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TickledPinkTwice
Regular Member


Date Joined Mar 2011
Total Posts : 241
   Posted 4/13/2011 4:39 PM (GMT -6)   
I have a question. My defecography is on Monday. They told me when I get there that I will drink some Barium and then of course they will squirt some inside me too. Is it normal to have to swallow it? I had a friend that didn't have to drink any. Would this mean they are doing a barium x ray too or is this normal?
 
ETA I have read that many do not have any prep for the defecography but I do, anyone else have to?

Post Edited (TickledPinkTwice) : 4/13/2011 3:56:33 PM (GMT-6)


lifeinterrupted
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Date Joined Mar 2011
Total Posts : 103
   Posted 4/13/2011 5:19 PM (GMT -6)   
Yes it's normal they want to look at your small bowel to see if its prolapsing into or on top of your rectum so there are to different types the one where there is no prep and they just put barium up your rectum then the one where you prep and they make you drink it as well as put it into your bottom and vagina.... Least to say not fun at all!!!! ;-)
Dee
dx with uc July '10
Current on going undiagnosed bowel disorder

Prov3:5,6

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/13/2011 5:30 PM (GMT -6)   
Tickled,

The fact that they are having you drink the barium to see if your small bowel is dropping into the rectovaginal septum and possibly narrowing your rectum on defecation is the BEST THING YOU CAN HAVE DONE. I did not have that, so because I only had the rectum and sigmoid colon filled with barium from the bottom, that is how the mis-read of my scan happened. It was not my sigmoid colon blocking off my rectum, but a loop of small bowel. Mine was done with a different contrast and different machine, so there were other factors, but the fact that they are having you drink the barium means they are aware of a more common condition among women with prior hysterectomy (enterocele) descent of small bowel instead of (sigmoidocele) descent of sigmoid colon blocking off rectum.

Because of mis read of my scan I was told by 3 colorectal surgeons I needed my sigmoid colon out which on retrospective review I did not. I had it out, it was done wrong, scarred in, lost use of my rectum, and colon and have permanent ileostomy. So I did not get accurate testing, but I did not know at the time.

If it is only the small bowel prolapsing all they have to do is close the space the small bowel prolapses through (the space between rectum and vagina that opens due to the prior hyst.) That is all I needed. My case is not the norm and is tragic.

I think you have colonic inertia as I recall, so if you have a total colectomy your issue it different than mine, BUT all I needed was the rectovaginal space closed with no intestine removed of any description as my guts all worked great.

You are in good hands. The swallowed barium I have heard can be constipating so do take a laxative after that, that is the only caution I would give. Good luck, Rosemary

TickledPinkTwice
Regular Member


Date Joined Mar 2011
Total Posts : 241
   Posted 4/13/2011 6:39 PM (GMT -6)   
Thanks so much!! I thought there had to be something else to the test. I appreciate all the help. I always feel like I ask too many questions.
Rosemary, I am sorry. It is better to be be thorough. How are you now?
26 years old
Idiopathic chronic Constipation for as long as I can remeber. Abdominal distention and painful gas started 2/2011.
Tried:Increasing fiber and water,Zelnorm ,Amitiza, Colon irrigation
2006- Colonoscopy,removed polyps
April 2011- Sitz Marker shows Colonic Inertia, scheduled for Anal Manometry and Defecography.

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/13/2011 7:00 PM (GMT -6)   
Hi Tickled,

Well so far so good with my permanent ileostomy. Considering all the scarring and damage also done to my small intestine I'm lucky to be alive. I miss the absorption capacities of my colon and dehydrate a lot. BUT lucky a doc saved me the best that could be done. BUT considering all this was fallout of a misread scan, I now know way more than I ever wanted to know about defecograms. Am traveling a lot as I lost my job. Suing defendants and doing OK so far. Want to work again sometime, though have no energy to rejoin my former career as a teacher. sad to say. I miss the kids. Rosemary

TickledPinkTwice
Regular Member


Date Joined Mar 2011
Total Posts : 241
   Posted 4/13/2011 7:36 PM (GMT -6)   
Wow you have been through a lot. You are very strong!
26 years old
Idiopathic chronic Constipation for as long as I can remeber. Abdominal distention and painful gas started 2/2011.
Tried:Increasing fiber and water,Zelnorm ,Amitiza, Colon irrigation
2006- Colonoscopy,removed polyps
April 2011- Sitz Marker shows Colonic Inertia, scheduled for Anal Manometry and Defecography.

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/13/2011 9:42 PM (GMT -6)   
Tickled,

I would do anything to turn back time. BUt thanks, Rosemary

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 4/14/2011 2:10 AM (GMT -6)   
Tickled, it is exactly the way the test should be done. what kind of prep do they want you to do? do you mean like a colonoscopy prep? i also had to drink the barium, but i was told to only do an enema before the test. i've never heard of someone had to do a prep (like with colonoscopy) for a defecography..?
Hodaya
06/05/2007 - STARR procedure
colonic inertia w/pelvic floor dysfunction
08/16/2009 - total colectomy w/ileorectal anastomosis
07/08/2010 - loop ileostomy

frostyboy
Regular Member


Date Joined Mar 2011
Total Posts : 272
   Posted 4/14/2011 6:09 AM (GMT -6)   
Tinkle, I haven't had to the defecography yet, but when I had my appt. the other day with surgeon.  They told me when I do have it done (won't be long) that the only prep I would have to do for the test is an enema.  And yes, I was informed about the barium as well.  I will be doing all the same things later!  Like I said, the surgeon I went to the other day was great; very nice; informed; knowledge.  Keep us posted!  We're all thinking about you!  Sooo many people on here getting one step closer hopefully to healing!!!  :-)

TickledPinkTwice
Regular Member


Date Joined Mar 2011
Total Posts : 241
   Posted 4/14/2011 9:02 AM (GMT -6)   
Hurtboy- Good luck with your sitzmarker.
Hodaya- On Saturday, I have to be on a low residue diet. Then come Sunday, I am on all liquids. At 12 I have to take 4 dulcolax at around 6 I have to take a bottle of Magnesium Citrate. Then on Monday before the defecography, I have to have an enema.

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 4/14/2011 9:18 AM (GMT -6)   
that's really strange.. they never ask for this kind of prep and i have read so much back on the total colectomy threads - no one ever had it done this way. maybe they do plan on a barium enema and defecography at the same time..? ask your dr why you're doing it differently than everyone else here.
Hodaya
06/05/2007 - STARR procedure
colonic inertia w/pelvic floor dysfunction
08/16/2009 - total colectomy w/ileorectal anastomosis
07/08/2010 - loop ileostomy

TickledPinkTwice
Regular Member


Date Joined Mar 2011
Total Posts : 241
   Posted 4/14/2011 9:31 AM (GMT -6)   
Ok maybe I should, I didn't think it was normal prep.
26 years old
Idiopathic chronic Constipation for as long as I can remeber. Abdominal distention and painful gas started 2/2011.
Tried:Increasing fiber and water,Zelnorm ,Amitiza, Colon irrigation
2006- Colonoscopy,removed polyps
April 2011- Sitz Marker shows Colonic Inertia, scheduled for Anal Manometry and Defecography.

lifeinterrupted
Regular Member


Date Joined Mar 2011
Total Posts : 103
   Posted 4/14/2011 10:28 AM (GMT -6)   
Yes it's normal I had to do the prep actually the colo prep what my particular radiologist wanted done, it's so your completely empty when you drink the barium so they can see your small bowel so nothing is obscuring it. They will have you drink wait 45min and then they will put the other barium in you... This is much more thorough...
Dee
dx with uc July '10
Current on going undiagnosed bowel disorder

Prov3:5,6

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 4/14/2011 10:49 AM (GMT -6)   
Dee, this just seems so odd to me. are you sure it was defecography, where they have you sit on a toilet like sit, ask you to expel the barium and record on video x ray the defecation process??

i'm asking this, b/c i noticed in your signature that you have UC and ppl with UC usually don't do the defecography. maybe what you had was a barium enema, which is a totally different test from defecography.

TickledPinkTwice
Regular Member


Date Joined Mar 2011
Total Posts : 241
   Posted 4/14/2011 2:36 PM (GMT -6)   
I don't know. I guess I will just roll with it.
26 years old
Idiopathic chronic Constipation for as long as I can remeber. Abdominal distention and painful gas started 2/2011.
Tried:Increasing fiber and water,Zelnorm ,Amitiza, Colon irrigation
2006- Colonoscopy,removed polyps
April 2011- Sitz Marker shows Colonic Inertia, scheduled for Anal Manometry and Defecography.

lifeinterrupted
Regular Member


Date Joined Mar 2011
Total Posts : 103
   Posted 4/14/2011 3:43 PM (GMT -6)   
Yes I had the defecography test I've also had a barium xray test 2 totally separate tests, the prep depends on where your having it and who is doing it but more then likely what specifically they want to see... Yes I have uc but I have some type of nerve damage that is hard to diagnose.... ;-)
Dee
dx with uc July '10
Current on going undiagnosed bowel disorder

Prov3:5,6

Post Edited (lifeinterrupted) : 4/14/2011 2:46:20 PM (GMT-6)


lsimonetti
New Member


Date Joined Dec 2011
Total Posts : 3
   Posted 12/21/2011 9:13 AM (GMT -6)   
Hi all

I am new to this site and have a question about the Defecography I had last Friday. How accurate are these? I have ALL of the symptoms of a Rectal Prolapse and my Dr ordered the Defecography last Friday and it came back that I do not have Rectal Prolapse, but I DO have Very Bad Hemorrhoids! (Sorry TMI), is this possible???

I would really love some feedback!
confused confused

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 12/21/2011 11:13 AM (GMT -6)   
Isimonetti,

I am the queen of misread defecography!!!!!!! A resident mistook what was a loop of small intestine for my sigmoid colon saying my sigmoid colon descended between my rectum and vagina (thus calling it a sigmoidocele when in reality it was an enterocele) the descening loops of small intestine.

THe surgery for sigmoidocele is removal of sigmoid colon as opined by 3 colorectal surgeons upon the misread scan. As I KNEW NOTHING at the time, I had my sigmoid colon removed as I was told it was squeezing my rectum shut from the outside thus leading to difficulty with rectal emptying, my presenting symptom.

LONG story short: The surgeons I got involved with also "fixed" a cystocele (bladder drop) mentioned on the wrong read scan report that was so tiny it was negliglble, thus the "fix" gave me bladder issues. These surgeons I unfortunately got involved with then removed the top of my rectum for unknown reasons along with my sigmoid colon then didn't send it to the lab, go figure. I did not have a rectal prolapse or any disease. Did not and would not have consented to removal of top of rectum nor of sigmoid resection had I known all I now know. These surgeons also resuspended my vagina from my backbone though my vagina was not prolapsing. Did not consent to that either. And yada yada you get the picture.

Upshot Internal scarring cost me the permanent loss of colon and rectum; I have bladder damage; and for 7 months could not eat due to small bowel being scarred basically shut.

All that really needed to be done was small bowel needed to be pushed back in my pelvis and the space through which it descended on push phase of the defecogram test needed to be sewed shut. Then I had a rectocele that needed to be repaired. All this could have just been done vaginally thus no need for any colon resection or any surgery that would be open and give me small bowel adhesions

I had to look for 13 months 11 surgeons and 7 medical centers to find help. All that could be done for me was lysis of small bowel adhesions and permenent ileostomy. I was lucky to find someone to do this and am praying all keeps working. SO far so good and it's been 4 years. I have issues with some foods but as long as I continue to be able to eat I am happy.

BUT, as far as how accurate are defecograms? ONLY AS ACCURATE AS THE PERSON WHO READS THEM!!!!!! ANd according to reviewers of my case surgery should never be planned only based on defecogram. Depending on your presenting symptom, nerve, muscle, and many other tests need to be done along with defecogram.

You say you have symptoms of rectal prolapse. Is is hanging out of you? or do you mean internal rectal prolapse (intussuception). Do you have troube passing stool or are you incontinent? Be sure a radiology doc has signed the report and not just a resident. The signature lines will say (R) for resident (T) for teacher. If a resident signs, be sure the teacher did too. I knew nothing of signature lines when I had my defecogram which lead to all I went through and nobody called it to my attention until after the fact either.

That was my experience. Not saying you will have the same, but all these tests are very subject to interpretation! A lot depends on the imaging machine, the contrast used, etc. Mine was on a Tesla upright .5 MRI with ultrasound gel for contrast. That machine, to my knowledge broke and was never replaced. Lucky for future patients. Talk about hitting the wrong place at the wrong time. Most Defecograms are done with xray toilet type thing and barium contrast to which I am allergic that is why I had the other kind of defecogram I just described. BUT I did not know at the time I COULD have had the xray kind but with baby oatmeal mixed with gastrograffin as contrast. I never thought to talk to the actual radiology doc. They are real people though usually behind the scenes, but I have found all of them since my disaster defecogram to be very approachable. If you have any questions, it is perfectly ok to arrange consult with the actual radiology doc. THis was just my experience. Good luck. Rosemary

lsimonetti
New Member


Date Joined Dec 2011
Total Posts : 3
   Posted 12/21/2011 11:23 AM (GMT -6)   
OMG I am SO sorry to hear what you have been going through, what a nightmare! What state do you live in? Hopefully you did not have the test done at University of Penn in Phili, PA!
When I go to the bathroom, my “colon” pops out of the rectum, i’ve had discharge/bleeding when I wipe and have experienced Incontinence (UG)!
I didn’t know that “Hemriods (SP)” can pop out of your rectum just like a prolapse!
I also have problems peeing. I have to sit there with the water running in order to pee…it’s been a year of MANY dr’s and long drives to the Hospital! I have a colonoscopy scheduled for 12/27 and then I go see the dr 1/6 to schedule the surgery (to fix the Hemriods)

I wish you A happy and HEALTHY New year!!!

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 12/21/2011 11:58 AM (GMT -6)   
Isimonetti,

No the defecogram and whole mess was done in Mass. So are they going to fix the rectal prolapse. From what you describe they may have to take out some colon to shorten things up and pull the rectum back into your bod. Be SURE and get this done laporoscopically. Not open if you can avoid it. SOunds like they are going to just fix the hemherroids. Would this solve your issue.

The needing to run water to pee thing is what I have always had to do. This indicates a functional issue with not being able to relax the pelvic floor muslces or bladder sphincter. Functional not surgical. Be careful they don't mess with this.

Also on a defecography it should be noted the time it took to expell the rectal contrast. If it is prolonged then there is some form of anismus which is a fucntional issue and not surgical. On review of my scan by expert pelvic radiolgists this turned out to be my issue with the incomplete rectal emptying. So my symptoms were functional not surgical except for the two minor anotomic repairs I mentioned above, the rectocele and closure of space the small bowel protuded through internally. What I needed for the symptoms was Physical therapy. Your issue all different.

GOOD LUCK! Rosemary PS I've heard GOOD things of Univ of Penn Philly.

lsimonetti
New Member


Date Joined Dec 2011
Total Posts : 3
   Posted 12/21/2011 12:23 PM (GMT -6)   
Actually they said that I DO NOT have a rectal prolapse, they are saying I have hemorrhoids and the surgery they have to do is staple hemorrhoids!
I think I have rectal prolapse! I didn’t know that hemorrhoids mimic the same symptoms as a Prolaps!
IF I were to have the prolapse surgery they could not do it Laparoscopic because I have had so many and I have adhesions so they would have to cut me open

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 12/21/2011 1:43 PM (GMT -6)   
Oh, I get it. Yeah, I know they have this thing about once open always open for surgeries. If you think you have a rectal prolapse and they are going to repair hemherroids and leave your rectum prolapsing I would get a second opinion. Good luck. Thanks for clarifying. Rosemary

Christine1946
Veteran Member


Date Joined Aug 2008
Total Posts : 5484
   Posted 12/21/2011 5:54 PM (GMT -6)   
     You mean there is a chance for the small intestine to prolapse?  Suppose you have no rectum or colon?  Does it droop so it lies on top of the anus?  How do you know this is happening? 
     I sort of wondered what happens to all that empty space in there rolleyes .

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 12/21/2011 6:32 PM (GMT -6)   
Hi Christine,

Sorry for the confusion. I was referring to my original defecogram 2006 where the radiology resident wrote that my sigmoid colon was descending between my rectum and my vagina instead of a loop of small intestine (which was what really descended). The unneeded disaster sigmoid removal that landed me here was based on this faulty read scan.

The only reason a space opened between the top of my rectum and the top of my vagina was that I had had a hysterectomy years ago. In hindsight had I not had that, I would not have traveled to the road I did and ended up as an ostomate as without a hysterectomy no type of bowel loop can drop anywhere. The uterus, cervix, and all the connecting ligaments prevent dropping of any bowel loops anywhere. My hysterectomy doc did not tell me that. If he had I would have held on to my uterus for dear life :-)

Rosemary
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