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Bowel function after low anterior resection
I had a low anterior resection done in Feb 07 for stage 3 rectal cancer. I finished chemo & radiation by Oct 07. So far, I am cancer free. I never had an ostomy (temporary or otherwise). I have had trouble with bowel 'urgency' since the resection, which has improved but I still have to be near a bathroom all the time. I also have trouble with constipation or diarhea, sometimes both at once. I have 6 to 15 bowel movements per day (which are usually quite small & I have to strain alot). I never feel like my bowel has completely emptied. I also have a lot of pain and bloating. My surgeon says that my symptoms are not from the resection but from irritable bowel syndrome. I know that several rectal cancer patients suffer from the exact symptoms & several have had a j-pouch or an ostomy to releive the symptoms. I'm wondering if anyone has any recomendations. I'm very frustrated & have been thinking that I should ask my surgeon to give me an ostomy so that I can have freedom again.
Much belated answer here now years later...
Low-anterior resection 2003 with radiation, chemo and temporary diverting ileostomy.
I found the bowel & BM situation totally unacceptable -- the frequency, urgency, and incomplete emptying.
Within a month of the ileostomy take-down and restored bowel continuity and function, I started doing DEEP, complete "high colonic" enemas.
An extra bathroom for dedicated use is quite nice but not absolutely required. Stepping from tub to toilet is convenient. For the necessary cleanup I keep bleach at hand.
I installed a little showerhead diverter and have with a small hose (actually, surgical suction tubing, about 1/4-5/8" ID), plus an inline flow regulator/shut off (both from Home Depot).
Low-pressure & low flow, up to what you tolerate, is easy to manage.
Does not require deep insertion, simply holding end of hose/tube tight to anus with sphincter relaxation. I fill to fullness/discomfort but not pain and can usually tell if and when water gets all the way over to the right colon.
(This may all be contraindicated if you have diverticulosis. May want to check with your doctor. )
When it works well, it takes about 1-1/2 hours and only 2-3 repeat instillations to totally empty the colon.
It's good for 2-1/2 to 4 days -- which has slowly increased over time. The 2-1/2 days was quite consistent and predictable for the first 10 years with infrequent early surprises and you learn to gauge when the emptying is done (or nearly so :-/
It's been a YUUGE improvement but not perfect.
Variably and over the last 2-3 years, there's been generally increasing resistance, both to inflow of maximum amount of water, and of emptying, which seems most likely related to irritable bowel/spasm... ...Instead of the 1-1/2 hours it can take 2-4-6 or more, with numerous repeat instills (but lots of good reading time).
A few months ago it was so bad I was even worried about obstruction at transverse colon or right/hepatic flexure but colonscooy was normal.
(The Dr. told me the this enema regimen is not uncommonly discovered and used by patients after a low anterior... I'd thought I was just pretty smart and unique).
After the colonscopy there was excellent reversal back to normal, and even better, with results easily lasting now for up to 4 days for some reason (but not always).
Even now, 13 years later, I still explore diet modifications to better manage.
But you have to admit, 2.5+ days freedom for 1.5 hour bathroom time is HUGE!
Good luck!
Low-anterior resection 2003 with radiation, chemo and temporary diverting ileostomy.
I found the bowel & BM situation totally unacceptable -- the frequency, urgency, and incomplete emptying.
Within a month of the ileostomy take-down and restored bowel continuity and function, I started doing DEEP, complete "high colonic" enemas.
An extra bathroom for dedicated use is quite nice but not absolutely required. Stepping from tub to toilet is convenient. For the necessary cleanup I keep bleach at hand.
I installed a little showerhead diverter and have with a small hose (actually, surgical suction tubing, about 1/4-5/8" ID), plus an inline flow regulator/shut off (both from Home Depot).
Low-pressure & low flow, up to what you tolerate, is easy to manage.
Does not require deep insertion, simply holding end of hose/tube tight to anus with sphincter relaxation. I fill to fullness/discomfort but not pain and can usually tell if and when water gets all the way over to the right colon.
(This may all be contraindicated if you have diverticulosis. May want to check with your doctor. )
When it works well, it takes about 1-1/2 hours and only 2-3 repeat instillations to totally empty the colon.
It's good for 2-1/2 to 4 days -- which has slowly increased over time. The 2-1/2 days was quite consistent and predictable for the first 10 years with infrequent early surprises and you learn to gauge when the emptying is done (or nearly so :-/
It's been a YUUGE improvement but not perfect.
Variably and over the last 2-3 years, there's been generally increasing resistance, both to inflow of maximum amount of water, and of emptying, which seems most likely related to irritable bowel/spasm... ...Instead of the 1-1/2 hours it can take 2-4-6 or more, with numerous repeat instills (but lots of good reading time).
A few months ago it was so bad I was even worried about obstruction at transverse colon or right/hepatic flexure but colonscooy was normal.
(The Dr. told me the this enema regimen is not uncommonly discovered and used by patients after a low anterior... I'd thought I was just pretty smart and unique).
After the colonscopy there was excellent reversal back to normal, and even better, with results easily lasting now for up to 4 days for some reason (but not always).
Even now, 13 years later, I still explore diet modifications to better manage.
But you have to admit, 2.5+ days freedom for 1.5 hour bathroom time is HUGE!
Good luck!
Much belated answer here now years later...
Low-anterior resection 2003 with radiation, chemo and temporary diverting ileostomy.
I found the bowel & BM situation totally unacceptable -- the frequency, urgency, and incomplete emptying.
Within a month of the ileostomy take-down and restored bowel continuity and function, I started doing DEEP, complete "high colonic" enemas.
An extra bathroom for dedicated use is quite nice but not absolutely required. Stepping from tub to toilet is convenient. For the necessary cleanup I keep bleach at hand.
I installed a little showerhead diverter and have with a small hose (actually, surgical suction tubing, about 1/4-5/8" ID), plus an inline flow regulator/shut off (both from Home Depot).
Low-pressure & low flow, up to what you tolerate, is easy to manage.
Does not require deep insertion, simply holding end of hose/tube tight to anus with sphincter relaxation. I fill to fullness/discomfort but not pain and can usually tell if and when water gets all the way over to the right colon.
(This may all be contraindicated if you have diverticulosis. May want to check with your doctor. )
When it works well, it takes about 1-1/2 hours and only 2-3 repeat instillations to totally empty the colon.
It's good for 2-1/2 to 4 days -- which has slowly increased over time. The 2-1/2 days was quite consistent and predictable for the first 10 years with infrequent early surprises and you learn to gauge when the emptying is done (or nearly so :-/
It's been a YUUGE improvement but not perfect.
Variably and over the last 2-3 years, there's been generally increasing resistance, both to inflow of maximum amount of water, and of emptying, which seems most likely related to irritable bowel/spasm... ...Instead of the 1-1/2 hours it can take 2-4-6 or more, with numerous repeat instills (but lots of good reading time).
A few months ago it was so bad I was even worried about obstruction at transverse colon or right/hepatic flexure but colonscooy was normal.
(The Dr. told me the this enema regimen is not uncommonly discovered and used by patients after a low anterior... I'd thought I was just pretty smart and unique).
After the colonscopy there was excellent reversal back to normal, and even better, with results easily lasting now for up to 4 days for some reason (but not always).
Even now, 13 years later, I still explore diet modifications to better manage.
But you have to admit, 2.5+ days freedom for 1.5 hour bathroom time is HUGE!
Good luck!
Low-anterior resection 2003 with radiation, chemo and temporary diverting ileostomy.
I found the bowel & BM situation totally unacceptable -- the frequency, urgency, and incomplete emptying.
Within a month of the ileostomy take-down and restored bowel continuity and function, I started doing DEEP, complete "high colonic" enemas.
An extra bathroom for dedicated use is quite nice but not absolutely required. Stepping from tub to toilet is convenient. For the necessary cleanup I keep bleach at hand.
I installed a little showerhead diverter and have with a small hose (actually, surgical suction tubing, about 1/4-5/8" ID), plus an inline flow regulator/shut off (both from Home Depot).
Low-pressure & low flow, up to what you tolerate, is easy to manage.
Does not require deep insertion, simply holding end of hose/tube tight to anus with sphincter relaxation. I fill to fullness/discomfort but not pain and can usually tell if and when water gets all the way over to the right colon.
(This may all be contraindicated if you have diverticulosis. May want to check with your doctor. )
When it works well, it takes about 1-1/2 hours and only 2-3 repeat instillations to totally empty the colon.
It's good for 2-1/2 to 4 days -- which has slowly increased over time. The 2-1/2 days was quite consistent and predictable for the first 10 years with infrequent early surprises and you learn to gauge when the emptying is done (or nearly so :-/
It's been a YUUGE improvement but not perfect.
Variably and over the last 2-3 years, there's been generally increasing resistance, both to inflow of maximum amount of water, and of emptying, which seems most likely related to irritable bowel/spasm... ...Instead of the 1-1/2 hours it can take 2-4-6 or more, with numerous repeat instills (but lots of good reading time).
A few months ago it was so bad I was even worried about obstruction at transverse colon or right/hepatic flexure but colonscooy was normal.
(The Dr. told me the this enema regimen is not uncommonly discovered and used by patients after a low anterior... I'd thought I was just pretty smart and unique).
After the colonscopy there was excellent reversal back to normal, and even better, with results easily lasting now for up to 4 days for some reason (but not always).
Even now, 13 years later, I still explore diet modifications to better manage.
But you have to admit, 2.5+ days freedom for 1.5 hour bathroom time is HUGE!
Good luck!
I had a low rectal resection for colorectal cancer in October 2000. Before surgery I had chemo and radiation to shrink the polyp. An ostomy was not necessary. But since then I have had a complete change in my bowel function. I believe the change was caused by the surgery as well as the radiation. Radiation destroys good tissue and cell along with the cancer. Then I rectum is shortened by the surgery and the storage function of the rectum is lost.
Frequent small movements are common for me, 6 - 15 times a day is not a bad day for me. 30 plus is a bad day. The urgency part is a real pain especially when explosive movements are coming. I consider it a nuisance and a bother but it does not stop me from doing most things. Years ago I tried all the different recommendations from my doctors with no noticeable results. Different types of diet, fiber supplements, hot drinks in the morning, etc. I don't want an ostomy though that would give me more freedom in some ways. I have learned to make adjustments and still live my life. I'm employed full time and commute an hour by car each way. I have traveled extensively and learned how to manage things. I do take Lomotil by prescription when I know I will not have easy access to a bathroom. I also use the Lomotil when I have diarrhea on occasion.
I work with someone who did opt for the ostomy and it works well for her. She does not have to worry about being close to a bathroom. If she didn't tell me, I would never have known she had it. It is very manageable for her and many other people I know. So I believe you need to make an informed decision regarding what will be best for you.
For years I belonged to a large online support group for colorectal survivors, caretakers, doctors etc. There are listserv organizations you can join to get information, joining this list was a good place to start. The internet is a wonderful resource to find info and meet people with like concerns. Hope you find a solution that works for you.
Frequent small movements are common for me, 6 - 15 times a day is not a bad day for me. 30 plus is a bad day. The urgency part is a real pain especially when explosive movements are coming. I consider it a nuisance and a bother but it does not stop me from doing most things. Years ago I tried all the different recommendations from my doctors with no noticeable results. Different types of diet, fiber supplements, hot drinks in the morning, etc. I don't want an ostomy though that would give me more freedom in some ways. I have learned to make adjustments and still live my life. I'm employed full time and commute an hour by car each way. I have traveled extensively and learned how to manage things. I do take Lomotil by prescription when I know I will not have easy access to a bathroom. I also use the Lomotil when I have diarrhea on occasion.
I work with someone who did opt for the ostomy and it works well for her. She does not have to worry about being close to a bathroom. If she didn't tell me, I would never have known she had it. It is very manageable for her and many other people I know. So I believe you need to make an informed decision regarding what will be best for you.
For years I belonged to a large online support group for colorectal survivors, caretakers, doctors etc. There are listserv organizations you can join to get information, joining this list was a good place to start. The internet is a wonderful resource to find info and meet people with like concerns. Hope you find a solution that works for you.
I had an anterior resectomy for colorectal cancer in May 2005. Life after that has never been the same as far as bowel movemnent is concerned. However it does not have to be doom and gloom. There are good days and bad days. The good ones involve going having up to 4-5 bowel motions of fully formed stool but in a short space of time and the bad days involve urgency and frequency and going as much as 10 times in one evening.
I find Gastro-Stop tablets quite helpful in stopping this latter pattern but then you might not go to the toilet for two days and get bloating for it. However they are helpful when you need to go out and having a "bad day"
Things do improve, be patient. I eat everything except very oily stuff which are not good for you anyway. I have had trips overseas and there was no problem. However I NEVER go out without the Gastro-stop, which you get over the counter in any pharmacy.
good luck
I find Gastro-Stop tablets quite helpful in stopping this latter pattern but then you might not go to the toilet for two days and get bloating for it. However they are helpful when you need to go out and having a "bad day"
Things do improve, be patient. I eat everything except very oily stuff which are not good for you anyway. I have had trips overseas and there was no problem. However I NEVER go out without the Gastro-stop, which you get over the counter in any pharmacy.
good luck
Resection surgery for stage 3 in February 07.I've had gradual improvement from about 14 movements a day down to current 5 or 6. Life is still a bit constrained, nervous about straying too far from bathrooms, but continues to improve.
I've had three "diverticulitis" episodes, each treated with Cipro and Flagil. The first one was treated in hospital. Symptoms were very painful bowel cramps and blockage or near-blockage. I've found a daily stool softener (non-perscription Docusate Sodium) and about eight glasses of water a day seems to keep this from happening - so much so that I really wonder if I had an infection at all on the previous occasions. This reduces the amount of straining as well.
I've had three "diverticulitis" episodes, each treated with Cipro and Flagil. The first one was treated in hospital. Symptoms were very painful bowel cramps and blockage or near-blockage. I've found a daily stool softener (non-perscription Docusate Sodium) and about eight glasses of water a day seems to keep this from happening - so much so that I really wonder if I had an infection at all on the previous occasions. This reduces the amount of straining as well.
I had stage 3 rectal cancer and had resection surgery in August 2004, with a temporary ileostomy. I had ostomy takedown surgery in Januray 2005, and following the takedown I had all the problems you have described. It took a couple of years for things to get back to normal. Normal is not what it was before cancer, but it got a whole lot better in time. Be patient, it can take a while! It is frustrating but I would not recommend an ostomy unless there is no other choice. The ostomy was awful and I HATED every minute I had it.
Good luck,
jd
Good luck,
jd
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