lack of peristalsis due to laxative abuse

I have had chronic constipation for 16 years. I know why, and do not need advice concerning that. A GI DR.at UofM said I had a severe case of IBS 16 years ago. Anyway,the problem is that I have had to take laxatives every day for 16 years or I am in excruciating pain. Now, I have NO peristalic action. The muscle in my colon is dead. So the stool will NOT come out. Even if I use Ducalox rectal suppositories. Now, the laxatives turn the stool into diarrhea and it runs thru me. It sounds like water running thru a facet. It will NOT come out. I have stopped eating. I drink only liquids. I've lost 30 pounds as a result. I have 3 questions...1)Can peristalsis come back? 2)If so, how? And 3)Is it likely that I will have to get a colostomy bag? By the way, it may help to know that I have found out that this lack of peristalsis is due to the laxative abuse and nothing else.
Thank you so much.  

[Kevin Pho, MD]

To answer your questions:
1) It would depend on the cause leading to the lack of peristalsis.  If it is a treatable cause (i.e. metabolic causes like diabetes or thyroid disorders), then perhaps.  However, with some neuromuscular diseases, there is the possibility that it would not improve.    

2) With laxative abuse, there is no clear way to determine if the symptoms would improve, and prognosis would vary from patient to patient.

3) Surgery is the most definitive treatment for chronic constipation.  If this avenue is considered, then a colostomy bag can be possibility.

These options 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 patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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