NEW HERE! Sitz Marker Study

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tinkerbell2
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Date Joined Jun 2009
Total Posts : 418
   Posted 6/26/2009 1:14 PM (GMT -7)   
Hi everyone,

This is my first post and I can see that I will be spending a lot of time reading! Here is my issues in a nutshell.

20 years ago, gave birth to a 9.5 lb baby - and ripped apart internally. It really ruined my whole pelvic floor and I had to go to therapy to help restore some muscle tone. It improved somewhat, never good.. but the last 6 years things really started getting worse. My rectocele enlarged, and made it impossible for me to have a BM without an enema or fleet glycerin depositories. 6 months ago, I finally sought help as things down there started to pop out some.. I had surgery 3 months ago to repair the prolapses and had a rectopexy to pull up the rectum.. but I was still left without the ability to have BM's without a fleet, and even with that - I have to strain hard to have a BM and my BM's are flat (they have been flat for a few years now - before my surgery). My doctor put me on Miralax (which has helped) and sent me to a gastro dr. for a colonoscopy. I had that test last month, and was told I had a "redundant" and "twisted" sigmoid colon. I have a follow up with this doctor next week.

Back to my pelvic doctor - I gave him the results of this test and he feels that I need part of my colon removed. He ordered a Sitz marker Study and a new defecography test (I had one of these 4 months ago - before my pelvic repair). He also referred me to a colon rectal surgeon.

So.. I am on day 4 of my sitz marker study. I took 1 capsule on Monday and have had an x-ray each day. I did stop the Miralax on Saturday - before the test, but I am afraid it may have still been in my system - since I have had a BM everyday! Today - day 4 - I went a little, but I definitely feel constipated today. As of yesterday - there where 19 markers left ( but the tech did say she did a rough count). I am surprised as I have had a BM everyday! Today, she didn't count, but said they are still throughout my colon... but I came home and had a small BM a few hours later. Wondering if the Miralax will cause inaccurate results? Anyone with any thoughts on the Miralax, or what it means to have 19 markers on day 3?

I know that anyone who suffers from constipation knows how hard it is! I also mentioned that I have to strain to to have a BM.. but for the most part, my stools are not rock hard. I have soft stools - yet I can't move them out of my body!

answers4me2
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Date Joined Dec 2008
Total Posts : 1165
   Posted 6/26/2009 9:08 PM (GMT -7)   
Honey, me and you could be twins. LOL I am the mother to 4 kids. All were big babies, 9lbs, 9lbs 2oz., 9lbs. 8oz., and 10lbs 13oz. The 2nd one, the 10lb 13oz really messed up my pelvic floor...I could not pee for days after he was born, I had to be cathed. In 2005, my bladder, rectum, and uterus all fell. My bladder was literally hanging out a little, it looked like a bouncy ball hanging right at the edge of my vaginal opening. OMG, I about died because I never heard of this happening before. I ran to the doctor as fast as I could because I didn't know what was happening. He said it was a pelvic prolapse and it was from having such big babies vaginally. Well, he sent me to a urologist and another gynecologist and she said I needed a hysterectomy, a bladder sling, and to have my vagina lifted. I was like, ok, lets do it.

Well, I have always suffered from constipation, but after that surgery, I really learned the meaning of being constipated. I could not push down to poop. I would lean back, forward, squat, lean side to side, push down on my belly, etc. Nothing worked to help me get the poop out. I went back and forth between the gyn and uro doctors and they had no idea what the problem could be and sent me to a gastro doc. He ordered a colonoscopy and ct scan, told me to take more fiber with 4 tablespoons of mineral oil everyday. Needless to say, the tests came back normal and the fiber made my stool like a brick and I still couldn't poop. So, I went to another doctor, a doctor out of network, a urogynecologist because he came highly recommended.

He tells me I have a significant rectocele, a cystocele, and the bladder sling had eroded through the urethra and I needed another surgery. He was almost positive that I would be able to have a bowel movement when the rectum was up in the normal positon. So, I paid $6000.00 to have a sacralcolopopexy, all of our savings. So, I go home, 2 weeks went by with no bowel movement. He calls in a script for miralax , so, 3 days after taking 15 doses of miralax, I feel bubbly in the stomach, and I go to the restroom....GUESS WHAT??? I couldn't push at all. No matter how I turned my body, how much I pushed, how far I leaned back....nothing helped. I used suppositories and was eventually forced to disimpact myself. It was very painful too because I had horrible spincter spasms from the surgery. I just did not want to go to the ER and have them disimpact me. UH HUH, no way! I go for my follow up and I am very upset about not being able to poop. He just looks at me like I am deranged or something and tells me to go to another gastro doc.

So, now, 3 years later, I have been to numerous doctors and they all agree on one thing and that is that I do have colonic inertia...But, one doctor thinks I need to have a total colectomy, where they remove the colon and attatch the small intestine to the rectum...I was terrifed when he said that because I have never heard of this surgery. Then a month ago, I went to yet another colorectal doctor and he said I had mild intussesseption (sp?) of the rectum and anismus, which is where the anal muscle that holds the poop in, will not relax to let the poop out. He said removing the colon will not not help me get the poop out. So, on July 17th, I am going to be sedated and have a botox injection directly into the anal muscle, hopefully to relax it. And if this does not work, then I will have to get a temporary illestomy to allow the muscle time to rest. As far as my paralyzed colon, I have no idea what to do about it. I am terrified to have it removed.

I use 100 or more suppositories a week, numerous enemas, warm and saline, and spend 3 to 6 hours a day on the toilet unless I don't take miralax , and then I can go 3 weeks or more with no bm. My transit marker test on day 5 showed 15 markers in the ascending colon and about 10 markers in the transverse colon. My doctor said this shows an extremely slow colon. If you feel like the miralax messed up your test, ask the doctor if you can repeat it. Miralax builds up in my system too. I hope I haven't bored you to death, I just want you to know that you are not alone in this because I know how alone I felt. :)

tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 6/27/2009 3:56 AM (GMT -7)   
TDR, WOW.. thanks for your info! We are more alike then you even know! I didn't mention the procedure I had to fix my prolapses, but it was the same as yours - the sacralcolopopexy and TVT sling (my bladder too was protruding!). I truthfully am unsure if the surgery made it worse or not, because I used suppositories a,most always to have a BM. After the surgery - I stopped.. hoping it would work on it's own, but it was just awful.. I couldn't get the poo out!

My urogynecologist is the one who feels I need a resection. I have yet to see the colorectal surgeon, and I have a follow-up with the GI doctor next week. I am not afraid of more surgery - my biggest fear is that they are going to say they can't fix me! I'll be looking forward to hearing how things progress for you.

answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1165
   Posted 6/27/2009 8:18 AM (GMT -7)   
Yeah, I have used suppositories for years also. I have also been disimpacting myself off and on since I was 19, I am 39 now, but it was not everytime I had to have a bowel movement, more like once a month. Now, it is impossible for me to push the poop out. Every blue moon, if I have ALOT of poop in my colon, then some of it will come out on its own, but after about 25% of it comes out, then it just stops and I am back to using suppositories, enemas, and my fingers. NASTY way to live, I am telling ya. I also use 3 to 5 suppositories at one time. Do you do this? I will insert the suppositories and walk around and around. It is really no way to live. My family calls me the toilet queen because I spend so much time on the toilet. My doctor said when you have anismus, that it is like your rectal muscle is no longer taking orders from the brain. That is scary because one of the gastro doctors said that he thinks that I have nerve damage to the rectal muscle and there is no cure or surgery for nerve damage. But, I almost think I will be happier with a bag because surely it takes less time to empty a bag than the hours a day it takes me now to have a bm.

tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 6/27/2009 9:10 AM (GMT -7)   
With the MiraLax - I have been better then I have been in years! Better - but still have to strain often, and I just had my rectocele repaired - but I think there still may be an issue with the perineum area - because I can help things along by splinting. I have used Fleet liquid things (4 in a box) and they have helped me so much too.. I can get by with just 1 most of the time, the other suppositories didn't help much !

I just got back from my final xray for the stiz marker study. I still hope the MraLax isn't giving it a false reading - because on day 1-3 I had a BM (normal MiraLax one). Wednesday night things started to get uncomfortable... but anyway, I have the pictures on a CD disk, and as of this morning - there are 20 markers left. Some in the left side and the majority low in the colon. Not sure what this means...

answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1165
   Posted 6/27/2009 7:54 PM (GMT -7)   
I had 15 in the ascending colon and about 10 in the transverse colon. I am not sure what side the ascending, transverse, or descending colon are on? My doctor just told me most should be out of the colon on day 5. Miralax really has been a miracle drug for me too. I can atleast get the poop to move through the colon...BUT, my main complaint is inability to push the poop out after I finally get it to the rectum. How much miralax do you take? I take 2 to 8 doses a day depending how long it has been since I went. But, I have noticed that I have to take more and more. Do you?

tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 6/28/2009 4:14 AM (GMT -7)   
Hi TDR, I just started the MiraLax, and I am doing good on one to two doses a day. My GI doctor said it was safe to take up to 2 doses.. and I seem to be doing good with that, along with 3 capfuls of Citrucel a day. As far as straining to get things out.. it is getting more difficult for me! I really believe my rectocele is coming back! My rectocele is very low.. and when having a BM (TMI) part of my rectum is protruding. I am finding that I once again have to push all around the outside of my anus to empty. Without the MiraLax.. I never felt like I ever emptied all the way (and even with he MiraLax - this sensation happens too). I am very much looking forward to going back to my G doctor this week, and seeing the colorectal surgeon next month to see what they all have to say. I was so hopeful that the sacralcolpopexy would be the cure all... and bladder and stuff is good, but these darn bowels are terrible! After the sacralcolpopexy my bowels shut done - and I almost had to go back to the hospital for a GI tube... but hours before I was to head there.. they woke up (it was day 9).

answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1165
   Posted 6/29/2009 6:04 PM (GMT -7)   
Surely you don't have a rectocele that is too terribly bad after a sacralcolopopexy??? I do have some mild pelvic prolapse and some slipping of the rectum, but nothing that is keeping me from having a normal bm. Mine is the muscle that won't let the poop out...it is too tight and I think I have some nerve damage???? Did you have a defecogram yet? What about anal manometry? Because both of these tests were abnormal on me. But as far as the sacralcolopopexy, I am great. My entire pelvic floor was dropped, but, now it is almost perfect. I also have some small intestines that are too low, but again, nothing that needs immediate attention. As far as splinting, I never could get the hang of that. I just disimpact myself so that I can get out of the bathroom, and even then, it takes FOREVER for me to have a bm. My poop moves down real slow and it may take me going to the bathroom several times because I don't feel empty. This takes me hours a day.

tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 6/30/2009 11:54 AM (GMT -7)   
TDR, no - there is a big improvement as far as the rectocele. I am self diagnosing myself - and "think" I still have a little rectocele - or possibly a small rectal prolapse. I'll be happy to know the results of all the test and to see where I go from here. I had the defecogram prior to my sacral colpopexy and I have a new one schedule for August 4th. They mentioned the anal manometry, but I haven't seen the colorectal surgeon yet... so I am guessing he'll be sending me for one. As far as splinting... this is hard to explain, but on my right side of my anus is weak - and when I am trying to have a BM - the skin actually budges. If I press upward on the budging skin beside my anus - I can get the poop out.

Now that the sitz marker test is over - I am back on my beloved MiraLax. It helps me a great deal and on days I am having trouble, I can use the liquid Fleet suppository and have a BM. I really had a lot of damage to my back wall of my vagina when I gave birth (so much - I almost died from hemorrhage - and was rushed into emergency surgery - hospitalized 10 days - lost a lot of blood).

When I had my 1st defecogram , the radiologist said, my muscles looked good. I never lose any stool, so that's not an issue. I go Thursday to my Gastro doctor who just did the colonoscopy - and found my redundant & twisted colon - I am looking forward to hear what he says - as he has my results from a pelvic MRI I had done prior to my surgery.

answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1165
   Posted 6/30/2009 4:15 PM (GMT -7)   
Well, my muscle looks great too. It won't let poop, water, or even farts out. Incontinence is definately not a problem for me. LOL I hope your colorectal doctor is good. The 1st colorectal doctor ordered all of the tests, but didn't read any of them. He never watched the defecogram because it was on a VCR tape and he had no VCR player, and he never has seen the results of the anal manometry test to this day. He even denied ordering the silly test. OMG, I was so pissed. I went to the hopsital and got a copy of the test that I had a year ago and gave it to my new colorectal doctor. Just be careful with these doctors. No 2 doctors have yet to agree on how best to help me either and that makes me very nervous.

answers4me2
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Date Joined Dec 2008
Total Posts : 1165
   Posted 6/30/2009 4:17 PM (GMT -7)   
Oh yeah that is 1 test that i have not had and that is a pelvic MRI. Is that supposed to be better than a pelvic CT scan?

tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 6/30/2009 6:24 PM (GMT -7)   
I think my urogyn was an expert in pelvic floor prolapses and MRI's = he has written books and did seminars on the MRI's. He is the one who referred my to the colorectal doctor - hope he is good! I'd be pretty pissed to take the test and not have the doctor look at them! Ahhh.. I never use to have mush problems passing gas, but since my sacralcolpopexy - it has been hard to pass gas. I'll be following post here and hope you find that the botox works - and if not, hope they find something that will work!

Hisgal
Regular Member


Date Joined Jun 2009
Total Posts : 60
   Posted 6/30/2009 8:03 PM (GMT -7)   
I don't mean to interrupt you guys. I was reading your posts and I have colonic inertia and have for years now. I can go up to 5 weeks with no bowel movement. I have seen four different gastro docs. They have all come to the same conclusion, which is to remove the entire colon. I have had the sitz marker test done (had to go out of state for that one) also had the defocagraphy test done. I have now also been told I have some pelvic disfunction. I use several fleet suppositories at a time also and still can't go most of the time. I use the 48 oz. enemas and alot of the times barely produce anything. I am scheduled to have a laproscopic abdominal colectomy with ileorectal anastomosis next Wed. They will remove the entire large intestine and connect the small intestine to the rectum. Do either one of you know anyone who has had this procedure?

2b ColonFree
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Date Joined Nov 2008
Total Posts : 2603
   Posted 7/1/2009 3:48 AM (GMT -7)   
hi hisgal,
if you google "total colectomy part 3" (part 1 and 2 are hard to find) and then 4, 5 etc. till part 23 in which we are at now, you will be able to read about tens of women who went through this procedure for the reason of colonic inertia. there's a wealth of information there.

i havn't had surgery yet, but i'm on my way to schelduling.

i wish you the best of luck with your upcoming surgery!! please keep us updated on your progress.
Hodaya
 
06/05/2007 - STARR procedure 
colonic inertia w/ pelvic floor dysfunction


tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 7/1/2009 4:04 AM (GMT -7)   
Hisgal, I have been reading the threads Hodaya mentioned - there is a lot of reading there! I personally do not know anyone that has been through this - and it is scary!

What have your doctors said about your pelvic dysfunction? Will your surgery help in this area or only in regards to the colonic inertia? I have yet met with a doctor that has seen my sitzmarker study results and I am not sure what the diagnose will be. 20 markers left - so something going on. On day 5 I had 9 in the left side and the rest in the rectum area. I know they are looking for a functional outlet obstruction.. what ever that exactly means!

Hisgal and Hodaya - best wishes to both of you on your surgeries! I hope you'll both be posting so we can follow you procedure and recovery!

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 7/1/2009 4:33 AM (GMT -7)   
thanks tinkerbell :) i'll will keep you updated in the total colectomy part 23 thread. i wish you the best of luck too with everything you decide to do!
Hodaya
 
06/05/2007 - STARR procedure 
colonic inertia w/ pelvic floor dysfunction


answers4me2
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Date Joined Dec 2008
Total Posts : 1165
   Posted 7/1/2009 10:24 AM (GMT -7)   
Hisgal, can you push the poop out when you get it to the rectum? Because I have colonic inertia and something else called ansimus, which is where your anal muscle won't relax and this causes an obstructed defecation. That is how my doctor explained it to me atleast. So, when I take my miralax, I can get the poop to move, but when it gets to the rectum, then I can't push it out. I use suppositories, enemas, and manual removal of the feces to get it out. My 1st doctor recommended a total colectomy, but the doctor that I am seeing now said the total colectomy would help with the colonic inertia, but I would still be unable to push the watery poop out. Right now I can't even poop water without some rectal stimulation. Shoot, I can't even fart most of the time. My life revolves around me taking a poop.

tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 7/1/2009 3:30 PM (GMT -7)   
Hi there, I got my report from the Sitz mark study - and confused! As I mentioned, I took MiraLax and it was still working the day I went in for my baseline X-ray. I had a BM that morning! Here's my report - in summary

Day 0- shows a large amount of fecal material in colon - otherwise normal. So even though I went, and felt like I finished - I apparently was not. ?? Day 0 I swallowed the capsule with 24 markers.

Day 1 - markers predominantly in the ascending colon (15) few within mid abdomen and small bowel, 1 in sigmoid and stool seem throughout entire colon.

Day 2 - stool present throughout entire colon. Some markers from the right colon have progressed to the splenic flexure (whatever this is!!??) and descending colon. More markers present in the sigmoid colon. (I had a BM this night)

Day 3 - Large amount of stool seen throughout colon. Markers scattered throghout colon, similar to yesterdays finding.

Day 4 - minimal forward movement of markers, however, 3 markers remain in right ascending colon. Excessive stool is noted

Day 5- seven markers in transverse colon, thirteen in rectosigmoid colon - 20 markers left.

So, my main surprise is that is shows excessive stool throughout the test. The first 3 days I was had a BM (thanks to MiraLax) the rest of the time I was constipated and did not have a BM, except for day 5 - I was so uncomfortable I tried and got a small amount out.

I hate waiting for a docotr to give me an official diagnose... but obviously things are not good.

answers4me2
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Date Joined Dec 2008
Total Posts : 1165
   Posted 7/1/2009 6:00 PM (GMT -7)   
Yeah, sounds like a slow colon to me. I had the same thing. The 1st xray taken 24 hours after I took the transit marker capsule already showed "moderately fecal distended". I never went even a little bit the entire 5 days....so. on day 5 mine showed 15 markers still in the ascending colon and about 10 in the transverse colon. Mine never made it to the descending colon or the rectosigmoid colon...I figured this was because my poop was not moving seeing as I never went any. And I also don't understand why my colon was moderately fecal distended when I thought I had cleaned myself out the days before I took the capsule. I just don't understand how the markers can even move when we have colons full of crap????? What does all this mean??? I wish I knew. But, I bet you have an outlet problem too....ya think?

Hisgal
Regular Member


Date Joined Jun 2009
Total Posts : 60
   Posted 7/1/2009 8:49 PM (GMT -7)   
Hi and thanks to everyone that replied to my many questions! The doctor told me that the surgery would not help the pelvic floor situation, however the pelvic floor disfunction is not severe yet. I do have major trouble getting the poop out. I have to twist and turn and have had to manipulate it myself to get it out. I am hoping this will help with any issue I may have with diarrhea after the surgery and not losing control on myself. The surgeon said I may need therapy to improve the pelvic function, but it is very painful. Thanks for the info about the website. I wish you all the luck Hodaya. WHen is your surgery? I am going to google ansimus and see if that is what I have!

tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 7/2/2009 4:14 AM (GMT -7)   
Hi, based on my prolapse condition, and living so long with it - I am sure I have some type of outlet issue. There are days that things work good - which always puzzles me, but other times I too have to wiggle and push around to empty. The MiraLax is by far the BEST thing I found in years!!! It does mask a lot of my symptoms much of the time (not always - but a lot). I would say the most difficult part is my need to strain - even when the stool is soft! It is stuck, and it feels like it is stuck - before it is all the way in the rectum.

I am so happy I found this site.... I have lived so many years telling NO ONE about my issues! To find that I am not alone is so comforting.

answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1165
   Posted 7/2/2009 10:27 AM (GMT -7)   
Me too. I have always kept this kind of stuff to myself because it is so embarassing to talk about. This room has been great! But nobody but ya'll have gotten the 100% truth version. My husband has no idea how I poop, he only knows it takes me hours. How do you tell your husband you disimpact yourself???

tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 7/2/2009 10:49 AM (GMT -7)   
TDR, My husband had no idea about anything - he was kinda shocked to know about all my prolapse issues! He was like "how come you never told me?" ummm.. kinda hard to tell someone you need laxatives to have a BM and that you have to help via your hands to get poop out!

So I went to my GI doctor, who said I had a redundant and twisted colon, but he was shocked that my other doctor felt I needed a colon resection... then he read my Sitz Marker report and was shocked. He said it was very bad, not good. He thinks I do definitely need another Decefography (which is now moved up to next week) and feels maybe something needs to be fixed, but he feels that if I can have a BM at least every other day on the MiraLax, I should avoid surgery at all cost at my age (48). He said it might help, it might not help at all, or it could give me diarrhea... but he said his final opinion would be after all the tests, after I see the Colo rectal surgeon, and after he has a conference with the surgeon.

He said I possible have three things going on.. 1) the slow colon 2) strictures in the sigmoid colon making it hard to get the stool into the rectum 3) pelvic floor dysfunction - which bio-feedback would help. So now I wait till the end of the month to see the colon rectal surgeon.

answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1165
   Posted 7/2/2009 11:09 AM (GMT -7)   
My opinion, see as many doctors as you can and don't stop until you feel comfortable with the doctor that will do your surgery if you have to have surgery. I have seen 2 gastro and 2 colorectal doctors in the past few years for this particular problem. Not one of them agrees on how best to fix my problems. And they all see something different on my defecogram. WHAT THE HECK? Now, my urogyn who did my sacralcolopopexy was awesome! But, he is not a colorectal doc and he deals with pelvic prolapses, fistulas, mesh erosion, bladder problems, etc., but not with bowel problems. So, I have been bouncing around trying to figure out what to do and who to see. But, I did kind of like this last colorectal doc that is going to do the botox injections on July 17th. But, his office is slow to return calls and I myself had to leave 3 messages and 2 emails to the doctor himself to have him call me back about the anal manometry test and to see IF I COULD even schedule the botox injections. I am a school bus driver and wanted to have this sorted out before I go back to work on August 3rd. But, here we are again, another summer and nothing has even begun. GRRRRR, just pisses me off. Oh yeah, I am 39 years old and mom to 4 kids. If I need any type of surgery, then I think it will be better if I have it before I get too much older.

tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 7/2/2009 5:33 PM (GMT -7)   
TDR, I really love my urogyn too, he is top in his field, and I do trust him. I will be meeting with the doctor he is referring me to (colon-rectal surgeon). I never really addressed the issues before - I just used things that assisted me in having a BM. Most didn't work, but now with the MiraLax working okay - it confuses me. I do agree with getting things fixed while I am young and health. I don't want to face this at age 70 +!

So what were your options given to you by all the doctors? Has surgery been mentioned, or do they feel the Botox will do the trick? If the botox works.. do you have to have it done every few months?

My GI did say today that they most likely will want to have the anal manometry done as well... I hate this crap - pun intended! LOL
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