Colonic inertia and lazy stomach

[lilkarla]

I am a 35 year old female with no pregnacies.  I am seeing a GI and a colon/rectal surgeon. I have been recently diagnosed with colonic inertia and have been advised to administer warm water enemas every other day for now.  Laxatives do not work for me.  Upon further testing of the stomach it appears that does not digest properly either (lazy).  I have been placed on domperidone for that but not getting any relief from the bloating and full feeling.  This week I had a gallbladder ultrasound (negative) and a HIDA scan (still waiting on results).  Over the last couple of years I had two hernias repaired around the same area - right above the belly button.  I have questioned both doctors about the chance of scar tissue or another hernia causing some of these problems but they have both dismissed it.  At times when my stomach is bloated and the hardest I feel little "balls" all around the upper stomach area between my ribs.  Also, If the colon and the stomach have muscle issues could this be related and be some type of muscle disorder?  Even after administering the warm water enema and having good results my stomach area and parts of the upper intestines always feel hard.  The only tests that I have had are defogram, upper GI, gallbladder ultrasound and HIDA scan.  My colonoscopy was 5 years ago and both doctors say I don't need another now since it was negative.  Laxatives dont work and if I try to wait and see if something happens I could be constipated for as much as 2.5 weeks and then I must do enema and halflyte colon prep because the impaction is so severe.  Every other day keeps me feeling somewhat normal now.  

Also, the rectocele has not gotten better and it is very painful.  How long do you wait for it to repair itself?  I has been out for about 4 months and when I jog or sweat it seems to get more irritated.  Just looking for a pair of fresh eyes.  

[lilkarla]

I did have the gastric empyting, forgot to put that.  It showed slow digestion and that is when i got on the domperiodone.  What about the possibility of scar tissue causing any problems?

[Kevin Pho, MD]

You have had a comprehensive evaluation for your condition, which would rule out many of the major causes.

A gastric emptying scan can be done to exclude gastroparesis, which can certainly cause your symptoms.

If present, there are a variety of treatment options including the medications Reglan or erythromycin.  More experimental approaches would be Botox injection as well as consideration of a gastric pacemaker.

These options can be discussed with your gastroenterologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com