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Avatar universal

Could a rectal prolapse or IBS cause narrow stool or small balls?

My IBS was pretty much under control and then after a few rounds of antibiotics and doubling up on Culturelle probiotic to prevent diarrhea plus still being slightly hypothyroid I became extremely constipated early December.  I could only have BMs that were tiny balls, some with mucous (IBS?).   Took Colace and Miralax and ate more fiber rich foods (despite the fact that high fiber disagrees with my system) and drank more water.  I even started to dribble olive oil on my food.  Then I was up all night going to the bathroom and ended up with near diarrhea.  Since then my BMs have been on the soft side but on the narrow side and some soft small balls.  I dont know how to get out of the rut I put myself in and if I go to the GI  doctor she will say "colonoscopy".  I dont want to go there as once was almost hospitalized for severe bleeding for 8 hours from explosive diarrhea as in the prep. Luckily heavy steroids stopped it   but that doctor (since retired) never pushed me to have a colonoscopy and in fact said not to or the prep would kill me. I was on steroids for a year after that and got severe osteoporosis.  I also have a rectal prolapse from all the constipation I have been through with being hypo and wonder if that may even be contributing to the narrow stool.and/or balls.  Thank you.
5 Responses
Avatar universal
You should still see a GI doctor for further workup and evaluation. Even if you decline conventional colonoscopy, you may benefit from capsule endoscopy and/or virtual colonoscopy, noting the latter would still require the dreaded prep. Alternatively, consider CT or MRI enterography to rule out enteritis, colitis, or other pathology.
1 Comments
Thanks but allergic to iodine contrast, Gastrografin and cant do barium either and I believe these are associated with the scans.  As far capsule endoscopy I have severe scoliosis and my organs are misplaced and intestines affected plus having a redundant transverse colon so capsule may not make it through.  I am lost.  My diaphragm and part of colon are up in my lung area.    The GI  doc never takes any of this under consideration.  All she is interested in is that colonoscopy.  The other problem with that is I am allergic to the carba mix in the bends of the scope and would have to be on steroids to prevent swelling.
Avatar universal
You can still consider MRI enterography. For intravenous contrast, MRI uses gadolinium contrast whereas CT uses iodinated contrast; there is no cross-reactivity between different classes of contrast media.* For oral contrast, this uses VoLumen (barium sulfate suspension), which rarely has allergic reaction.

While you should not have a contrast study if you had prior severe allergic reaction (e.g., anaphylaxis), you can still consider having a contrast study if you had prior mild to moderate allergic reaction (e.g., itching or hives), as your doctor can provide a premedication regimen consisting of prednisone and diphenhydramine to decrease your risk of allergic reaction.

If you decline CT or MRI with contrast, doing a CT abdomen/pelvis without contrast may still be of benefit. You may see obvious bowel wall thickening suggestive of enteritis and/or colitis.

*Source: American College of Radiology Manual on Contrast Media, available at:
https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf
Avatar universal
Regarding capsule endoscopy, I would not rule it out so quickly. Ask your gastroenterologist if you are a candidate. If you cannot get conventional colonoscopy, capsule endoscopy is better than nothing.

The most common applications for capsule endoscopy include evaluation for (1) obscure GI bleeding, both overt and occult, including iron deficiency anemia; (2) suspected Crohn’s disease; (3) surveillance in patients with polyposis syndromes; (4) suspected small intestine tumors; and (5) suspected or refractory malabsorptive syndromes (e.g., celiac disease).

The relative contraindications include patients (1) with known or suspected GI obstruction, strictures, or fistulas based on the clinical picture or preprocedure testing, (2) with cardiac pacemakers or other implanted electromedical devices, (3) with swallowing disorders, and (4) who are pregnant.

Source: American Society of Gastrointestinal Endoscopy Technology Status Evaluation Report, available at:
https://www.asge.org/docs/default-source/importfiles/assets/0/73730/c4d44578-c3d0-4583-9949-b15f3e8537e0.pdf
Avatar universal
Do you have IBS (irritable bowel syndrome), IBD (inflammatory bowel disease, such as Crohn's or ulcerative colitis), or both? I noticed you stated you had Crohn's disease in one of your old posts. If that is the case, you already have a diagnosis for your digestive symptoms, and you should follow up with your gastroenterologist to optimize your medication regimen.
1 Comments
Here lies the problem - my retired GI doc never pushed colonoscopy because I had hemmoraging from explosive diarrhea back in 2001.  I was put on heavy steroids and told if still bleeding at 8PM you will have to be admitted.  Luckily by 8PM the bleeding stopped but it was so bad all day that I filled a whole urine specimen cup with pure blood, no feces and when I took the cup away the blood was still pouring out.  A few days later he did a rigid sigmoid and told me he saw where the bleed was in my sigmoid and said it looked like Crohns but since there was no biopsy taken my new GI doc wants to hear none of it. I can not do barium anything because of my slow digestive system. I had a barium enema once and an upper GI seri4es, both times the doc called me and said if you do not take 3 more oz of MOM you will be in the ER with complete blockage as I was not evacuating. Both times I got a terrible infection that spread to the front tissues and my Barthelens gland was swollen and sore for almost a year both times from the infections.  Was told not to do barium also. As far as allergies are concerned i.e. Gastrografin caused my lower abdominal pain to escalate to over the top and by the time they did the ctscan.  my whole colon was swollen almost shut and the whole colon was searing pain.  That was oral Gastrografin.   Being I am allergic to Crohns meds I was put on Librium and Librax and have been since then.  I have many medication allergies - only have 2 antibiotic classes left.  No fun.The pain was so bad I could not stand it. Now I have gone thg other way and can stop giung.from overdoing.  This is worse than being constipated.
Avatar universal
Sounds like you have been through a lot! Your situation is extremely complex and challenging, beyond the scope of this forum, and probably even pushing the limits of a typical 15 min appointment with a gastroenterologist. Between your numerous allergies to medications and contraindications to diagnostic tests, there are so many wrenches thrown into this problem. My advice would be to seek further evaluation at an academic medical center more equipped to deal with cases such as yours. Hopefully, you can find a gastroenterologist who is patient, understanding, and accommodating. Good luck!
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