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subtotal colectomy for slow transit constipation
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subtotal colectomy for slow transit constipation

Hi,
I am a 32-year-old female from Greece. I had a long history of chronic and severe constipation, which (as years went by) couldn’t respond to any diet or long-term use of medication. Initially, I followed all conservative treatment measures, but failed. The  development of this condition was something that I could not control. Gradually, I became refractory to all forms of pharmacologic and fiber therapy, and had difficulty in voluntarily passing stool. Quite often, bowel movements could only be accomplished through the use of high volume enemas and laxatives. I was complaining of having to make a conscious effort to relax due to everyday abdominal pain, digestive trouble, bloating and nausea. I avoided fruits, vegetables, sugar, milk, gluten and drinks. Waking up flat and looking “pregnant” after my first bite (literally one bite) of carefully chosen and soft-cooked food, made me have low mood accompanied by loss of pleasure in normally enjoyable activities.  Consequently,  I stopped eating properly, felt tired during the day, worked less than 4 hours and had sleeping problems. The feeling of fullness, the severe cramping and the general discomfort had a major effect on my quality of life, which was associated with fear for the future. Barium enema and colonoscopy screened  a healthy, but very long colon- instead of being the standard 4 to 5 feet long, it was almost double in length. However, the etiology of my case was considered to be rather psychological and I became obsessive with the idea of finding a solution to my problem. Despite the fact that I tried psychotherapy (never tried antidepressants) and alternative treatment (homeopathy, acupuncture, iridology and maya abdominal massage), there was no improvement in the perception of my physical, emotional and general health spheres. 6 months ago I  performed two physiologic tests that had never heard before: defecography and transit time study using x-rays to follow radiopaque markers. It took me all these years to find out that I was a patient with stc (slow transit constipation). My stc was also accompanied by an isolated disorder of rectal evacuation (Pelvic Organ Prolapse: enterocele and rectocele formation), though I never had a hysterectomy or childbirth. The solution was the colectomy. My colorectal surgeon (head of department of colo-rectal surgery at hospital) recommended that I should undergo a subtotal laparoscopic colectomy with ileorectal anastomosis. I was very scared, but I knew that I was one step further. Weighing of the pros and cons and the eventual benefits on my social life, I decided to end this endless hardship immediately. Unfortunately, I had an early postoperative complication (ileus) and underwent a re-operation.  

Post-operatively, the results are mixed: my bowel-movement frequency has been increased (diarrhea, 6-10 voids per day, with significant urgency in the morning hours), but the functional outcomes remain the same: abdominal pain, bloating, digestive trouble and nausea.  I am advised to drink fluid, include a  strict diet and follow a pharmacologic therapy (2 caps of ultra levure 250mg, 3 tablets of ibutin 300, 1 bag of probiotic VSL#3 and 2 papaya caricol sticks, per day). I am also encouraged to perform daily physical exercise (particularly yoga), psychotherapy and alternative treatment (homeopathy and acupuncture). From a STC to an IBS (irritable bowel syndrome) patient: this is my new profile. I feel lost. I wonder if it is early to evaluate this situation and its impact on my life.

Should I dream of a quality of life after subtotal colectomy for slow-transit constipation? Could anyone please provide me with any information or knowledge where I could open a new window towards taking control of my health?

Thank you..  
Avatar_m_tn
In 2004 I underwent a total colectomy for torrential diverticular bleeding.  I do not know whether the end result and after-effects would be expected to be similar for my condition compared to yours.  However, in response to another Medhelp patient's question I posted my own experiences on:-

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

I think you should seek further advice from your surgeon who has a responsibility to provide all necessary post-operative care and healing.  From my part, after my operation I did not experience any long-lasting discomfort.

please feel free to come back with any further questions.

regards
Morecambe
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