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Constipation after bowel resection
329994_tn?1301666848
by lvfrogs, Jul 09, 2008
Hello everyone,
I am new to this forum, having just recently (3 weeks) had a bowel resection, emergency operation, vertical incision, not a laparoscopy.  My question to anyone, is this:  I am still constipated (just like before the operation), bloated and eating little.  What have you all done for this? My doctor says that I can eat whatever I want, but that is not the case. If I eat very light, soups, some fruit, I am ok.  Anything more and I am nauseous and miserable.  I can only go to the bathroom if I take a laxative.  I know that I am only 3 weeks out but would love to start feeling better soon. I am also extremely tired and would like to know if this is normal. I find talking to other people that have gone through something similar is better than talking to the doctor.  Any help is greatly appreciated.
Thanks!
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Member Comments (24)
Avatar_m_tn
by Morecambe, Jul 09, 2008

Hi - I underwent a total colectomy four years ago.  Log on to:-

http://www.medhelp.org/posts/show/523166

to read my own description which I posted in answer to another patient's question.

I am surprised by your experience in regards to a continuing constipation rather than frequent liquid motions which are characteristic of a total colectomy.  The colon storesd water and when it is removed there is supposed to be much more water that passes through the remaining shortened large intestines.

You could try dringing more water and following my "more fibre" recommendation.

I wonder if you might have a lingering ileus?  Suggest to ask your surgeon.

Do revert with any further questions.

regards
Morecambe
329994_tn?1301666848
by lvfrogs, Jul 09, 2008
Hello Morecambe,
I did not have a total colectomy, like you did. I just had an intestinal removal and resection.  I am drinking lots and lots of water, eating prunes, other fibre and if I have to, taking Milk of Magnesia.  The doctor had me take Magnesium Citrate one time, he thought that would get it going.  Of course, I went, but since then have only gone once on my own. I see him next Tuesday so plan to ask him some questions.  

I didn't even know what an ileus was? So thank you, I will ask him about that. I looked it up on the internet.  Your post that you referred me to was very informative, thank you! You have been a big help.

Take care!

Avatar_m_tn
by Morecambe, Jul 09, 2008
Hi again - I'm a bit perplexed by your comments.  From the tenor of your posting I am assuming that the original bowel resection was to overcome serious constipation?  If so, then why not cut out the part of the bowel (i.e. the colon - or most of it) that acts as the constraint to defecation?  Why only cut out a small part that allows constipation to continue??

Or was your bowel surgery for another complaint (e.g. an ulcer) which cut out only a very small section that would have made no difference to your underlying constipation?

If indeed you are suffering from chronic (incurable??) constipation, you might want to ask your doctor/surgeon "is it still possible to have another operation that will definitely cure the problem - i.e. a total colectomy???)."  Obviously quite drastic - but if it gives you back your life.....

Wishing you well
Morecambe
329994_tn?1301666848
by lvfrogs, Jul 10, 2008
For over a year, I have had bloating, constipation - change in bowels, not always constipation, sometimes I would go 4 or 5 times in a couple of hours (morning), fatigue and when I ate, I ate very little but felt like I had eaten a big Thanksgiving dinner. I was having some gyn problems too and I thought it was related to that. In the meantime, I had been going to my primary, my gastro doc and my gyn. They all knew of these complaints.  About 5 months ago, I started having severe stomach cramping that would come and go but it was bad, like really horrible labor pains. I was told to eat more fiber, you have a stomach virus, etc.  The last time it happened, 3 weeks ago, I went to the ER because I just could not take it again.  My white blood cell count came back at 20,000 so they ordered a CT scan.  The CT scan showed an inflamed appendix so they thought I had chronic appendicitis, where it flairs up and backs down over and over.  So they scheduled emergency appendectomy.  When they operated for that, the appendix didn't look that bad, so the surgeon took a look around and he found a foot long section of my instestine that was scarred, twisted in two places and obviously blocked.  So he did major surgery to remove and resection that.  I hope this helps more with my explanation and sorry it is so long!

I see the surgeon on Tuesday of next week and plan to ask him about the ongoing constipation.  He is concerned about that but it's been two weeks since I have seen him last and in these two weeks, was the first time that I had really started eating more substantially (or trying).

Thanks for your advice and help.
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by whatever676, Jul 10, 2008
What is a total colectomy? Do you have to wear a bag or something after the surgury?
Avatar_m_tn
by Morecambe, Jul 10, 2008
Hi Ivyfrogs - thank you for your clarification.  My (unqualified) viewpoint would be that the one foot of removed intestines (for suspected appendicitis) was insufficient to reverse the constipation.

What to do now?  If you are prepared to undergo another (bigger/more traumatic - as you will have seen in the posting to which I referrred you) surgical operation and if your present situation is intolerable - I would ask your surgeon on Tuesday "Look although it may be quite drastic, would a total colectomy solve everything for once and for ever?"

I recall Dr Pho (on the "ask an expert" part of the G.I. forum) saying that surgery can be a last resort for chronic constipation.

Good luck - let me know how it goes - Good luck

Morecambe

Whatever676:-

a total colectomy is the removal of the colon.  It is also called an ileorectal anastomosis.  An incision in the most distant part of the ileum is made and also an incision in the top of the rectum.  The two incisions are sutured (= an anastomosis)together.  It's a bit like cutting out a few feet of a garden hose that is split open and leaking - and then joining the remaining sound parts together.  The split part of the colon/garden hose is then thrown away.  Depending on the "geometry" of the two open parts a colostomy bag may/may not be required.  My surgeon said that hit is necessary in ~2% of cases.  But there are probably other reasons why, during the operation, the surgeon may have to decide to insert a colostomy bag.

Try typing in "total colectomy" or "ileorectal anastomosis" into google/yahoo etc and you will find thousands of clips - some of which originate from prestigious hospitals and which include a diagram.

Good luck

Morecambe
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by lvfrogs, Jul 10, 2008
To Morecambe,
Thank you for your advice. I see my surgeon next Tuesday and I have kept track of everything since my last visit 2 weeks ago.  I will see what he says and in the meantime will do some research into a colectomy. Thank you for your help!
Avatar_f_tn
by Bad_Luck_Gut, Jul 10, 2008
Thanks for all the advise earlier, I had ileorectal anastomosis surgery on the 28th of May.  I am still in a great deal of pain.  I was hoping for a quicker recovery.
Avatar_m_tn
by Morecambe, Jul 11, 2008

Hi - what an appropriate name - but I hope that you can re-name yourself "Happy Gut" or "Painless Gut" soon!!

It is over two months since your surgery and I would have thought that you ought to be pain-free by now.  I was pretty much pain free after the wound had healed (2-3 weeks) and up to then, I recall that any pain was more associated with the wound rather than with "anger" from my remaining intestines.

I suggest you ask your surgeon to differentiate between pain associated with the wound and pain associated with your intestines and treat accordingly.  If the pain is identified with your intestines, maybe some imaging tests can identify the cause,  I really hope that you do not need a follow-up operation.

Good luck
Morecambe