Post operative problems

[Haneya]

My wife had surgery for colon cancer in December 2003. The cancer was located close to the anus. The histology showed that there was no cancer remaining (Dukes A) and there was no post-operative chemotherapy. She had an ileostomy for seven months and a reversal was carried out at the end of June 2004. In mid August, following sever pain, an anal fissure was repaired. For the last two months she has continued a cocktail of analgaesics but still suffers pain and discomfort. She evacuates her bowels sometimes 8-10 times per day, and 2-3 times during the night. It never feels that the bowel is empty and there is always "pressure" to use the toilet. Part of the discomfort is the burning sensation and irritation in the vicinity of the anus. The use of haemorrhoidal cream does not relieve the pain. Occasionally there is blood in the stool. Her diet consists of fruit, vegetables, cereals (bread and porridge), fish, chicken and little red meat.
Although I realise that adjustment of the bowel may take some time, there does not appear to be any progress or reduction in pain and discomfort. What can be done to improve this, reduce the discomfort and improve bowel control?

[Kevin Pho, MD]

As with any major bowel surgery, there is indeed a time of healing and adjustment before the discomfort can be resolved.  You may want to ensure there isn't anything else going on that can be causing your symptoms.  An undiagnosed mass or stricture can cause the bowels to always feel full, and a colonoscopy or sigmoidoscopy can be considered to evaluate for this possibility.  

You may want to discuss these tests with your personal physician or be referred to a gastroenterologist.  

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.
Medical Weblog:
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