Constipation-surgery???

Hi,

Im 22yr old female. Ive been suffering from chronic constipation for approx 6 years now. I was first diagnosed with IBS but that doesn seem to be the case.. no medication or laxative have ever worked. I went for a colonoscopy last year, after taking movicol for 4 days prior and the prep to clean out the colon before the procedure,not much came out & there was still waste in the colon. Specialist reckons I have a slow moving colon, meaning it doesn push stuff out quick enough. Yesterday I had upper endoscopy to take biopsy to rule out cealiac even though bloods showed up normal. I have been tested for hypothroidism which was negative. He has now gave me a prescription for a new drug only used in trials, and basically if this doesn't work, next option is surgery.. Is this my only option,? I know its a major operation and just feel that maybe I am too young to have some colon removed. There is a lot of forums that contradict the benefits of the surgery and some now have chronic diarrohea which I don't particularly want either. Any suggestions???

[patient915]

Welcome to the gastroenterology community!  Can you please list all of the medications you have tried?  Have you had a sitsmarker test?

[nikkipuzzc]

No which I'm surprised, sounds like it could be useful but he hasn't mentioned it. I've been on colofac for IBS which worked for a couple of weeks initially but then stopped. Can't even remember the names of half the meds, mostly laxatives and stimulants,. duclolax, mirolax ( i think) milk of magnesia, senakot ( which crippled me) movicol, fybogel, fibre sure ( just adds fibre to diet), 2 pints of the prep stuff because it had gotten so bad, enemas..I've tried to re-do my entire diet with jus high fibre foods, juices, and senna tablets but nothing seems to be working.. Thanks for your reply.. :)

[patient915]

I would recommend a sitsmarker test to see how your motility is.  I also think that an abdominal CT scan would be a good idea.  I personally believe that removing the colon is the last resort for constipation so I'm going to suggest a couple different ideas.  First, try a really low fiber diet.  Usually people with constipation need a high fiber diet, but occationally this will actually make things worse.  Look up to see which fruits and vegetables are low-fiber and only eat those, along with other low-fiber foods.  The only other laxative I would recommend trying is called magnesium citrate which I've found is one of the strongest laxatives out there.  How much water are you drinking every day?  If you are not drinking enough water, the laxatives won't do anything.

[nikkipuzzc]

Thanks again, might try that one.. i was on pretty low fibre diet first and that why i thought i was constipated, i would generally have an average diet, dont eat very healthily 100% of the time, no point lying :) I am trying everything now. Had abdominal scan and scan of thyroid, thats what they thought it could be too because had all of the symptoms plus a goitre, but theyre constantly showing normal. I drink a lot of fluids, drink about 1 and half litres water a day, was drinking a lot mre but made no difference other than a lot of trips to the loo to pee.. :) I cant see why he wouldn have recommended the sitsmarker test yet, maybe he will, but he said it appears to be quite slow moving anyway particularly because of my age..,

Thanks again..

[patient915]

A normal person should drink at least 2 liters of water a day so I would recommend increasing how much you are drinking.  Try eating healthy for a couple weeks and see if that helps.  If changing your diet can help enough to avoid surgery then that would be great.  Magnesium citrate can be bought over the counter,

[nikkipuzzc]

Have done that but trying a new diet now, he gave me amitiza so giving those a go now.. hopefully they'll work.. thanks for ur help :)

[patient915]

Amitiza might help, but with your level of constipation I doubt it will help much, although it works differently than most other laxatives so it is worth a shot.

[Morecambe]

Several years ago I underwent a total colectomy - not for chronic constipation - but for torrential diverticular bleeding.  In response to another Medhelp patient's question I posted my experience on:-

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

If you decide to undergo surgery perhaps my observations may be relevant in making your decision.

regards
Morecambe