Colonic Inertia?!?!

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rcooke1129
New Member


Date Joined Aug 2009
Total Posts : 6
   Posted 12/9/2009 1:24 PM (GMT -6)   
So, I am having the Sitz Marker study done this week, so I was looking up informtion on the study, so I'd know what to expect. While searching for information on this study, I came across Colonic Intertia, which I had never heard of before. I am curious to what your thoughts are. Do you think I could possibly have colonic intertia? I know the test should answer that for me...but my doctor is not quick with getting back with me.
 
Anyways....my history.
 
A year and a half ago I was diagnosed with Urinary Retention and a Neurogenic Bladder (nerves to bladder are no longer working). I was given a neurostimulator to help the bladder receive nerve signals.
 
For the past 3 months I've been suffering from chronic constipation. Without meds, I don't have bms at all.
I have been tried on 8 meds for the constipation, with not much luck (Miralax, Amitiza, Kristalose, Align, Xinc, Xifaxan, Dulcolax, Magnesium Citrate)
 
2 months ago, I had a breath test done which as my doctor's letter said "indicates small intestinal bacteria overgrowth SIBO), and a month ago I had a colonoscopy done, which was normal.
 
The biggest problem I've been having with the constipation is that almost every week, because I am so backed up, I get nauseas constantly and horrible vomiting. One week I vomited 26 times in two days, another week it was 22 times in two days. I am usually 98 lbs, and have lost 14 lbs in less than two weeks, because of the excessive vomiting as well as unable to eat for a couple of days due to horrible nausea (eating causes vomiting).

I have been to the emergency room 3 times in the past 2 months from being dehydrated from all of the vomiting. The last time I was in the ER (a few days ago) I had had a bm that morning. When I had gone to the ER and they did and abdominal XRay, it showed that I was still extremely backed up, even after having a some what "normal" bm.
 
In the past I also had an abdominal Obstructive Series Xray done, which showed that there are no anatomical abdnormalities in the intestine.

If anyone has any thoughts, I would love to hear what you think.

I have to admit, after all that I've read on colonic inertia... and the whole surgery thing, I've got my fingers crossed that that is not what I have; but as long as my life can somehow return to normal, I am up for anything.
_________________________________________________________________________
 
Symptoms:
-Constipation (must take mag citrate for any bm to occur)
-Abdominal pain/discomfort
-Abdominal distention/bloating (sometimes severe enough I look prego)
-Occasional blood in stool (not excessive amount, but not a small amount)
-Nausea
-Vomiting (excessive)
-Weight Loss (14 lbs) I am usually 98 lbs, and have dropped to 84 lbs (excessive weight loss for me)
 
 
 

pelztier86
Regular Member


Date Joined Apr 2009
Total Posts : 401
   Posted 12/9/2009 3:51 PM (GMT -6)   
rcooke1129,

I don't know whether you are female or male...Colonic inertia does occur more often in women than in men, for sure you can have it anyway.

But to be honest I think your symptoms sound too severe just to be caused by isolated colonic inertia.
Vomiting, especially extensive, ist usually not seen with colonic interia and is usually a sign of a paralysed (small) bowel.

I also suffered from severe nausea and could barely eat anything prior to my colectomy/ileostomy.
I had had two colon resections before which left me with 20cm colon but which remained unsuccessful.

I did some research in the internet and came across an even rarer condition called CIP which is chronic inetstinal pseudoobstruction. It basically means paralysis of the entire digestive tract, not only colon which causes paralytic (sub)ileus. CI normally does not cause obstructions unless you haven't had abdominal surgery which could have caused adhesions.
I also found out that my symptoms could not be solely explained by colonic inertia I certainly had and that they were much severe. I was in horrible pain/abdominal spasms all day and suffered from sever nausea along with extreme constipation.
It was living hell.

I also begain to develop urinary retention/bladder spasms and was finally diagnosed with neurogenic bladder.

In my desperation I wrote to an Italian expert and told him my symptoms; this was after my second surgery that has failed as well and after which I was considered anorectic again.
I had struggeled against this suspicion before I found two colorectal surgeons who thought I could have colonic inertia. I had lost a lot of weight (20pounds) and was markedly underweight.
Normally you don't see extensive weight loss with colonic inertia.

I went to Italy and underwent special tests (small bowel manometry, gastric emptying, entero CT etc, x-rays) which all came back saying that I do have CIP which affects my stomach (where it causes delayed gastric emptying), my small bowel and my colon that was worst.
Furthermore severe bladder symptoms are often seen with CIP.
I then had the colectomy with the ileostomy since it seemed that my colon was affected worst (grossly dilated) and so far it has given me significant relief in terms of nausea and pain.

On the x-rays..did your docs say anything from functional/paralytic ileus? For sure with CIP you can't find an anatomical obstruction since it is not a mechanical hinderness but "just" the decreased motility.
Did they say anything about air-fluid levels/dilated bowel loops that are usually seen with a paralysis of the bowel?

At least it would be very important for you to have a gastric emptying study, a small bowel follow through/entero CT (and a small bowel manometry at best) to test the motility of your small bowel. And you should have a defecograpy to test the function of your pelvic floor and rectum to see if you have an outlet problem either. The answer to these questions influence the decision if you are a candidate for any surgery.

With CIP you benefit rather from an ileostomy than from a ileorectal anastomosis which is usually done with colonic inertia.
If your small bowel is alread really bad than an ileostomy may help less, but for sure it would be better than having your colon.

I am now on parenteral nutrition since I reached a sever weight (below 80pounds). Since surgery I have been able to eat some by mouth and I do the intravenous feedings as supplement to help me gain weight.
It also decreases symptoms I still have (from my small bowel and stomach but which are less extensive than prior to surgery; I also have a permanent catheter to drain the urine since I am unable to empty ma bladder by my own).
With CIP it is unlikely to have a cure but maybe you can improve your quality of life.

Sarah

pelztier86
Regular Member


Date Joined Apr 2009
Total Posts : 401
   Posted 12/9/2009 4:42 PM (GMT -6)   
I also had bacterial overgrowth that arises when your small bowel is slow and can't keep the false bacteria away.
This can cintribute to your weight loss since bacterial overgrowth leads to malabsorbtion.

Bacterial overgrowth is ususally not seen in colonic inertia unless you have an icompetent ileocecal valve.

rcooke1129
New Member


Date Joined Aug 2009
Total Posts : 6
   Posted 12/26/2009 5:36 PM (GMT -6)   
Thank you for your thoughts.
I received the test results a few days ago. The doctor said that it was both good news, and bad news.
The good news being that all of the markers made it to the colon, the bad news being that 23/24 were still in the colon on the 7th day. Unfortionately, I also have a "redundant" colon- as the doc said, most peoples colon is an upside down U shaped, mine is more like a roller coaster, so it was hard to pin point exactly which part of the colon that the markers were at.
I was referred to see a specialist, who i am scheduled to see in late February.
I was also told that the reason I ended up with SIBO, is because I was so backed up that there was no where else for the bacteria to go. The SIBO was a result of my problem. I hope that I get some real answers soon.
I have lived too long with unexplained medical problems, and am honestly getting fed up with it.
 
Anyways, thanks again for your thoughts.

tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 12/27/2009 7:42 AM (GMT -6)   
Hi, were the markers stuck in mostly one area - or scattered throughout? I've been through sooooo many tests for my issues.. have you ever had a defecogram? I think this too is an important test. Anyway.. my colon was severely redundant... both the sigmoid and transverse (and prolapsed as well). Again, not knowing if you are male or female.. or if you previously had a hysterectomy or any prolapse repairs..?

a bit over 2 weeks ago, I did have 18" removed, which included the sigmoid colon. The redundant, floppy transverse is still there, and hopefully doesn't cause issues. Right now I'm on MiraLax 3 x's a day, and I'm going.. and I hope that once I cut back things will still keep moving. My issues was I couldn't get it out without excessive straining... plus because I was so redundant and it stayed thee way too long, my stools just because too hard.
~Jenise~


rcooke1129
New Member


Date Joined Aug 2009
Total Posts : 6
   Posted 12/27/2009 6:04 PM (GMT -6)   
Sorry, I am a 20 year old female. Most of the markers were clumped together and some were still scattered throughout. I have never had any major abdominal surgeries before; I have heard that surgeries can affect the intestine and such, but thats not the case for me.

I actually have not had that test done yet, but have read about it, and am fully expecting that the specialist I will be seeing next month will probably have that done.

I cannot believe you have had major abdominal surgery just 2 weeks ago, and you are at least at a computer. This tells me that you are a strong willed person- I like that.

Any ways, I will let you know if anything new comes up- LIKE A DIAGNOSIS!!!!

XtremeMisery
Veteran Member


Date Joined Sep 2007
Total Posts : 687
   Posted 12/28/2009 12:15 AM (GMT -6)   

Thinking fo you....I suggest reading through the TOTAL COLECTOMY sections......go back as far as you can. There are many of us with colonic inertia.....hope you get some answers.

Lizzie


Chronic Lifetime Constipation, Dx IBS-C for 7 yrs
Diagnosed Colonic Inertia-Oct 2007
Total Colectomy with ileorectal anastamosis- Jan 28, 2008
Ileus with suspected leak- Feb 1, 2008, ended with four abdomal abscessses and 2 drains
Diagnosed with small bowel Fistula- March 6 2008
Drains removed- End of March 2008
Continued Constipation- biofeedback for 3 mo Aug 2008, Dx Rectal Inertia (Anismus)
Admitted with Small Bowel Obstruction April 4, 2009 and emergency ileostomy 4/13
Re-admitted with abdominal abscess. Released 4/24
Cleveland Clinic twice for 3/4th referral. Anismus undetected (no medical explanation)
Retracted stoma-infection/skin breakdown.
Ileostomy Reversal- Oct 8, 2009. Ileus/Dehydration 10/13. New rectal dysynergia-biofeedback-11-19
 
"The Greatest Healing Therapy is Friendship and Love"


tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 12/28/2009 7:20 AM (GMT -6)   
Hi yes, do read the TOTAL COLECTOMY thread, as most of all suffer from constipation. Most of my markers were clumped together in the recto-sigmoid area. Some test said I had a sigmoidocele, another said no.. My entire pelvis was prolapsed, and 9 months ago I had major reconstructive surgery - and a hysterectomy. They secured my vagina and rectum up with mesh, and after this surgery - my issues (which were there before) intensified. I really had to struggle to have a BM. For years - I used enema's and suppositories, but after this reconstruction, it was just worse. So.. in the end they found my sigmoid twisted, prolapsed and redundant.. and my stool just got backed up from that point. My GI said I have Colonic Inertia, my surgeon said no.. so I really don't know at this point!

I really am doing great after this surgery. I expected it to be much more difficult.. as everyone said it would be. The first couple days were hard, but I really feel almost normal - and I'm a LOT older than you! (48). I suffered 21 years.. and my only regret is that I never sought help, as I was embarrassed. So now.. 2-1/2 weeks post op, my stool is getting to my rectum and I'm able to go. Still not sure how sussfull it is as I am taking large doses of MiraLax and my stools are liquid, but it is reaching the rectum which it wasn't before unless I used a suppository. You just a babe at 20 years old, and you shouldn't have to struggle so.. so keep seeking help, even if you need to get a few opinions! Best wishes to you!
~Jenise~


cravelife
New Member


Date Joined Jan 2010
Total Posts : 9
   Posted 1/8/2010 3:24 PM (GMT -6)   
Hi, i'm new to this and not sure this is the right spot to post..but here goes. i'm 24 years old and have had kidney, bladder , and constipation problems forever. well after a car accident in 2007 i started to get real sick..long story short i went through several tests....several. in iowa city after a year of biofeedback and no results they did a 24 hr study puting a scope through my entire colon(with me wide awake!) and said i have colonic interia and severe pelvic floor dyfunction. they said that the only thing i could do was surgery. however i could not find a surgeon who would do this, they said that the risks were way to high and my age. i was in the hospital with nose tubes and everything else all the time. they finally had me doing a gallon of golytly every two days just for a little bm..that stopped working all togethe in august of 2008. i have not been able to be cleaned out since then, they can not find a way. i have been going to mayo clinic for over a year now and have done extensive treatments. at home i'm doing about 7 treatments a day. my pelvic floor has come along way..it's for now rehabilitated :) that was a huge success! however i'm still not having bms..at all..as in none in months. i vomit alot, infections all the time, dehydrated all the time, just sick constantly. so finally the surgeon at mayo has agreed, he's not happy about it and has warned me that it's no gaurantee and that i might get worse..i'm scared out of my mind!! i don't want this surgery..never have but what else do i do? i'm told i won't live if i continue this way, i won't . but all i hear is they can't help me and this surgery could make me worse?! I have a two and three year old, i take care of them everyday and they have no clue i'm sick, i live for them. so i need to be able to make the best desicion, i can't turn back from this so...any help from anyone would be great! i'm scheduled to have surgery on feb 1..go into the hospital on jan 29...so soon! thanks so much! i've been just reading what ppl write for months..this is the first time i've ever written on here. thanks so much :)

Trigirl
Veteran Member


Date Joined Jan 2006
Total Posts : 768
   Posted 1/8/2010 3:52 PM (GMT -6)   
Crave- wow, big problem to deal with. Hope all goes well.
This heights by great men reached and kept, were not obtained by sudden flight, but they while their companions slept, were toiling upward in the night.
H.W. Longfellow
Thyroid cancer removed 1988
Stomach problems finally figured out 2001 Crohn's/Colitus
Tried every drug without much success
Colon/rectal cancer removed Aug 2009
Trying


cravelife
New Member


Date Joined Jan 2010
Total Posts : 9
   Posted 1/8/2010 5:36 PM (GMT -6)   
Thank you very much!:)
i'm very very frightened and still have no idea what the right thing is to do. do you have any advice you can give me? anything is deeply appreciated. thanks and i hope you're doing well also. god bless :)

pelztier86
Regular Member


Date Joined Apr 2009
Total Posts : 401
   Posted 1/8/2010 6:17 PM (GMT -6)   
cravelife,
have you had your small bowel checked? it is important that it is ok and has no motility problem either before you undergo surgery.
Your bladder problems and vomiting issues let my think of my own history and condition which was first labeled as colonic inertia. Then I was finally diagnosed with chronic intestinal pseudoobstrcution which means paralysis thoughout the entire digestive tract, not only isolated dysmotility of the colon like with colonic inertia.
Usually you have no or less problem with the bladder and vomiting/nausea if you suffer from colonic inertia.

cravelife
New Member


Date Joined Jan 2010
Total Posts : 9
   Posted 1/8/2010 9:12 PM (GMT -6)   
wow..that does make alot of sense..perhaps that's why the surgeon said this surgery may not take away the pain and vommitting..and it's such a huge surgery with no going back. i have had my bowel checked and at the time it was ok...it's hard to explain i've been through so many procedures and tests...terrifying "torture chamber" treatments and have recieved different answers from different doctors.
baiscally here's the deal though..i haven't pooped in months i can't eat, always vomit, way under weight i don't have periods anymore, sometimes black urine..and noone can help me if i don't do this? i'm just so tired of hurting..there's to much good i can do and to many other ppl i can help i don't have anymore time to waste with this....fusterated :P

pelztier86
Regular Member


Date Joined Apr 2009
Total Posts : 401
   Posted 1/9/2010 6:01 PM (GMT -6)   
i think it is a trial..at that time i had surgery I thought that it could only become better since it was already very bad.
Maybe you can ask for a temporary loop ileostomy to see if bypassing the colon does help you. If it does then you cen go on with removing the colon. In this procedure you usually get an ileorectal anastomosis so you don't have to wear a bag.

cravelife
New Member


Date Joined Jan 2010
Total Posts : 9
   Posted 1/13/2010 7:23 AM (GMT -6)   
they did talk about a temporary loop ileostomy, but i had no idea it could be without a bag! that would be great. the surgeon said he's not entirly convinced that removing my colon would fix the vomitting and pain but he said if we did this procedure first it would say. at the same time there's a chance that he wouldn't reverse this procedure! but i'm not so sure how this would tell him anything? can you give me anymore info about this? also my pain and nasuea in my opinion is from not having a bm for four months! and no nutrition, sleep, and stress now of surgery! i've never had problems before like this. i never even had nasuea when i was pregnant. but..what do you think?
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