Lower Colon problems for 15 years

Doctor,

I'm a married man in my late 20's with a young child.  It's very hard for me to write this as I try to block it from my mind.  I believe in Teddy Roosevelt's philosophy that your mind has the ability to overcome illness but it's just not working for me.

Here's some background info:
When I was about 14 I sustained an injury to my rectum.  I had a small plastic jump rope handle inserted into my rectum.  There's never been anything up there since then but I've had complications ever since that one incident for the last 15 years. I'm certain my bowel movements were perfectly normal up until that time and I'm certain they've been abnormal since.  About one year after this incident I had the colon scope and it showed inflammation in my lower colon and rectum but that's about it I believe.  The doctor was not aware of what had happened to me a year earlier (so maybe he missed some injury?)

All throughout high school I had many bowel movements of nothing but clear or stingy mucus.  By the time I was in college, I learned to live with my symptoms and go at least 2x per day.  Towards the end of college, I noticed I not only continued to have the frequent bowel movements but I also began to have a lower colon and rectum that produced very loud and unnatural rumblings on almost a daily basis.  The condition seemed to be working it's way up my colon.

Now, I'm out of college and in a professional job.  I have a bowel movement each morning that many times appears normal.  However, when I have a normal bowel movement in the morning, 80% of the time it seems to trigger the need to expel a very large amount of gas and possibly more feces or mucus usually a couple of hours later once at work.  If I don't go again, my stomach sounds literally like the laxative scene from the movie Dumb & Dumber for a few hours at which time it usually passes.  By the time I'm off work, I usually need to go again in the evening -- usually after I eat.

If I happen to make it a day or two without a bowel movement, I feel great....it's the bowel movements I believe that trigger all the problems that must lie in my rectum or lower colon.

Another clue of what might be wrong, I've learned to go to the restroom a couple of times per day and wipe.  Many times the toilet paper will be damp with a brownish/yellowish color---and I'm certain I was clean when I left the house.  Generally it's not enough to leave any markings on my clothes especially if I keep it checked.  Occasionally I will feel the leakage, but usually not, when I do feel it, it's similar to when an air bubble runs up your swimsuit in a pool.

To rule out bacteria or infection, I had all these stool sample tests done about a year ago but all they showed was a little blood in the stool.

I used to tell my wife that I'd never have colon cancer since my colon is always empty due to the chronic diarrhea but then I came to the realization that if my symptoms go untreated much longer I may be dead in 10 years.    I was resolved to accept my fate but with a young baby I want to see him grow up.  Living with this for 15 years has been hard but making it for another 15 may be physically impossible for my body.....I'm healthy on the outside (maybe even overweight) but my insides have got to be struggling.

If you're still reading all this, I do appreciate your guidance.  I know I need to see a doctor but this is so out of the ordinary should I go to some specialist?  What do you recommend?  Is there any kind of medicine I can try or maybe some antibiotic?  

[Kevin Pho, MD]

If in doubt, I would also recommend discussing your concerns with a physician.

I agree with sending the stool off to exclude infection.  Testing for malabsorption as well as obtaining blood tests for celiac disease.

If colon cancer is a concern, you can consider repeating the colonoscopy, as this is the most comprehensive test that can rule out this possibility.

If the diagnosis continues to be non-revealing, irritable bowel syndrome can cause an increased sensitivity to colonic gas.  Treatment with antispasmodic agents and/or tricyclic medications can be discussed with your personal physician.

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