Can surgery cure my Slow Transit Constipation and IBS-C?

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Heinstein
Regular Member


Date Joined Oct 2012
Total Posts : 23
   Posted 2/11/2013 4:49 AM (GMT -6)   
I've been diagnosed with IBS-C and Slow Transit Constipation by a gastroenterologist. I was told that my colon was abnormally long, thin and floppy for my age. He said the texture of my colon was like that of an elders and I'm only 22 years old. It's been 11 months since I was diagnosed and my condition hasn't improved at all.

Here's my brief history:

    1. Food poisoning from takeaway sushi 3 months prior to getting IBS symptoms
    2. Experienced intense anxiety/panic attack at work for 1/2 hr(I broke some expensive equipment) a month prior to getting IBS symptoms
    3. Drank 30 ~ 70 ml of 1 year old opened red wine. Within 5 minutes, it gave me an intense upper abdominal pain for 10 minutes a week prior to getting IBS symptoms
    4. Started getting mild abdominal pain, constipation and food intolerances
    5. Was prescribed Buscopan Forte for 3 weeks
    6. Felt my lower abdomen slide down/drop while straining hard and stuff came out of my anus which looked like a partial prolapse. From then on, stuff always came out of my anus whenever I was straining.
    7. Few days later, all of my symptoms worsened significantly and I started getting tenesmus and mucous without stool
    8. After drinking sip of soda, my lower abdomen inflated so painfully that I thought it was going to pop
    9 Diagnosed with Impacted colon after an X-ray and was prescribed stimulant laxatives for 5 months
    10. Changed to a different doctor who prescribed me a Nexium and Psyllilum for my gastritis
    11. My symtoms gradually lessened after several months of Nexium and Psyllium
    12. My symptoms went from severe to moderate but it stopped getting better after that
    13. Had a CT Scan because they thought I had Sigmoid Vulvulus during a Colonoscopy
    14. CT Scan showed no structural problem so I was diagnosed with IBS-C and Slow Transit by a gastroenterologist


These are the results from the tests I had:

ENDOSCOPY REPORT said...


Findings:
Digital rectal examination: No masses felt.
Colonoscope advanced to the: Caecum. Bowel preparation good with adequate mucosal views throughout. There was an unual twist in the colonic mucosa in the area of the mid-sigmoid which made it difficult to pass the colonoscope. It had the appearance of a partial sigmoid volvulus. Allowing for this, after passage past this point, passage of the colonoscope was not problematic. I detected poor bowel tone with a degree of "floppinesss" of the colon. This could explain recent constipation arising from slow colonic transit. Rectal and colonic mucosa appeared normal throughout. This suggests that the twist in the sigmoid may arise from an extrinsic source. Random colonic biopsies taken. No polyps or malignant appearing lesions seen. No evidence of mucosal ulceration or inflammation.
Withdraw time: 10 min.

Conclusion:
1. Unual twist in mid-sigmoid colon, but otherwise colonic mucosa appeared normal throughout. Await biopsies.

Plan:
1. Post recovery consultation performed.
2. If a CT scan has not been performed, suggest this be done prior to my review.




CT Abdomen said...


Clinical Information: Worsening constipation. Unusual twist in the sigmoid colon reminiscent of a Volvulus/extrinsic compression? Extra colonic mass or compression in abdomen. No previous films however are available for comparison.

Technique: Post contrast axial scans obtained through the abdomen and pelvis.

Findings: No focal abnormality identified in the liver or spleen. The kidneys are concentrating contrast normally, no evidence of obstruction. Pancreas is normal. Gallbladder is well distended. No para-aortic lymphadenopathy. There is a relatively homogeneous density in the pelvis above the urinary bladder presumed to be bowel but it is difficult to assess due to the absence of intra mesenteric fat. No evidence of bowel obstruction. No free fluid in the abdomen or pelvis. No para-aortic lymphadenopathy. Bones are normal.

Conclusion: No definite intra-abdominal pathology can be identified to account for patient's symptoms. In particular no evidence of colonic volvulus or obstruction.



Specimen: RANDOM COLOIC BIOPIES said...


Macroscopic: (JM/PC)

The specimen consists of multiple mucosal biopsies ranging in size from 2 to 6mm. All embedded.

Microscopic:

The sections show fragments of colonic mucosa which show a few neutrophils focally in the lamina propria.
Three scattered lymphoid aggregates are also present in the lamina propria.
The other cellular components of the lamina propria are normal.
The surface and crypt morphologies are normal with a normal goblet cell population.
There is no deposition of collagen in the subepithelial stroma nor an increase in intraepithelial lymphocytes.
Parasties, ova and cysts are not found.
There is no evidence of inflammation or neoplasia

SUMMARY: BIOPSY, RANDOM COLON
MINOR MUCOSAL INFLAMMATION POSSIBLY REPRESENTING A RESOLVING SELF-LIMITING COLITIS.
However, correlation with clinical and colonoscopic findings is essential.


My main problems now are:

    1. No bowel movement for up to 3 days or more(even with psyllium) unless I take laxatives/coffee
    2. Have all kinds of food intolerances which causes me to visit the toilet multiple times a day with my tenesmus and mucous w/ stool if I eat them.
    3. Stuff comes out of my anus when I strain which looks like a partial rectal prolapse(Possibly missed during a colonoscopy).
    4. Lacking in energy and difficulty concentrating possibly because of the above.
    5. Have trouble exercising because of constipation.
    6. When I'm bloated, my right lower abdomen is more inflated than my left lower abdomen which makes my stomach look unsymmetrical. Even when I'm not bloated, my stomach tone doesn't look symmetrical particularly after I eat.


I have changed my diet, take probiotics, multivitamin, fish oil, psyllium and do weights and cardio exercise a lot but I'm still miserable everyday and my life is not the same anymore with this condition. I'm thinking of getting a surgery next year if that's the only way to cure my condition.

In the first couple of months I was eating lots of fruits and vegetables and avoiding literally everything that caused symptoms but now I kind of gave up eating healthy because I know that my condition is not going to improve anymore. So now I drink coffee almost everyday even though it causes some tenesmus and mucous because it helps me empty my bowel and gives me energy which I'm lacking in because of my condition.

Here's the strange reaction I get to certain food/drinks:

    1. Green tea causes tenesmus, mucous without stool and rectal bleeding.
    2. Black coffee causes tenesmus and mucous without stool. And I get less of these symptoms if I mix it with milk.
    3. Lactose-free Yogurt causes rectal bleeding which is only visible after I wipe with a toilet paper and I don't think it's from haemorrhoids.


So my question is, Is all of my condition incurable or can some of them be cured through surgery? If it's curable, is it a good idea to get a surgery? Or should I wait until scientists finds a better cure for all of my conditions e.g. stem cell research?

Also, should I consider getting tested for pelvic floor dysfunction, sitz marker test and defecogram? If so, which one should I get tested for?

Post Edited (Heinstein) : 2/11/2013 4:32:21 AM (GMT-7)


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 22057
   Posted 2/11/2013 8:28 AM (GMT -6)   
Wow, you have a lot going on don't you? I'm so sorry to hear your having to endure that :( but your questions should be answered by your GI.

I would think you would do well with a resection, but I'm not a doctor. But something needs be done, that's for sure. You're only 22, so I imagine that it might get worse as the years go by.

Do you have an appt with your GI soon?
SHERRY
Moderator-Allergies/Asthma, Alzheimer's, IBS, Co-moderator-UC
Diagnosed Left sided UC '92 - meds: Colazal, Remicade (6mp discontinued due to neuropathy)*Unable to tolerate ALL mesalamines*, IBS, Diverticuliar Disease, Fibro, Sacroiilitis, Raynauds, OA, PA, Rosacea, Psoriasis, Dry Eye and allergies controlled by Zyrtec and Singular

Heinstein
Regular Member


Date Joined Oct 2012
Total Posts : 23
   Posted 2/18/2013 6:24 PM (GMT -6)   
Yes I have an appointment today with the gastroenterologist. I will ask him what my options are for treatment.

GastroGeorgieGirl
New Member


Date Joined Mar 2013
Total Posts : 7
   Posted 3/1/2013 9:11 AM (GMT -6)   
Dear Heinstein:
You are not alone. I recently was diagnosed with Slow Transit Constiaption after taking the Sitz Marker Test. I also have Annorectal Dyssynergia and have suffered for decades after an array of IBS symptoms. The Sitz Marker was a rather easy test to take. While our case is different in many ways, there are threads of similarities. I, too, have many fears about my situation and simply need a support forum to help me through my fears.

joescopa
New Member


Date Joined Dec 2013
Total Posts : 1
   Posted 12/16/2013 4:07 PM (GMT -6)   
GastroGeorgieGirl said...
Dear Heinstein:
You are not alone. I recently was diagnosed with Slow Transit Constiaption after taking the Sitz Marker Test. I also have Annorectal Dyssynergia and have suffered for decades after an array of IBS symptoms. The Sitz Marker was a rather easy test to take. While our case is different in many ways, there are threads of similarities. I, too, have many fears about my situation and simply need a support forum to help me through my fears.


Hi, my sister is in the process of taking the Sitz marker test right now, we are day 4 of the test and she just had her first xray... we are pretty sure she will be diagnosed with slow transit constipation as well because almost all of the markers are still at the upper portion of her colon. She has been having these problems since about 7 years old (she is now 19) and after being diagnosed with many different things, the sitz marker test has been the first step toward having an operation to finally solve this issue. I'm new to this site and am encouraging my sister to join as well, I was wondering if anyone has had any surgeries specifically the sub total...as i think that is what we are headed towards in the near future. My sister is very worried about having to have the colostomy bag and we are trying to find ways to hopefully avoid that happening to her.
thanks for any insight you can provide.
-Big Bro Joe

kate-iona
New Member


Date Joined Dec 2013
Total Posts : 2
   Posted 12/18/2013 8:56 PM (GMT -6)   
Hi, I'm new to this forum but have read quite a few stories on here similar to yours which some of the symptoms I can totally sympathise with!
I started having bowel problems roughly 4 or 5 years ago (I'm 19 now) and have been in and out of hospital ever since.
The first time I ever went to hospital with concerns about my bowels I was told I just had 'gas' and was sent home!
After consuming even the smallest amount of food I look like I'm 9 months pregnant and I suffer from the most agonising abdominal pains and it gets to the point where I can't keep any food down or even water..
I have tried everything - movicol, fibre gel, macrogol, ex lax, senna and during my most recent hospital trip I had 4 or 5 doses of picolax and 5 jugs of Klean-prep (normally given to prep bowel before colonoscopy) and none of this worked at all!
I've had countless X-rays which showed an impacted bowel literally full to the brim, also ultrasound and a ct scan which showed distension in the bowel loops..
My consultant diagnosed me with chronic constipation and possible colonic dysmotility - started me on a medication called PRUCALOPRIDE also known as RESOLOR to try get me moving - from what others on here have posted about this medication and the way my doctor described it to me, it seems to work straight away, give violent side effects they are never off the toilet with it.. Well I have been taking it almost 2 weeks now, for the first 4 days I had no bowel movement with it nor any unusual pains however I did get heart palpitations (since found out this is an uncommon side effect) then it started to help somewhat for a few days and my stomach seemed a lot less distended, however now it seems to have slowed down abit and I haven't had any movement for 4 days even with this tablet :/
I just wondered if anyone has tried out this drug and it not worked for them as I've only seen lots of success stories and it's left me feeling abit disheartened - especially as my specialist described it as some kind of miracle drug!

I'm awaiting a colonoscopy when my bowels have cleared out enough to do so and also a transit study to determine just how slow my bowels are - but I'm in the UK and the NHS are painfully slow at getting the ball rolling with things like this! Been told that surgery may be an option but only when all other options have been explored.

I just think that because I'm so young nobody is taking my problems seriously and because it is inside my body (apart from the pregnant looking belly) they think there is nothing wrong with me. I'm sick of being given disgusted looks and rudely being asked outright if I'm pregnant or even when I'm due! Even some of the doctors I have seen have been convinced I was pregant! I feel like it is taking over my life as I can't eat or drink properly, I'm in constant pain and feeling sick and it's starting to affect my work and there's only so much time I can take off sick!

Please if anyone has had any treatment for symptoms similar to mine and has seen improvements could you please share? As my consultants seem to be scratching their heads and running round in circles!

Thanks

Kate x

tricis56
New Member


Date Joined Dec 2013
Total Posts : 4
   Posted 12/26/2013 8:21 PM (GMT -6)   
Hi. I had ibs for about 20 years with 3 bms day. 4 years ago I had lot of stress and antibiotics for throat Infections and .my bowels have stopped working. I have been diagnosed with slow transit neurological gut disorder diverticulitis chronic constipation cfs . I am on resilor co danthrusate and picolax which I am told is the strongest combination. When this stops working I will have to have my large bowel removed.
I am interested to know about other people's health problems and what they are using as this is ruining my life.

lyyee
New Member


Date Joined Jun 2014
Total Posts : 2
   Posted 6/22/2014 2:04 PM (GMT -6)   
Hello..i have slow transit and gastroparyses pares is so basically my whole digestive syste
Is paralyzed. I have a nerostimulator..in fact I was a trial run by Dr's in Sydney. The device is made by Medronics in usa.itsthe only relief from the slow transit and also reduces bloat and pain.i have had one for 6 years and recommend all yiu who read this to look up the nerostimulator procedure.google medronics and the stimulator and also prof lubowski at Sydney coletrectal
I'm not sure if a Dr in America does this procedure.

lyyee
New Member


Date Joined Jun 2014
Total Posts : 2
   Posted 6/22/2014 2:07 PM (GMT -6)   
Please do not get your large bowel removed until u have exhausted all the avenues including the Nero stimulator..keep positive...and it helps your bowel..keep active even when u feel so disgusting..it helps...
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