spastic colon affected by hanging stomach skin from gastric bypass

Diagnosed 20 yrs ago w/spastic colon, ulcers, Crohn's disease and IBS (colonoscopy every 5 yrs). I was on steroids (for sarcoidoisis in liver) and gained 80 lbs. Was told to have a gastric bypass to take weight from liver area or ultimately I would have to have liver transplant. Gastric bypass performed 5/03 and I lost 100 lbs. My weight was primarily in stomach/liver area when heavy. I now need hernia repair in belly button area and want a panni for hanging skin (doctor estimated 4-5 lbs. skin there). Medicare is my primary but I've been told Medicare won't cover the panni surgery repair for the hanging stomach skin. I have pain with spastic colon if I try to walk for exercise or even when I do certain yoga stretches. I know this is related to the extra hanging stomach skin from the gastric bypass.  Is there any kind of test I can have done to confirm this 4-5 lbs. skin IS really affecting my spastic colon during exercise?  Have you had a other patient who experienced pain with hanging skin affecting their spastic colon? I take 40 mg. Dicyclomine for spastic colon as needed.  I would be most appreciative of any information you can give me.

[Kevin Pho, MD]

I am not aware of a specific test to determine if the pannus can be leading to your symptoms.  

Ruling out other causes can be considered first to exclude things like cancer, stricture, obstruction or mass.  Endoscopy can evaluate the colon and imaging the abdomen can be considered.

If negative, further treatment to evaluate the irritable bowel can be considered with tricyclic antidepressants or the antibiotics Rifaximin.  

These options can be discussed with your personal physician, or in conjunction 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.
www.kevinmd.com