic inertia, and a defacting proctogram showed that my rectum can't expell poop either. It's just as weak as my colon. I saw a colon/rectal surgeon who said that I must have my colon removed. I would not mind this, if I could keep my rectum. Because then my small intestines could be hooked to my rectum and I could go to the bathroom normally. So, here's my 3 questions....
1. Is there a way that I can get my pelvic floor, and most especially my rectum, functioning again?
2. Is there a way that I can get my colon functioning again?
3. When I had a colonoscopy, they did a biopsy. They said it was normal. If I had an overgrowth of yeast in my colon, would it have should up in the biopsy, or would I have had to request to be checked for that?
1) It would depend on the severity of the deficit. Mild dysfunction can be helped with pelvic floor exercises, but surgical options may be needed for more serious cases. A urologist can determine if further pelvic floor procedures are necessary.
2) Again, it would depend on the cause. However, surgery is indeed the most definitive option if more conservative therapy, such as medications like Reglan, aren't effective.
3) Yes, yeast would have shown up on a biopsy of the colon. You can also obtain stool tests.
These questions can be discussed with your personal physician.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin Pho, M.D.
Hi - in case you take the decision to have your colon removed, I thought it might be helpful to add to Dr Pho's response a summary of my own experience of a total colectomy. However, my operation was necessitated by torrential diverticular bleeding rather than the symptoms that you have described. I think the medical description of the procedure that you seek is an ileorectal anastomosis.
Hi, Do you remember me? I am "mifegr." I had to change my name (long story) I remember talking with you about a year ago. They want to remove my rectum as well as my colon because both are "dead." They are going to do a J pouch, but don't think it will work with me. People who get J pouches due to chronic constipation have really weak pelvic floors. And tests have also showed that I also have this. I have put this surgery off this long because I know that I'm going to have to wear a bag and I'm not ready for that. I just can't accept it. If this bowel problem of mine were the only health problem I have, I think I could accept it. But this, on top of all my other health problems, is the last drop in an already full barrel. I've talked to a psychiatrist. He encourages me to get the surgery because the quality of my life is so bad now due to my bowel problems. We'll see. Thank you for caring. You are always so willing to help everyone on this site. Hope all is well in England :)
Hi Gina - nice to hear from you again - I have often wondered how you were faring but I am really sorry to learn that you are still troubled by your "intestines" and other things - and also the mental pressure that this has inflicted on you.
Reading through your latest posting, I wonder whether undergoing the surgery (even with the J pouch) will work out as a "net gain" overall. I.e. on the positive side - better behaved intestines and maybe the relief of less mental anguish - but on the negative side - the "nuisance value" of the J pouch?? Can they carry out the colectomy without creating the J pouch? Just what are the consequences of limiting the surgery to the colectomy? Subsequent to the a colectomy only, if you are still in a state of discomfort can the J pouch be created later?
I don't know much about J pouches but I would have thought that progress must have been made to minimise the nuisance/discomfort and that sound medical advice must be offered to those patients who have the J pouch. Maybe it will be better than you fear?
On the psychiatric side, I would encourage you to seek help especially if there is a risk that your physical condition will dominate your mental attitude and behaviour towards the rest of your life. In my case I sought advice because the trauma of my torrential bleeding and the closeness to death left a real fear with which a psychiatrist helped me - a bit like surviving a plane crash or whatever I suppose....??
All is fine here in the UK - well apart from the awful financial scenario. If I am allowed to say so on Medhelp's columns, generally here in the UK we like your present President better than your last President!! Sorry if that offends anyone!!
Hello, and thank you for your post. I am having both my rectum and colon removed on March 30th. I'm nervous. I have not expelling anything rectally in 10 days. In fact, I asked me surgeon yesterday, "How am I going to clean out for the surgery?" and he said, "We will do the surgery with a full colon. You don't have to clean out. You'll be on lots of antiboiotics. Don't worry about it." Well, I'm worried. They are going to do a J pouch. For the first 3 months after surgery I'll be wearing a bag. My pelvic floor is so weak (every time I vomit, I urinate like crazy). For that reason, the J pouch may not work. He said that I may have to insert a tube rectally to drain it every time I go to the bathroom. To tell you the truth, even that sounds better than being severely constipated 365 days a week, year after year.
Please keep me in your prayers o.k?
Yes, everyone here in the US loves the new president too. Let's hope he'll be able to do something about the economy.
Hi Gina - your question about "cleaning out the colon before surgery" is similar to that which I asked my surgeon before my own operation. I said "is there any danger that when you cut out and lift out the excised colon, there may be a slight spillage of its contents into the abdomen which, presumably, could cause peritonitis.?" The surgeon said that "we give you strong antibiotics at the time of the operation". I also verified this with the anaethstatist when he came to see me just before "putting me under". Hence I think you can rest easy on this question.
I really hope and pray that - overall - you will be in better shape after the operation and that discomforts in the initial period after the surgery will gradually diminish in relevance as time goes by.
Good luck - and do let me know how things are when you are out of hospital .
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