dialated rectum

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stuckin
New Member


Date Joined Nov 2010
Total Posts : 12
   Posted 11/25/2010 1:18 PM (GMT -6)   
Has anyone heard of anyone who had ileo-rectal anamostsis with diagnosis of colonic inertia and dialated rectum? Dont have problem getting rid of waste from rectum or anus once it makes it there. Also an confused about what part is rectum and what part is colon,can anyone enlighten me please?
Stuckin

answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1325
   Posted 11/25/2010 1:26 PM (GMT -6)   
Stuckin, I have the diagnoses of megarectum, colonic inertia, anismus, and intussusecption. I had part of my colon removed and had a temporary loop ileostomy. As far as I know, the rectum is a part of the colon. Google the anatomy of the colon and you will be able to see where the rectum begins.
Diagnosed w/colonic inertia, obstructive defecation syndrome, anismus, rectocele, and intussusecption
2005-hysterectomy w/pelvic prolapse repairs
2006-sacralcolopopexy
2010-subtotal colectomy, rectopexy, and temporary diverting loop ileostomy. Parastomal hernia discovered in November, so more surgery, probably end ileostomy with relocation of stoma.

stuckin
New Member


Date Joined Nov 2010
Total Posts : 12
   Posted 11/25/2010 2:02 PM (GMT -6)   
Thank you for your response. I also have colonic inertia and am pushing for surgery. I have suffered for years and have been out of work for the past 2 years. Did you not have option of resection? Did dialated rectum cause you difficulty evacuating from rectum/anus?
Stuckin

answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1325
   Posted 11/25/2010 5:48 PM (GMT -6)   
Stuckin, I have also suffered for years with constipation and was diagnosed with IBS-C until I had the sitz marker test and it was then that my diagnoses was changed to colinic inertia.

Yes, I did have difficulty getting the stool out of my rectum....BUT, I had more than just the megarectum. I had intussusecption, rectocele, and anismus, which is where the puborectalis muscle does not relax.

I had 3 colorectal consults and 2 recommended a total colectomy with iloerectal anastomosis, but they were unsure if I would still have the outlet obstructive issue. It was the 3rd doctor that recommended that I have the rectocele repaired, the intussusecpted part of my rectum removed, and have the sigmoid colon removed and the temporary ileostomy placed to allow for the rectum to heal.

What did your sitz marker test show?

If you can get the poop out of your rectum, then I assume you will be fine with the total colectomy with ileorectal anastomosis. Did you have a defogram? What does your doctor suggest?

stuckin
New Member


Date Joined Nov 2010
Total Posts : 12
   Posted 11/26/2010 9:52 AM (GMT -6)   
Thank you so much for your response. Had proctogram 3 years ago when I finally convinced my gastro consultant to send me to a surgeon. I had been having a terrible time with constipation, in colon but also in rectum. Proctogram showed dialated rectum. I managed to get rid of most of lead but not entirely. Surgeon also mentioned some problem with angle. Results with manometry were hgh restng pressure, I think, whiich led surgeon to think I had anismus. Also had no urge to expell balloon iinflated to its fullest. Was sent for biofeedback where Physio ascertained that I had no anismus just very high muscle tone, which she said was good. She thought me how to use muscles properly to expel stool. I improved immensely with no more straining but also with help of duphalac to move things along and to soften stool. Since have had no problem getting poop out of  rectum. Physio was surprised at how quickly I relearnt how to go properly. Although I am in better shape I am still stuck in waiting for bowels to move. I could be waiting 2-3 hours before I have cleared out and I also use a lot of suppositories and water enemas as I always feel that bowel movement is incomplete, like it gets stuck further up in colon, not in rectum, once its there I can get rid if it easily. Then in evening I have to use supp and enema again. My whole day is revolved around this routine. I told the liaison psychiatrist (surgeon sent me to her to help me manage my problem and to work on apparent body image problem - in the case that I have surgery and end up with ileostomy). I am depressed and fed up staying in house, not being able to go back to work, not being able to go on holidays, not being able to leave house in morning to go to my sons football matches, becoming lethargic, losing libido as a result of taking 40g of ciprimil, which I have reduced to 20g. Also every morning after I take 60mls of diphalac and then soya bran and psyllium husk I get nauseous and exhausted, although it passes after half an hour its just horrible, and every morning, this cant be good for me. I told psychiatrist I had enough and wanted surgery. She tried to dissuade me and suggested sending me to another psyco-analyst, I nearly cried and said no that I wanted to go back to surgeon. We agreed that I would see another psyco but on condition that I also got appointment with surgeon and with her present. I managed to get an appointment for next Friday. I told her I wanted another proctogram and manmetry (I think the results will have changed as my rectum seens to have come alive again) and motility test of small bowel. When I did sitz marker test 2 years ago markers were left in rectum and colon, not not small bowel I think. I told psychiatrist that I thought I was an ideal candidate for colectomy with ileo-rectal anamostosis, the surgeon had even mentioned this before. One minute they are telling me I am deal for the operation the next they are trying to dissuade me and pointing out risks etc. I would not go through it unless it was absolutely necessary, even if I do end up with an ileostomy at leatI would have a life again. I have a small rectoceol but apparently it is insgnifcant , not causing me problems and not in need of repair. Have sone degree if pelvic floor decent but again doesnt seen to be causing problem. My rectum used to protude through anus during straining occaisionally but that hasnt happened in last 2 years, probably because I dont strain any more. orry for such a long post.
Stuckin   

tinkerbell2
Regular Member


Date Joined Jun 2009
Total Posts : 418
   Posted 11/26/2010 10:26 AM (GMT -6)   
I only have a minute to type.. but I had the same feeling of stool stuck higher up.. turns out my colon was very twisted and redundant. I had a resection, they removed the entire sigmoid and finally - first time in YEARS and YEARS.. stool actually gets down into the rectum. Only thing now.. is after multiple surgeries, I still can't get it all out. :( I just had surgery a few weeks ago, with very specific instructions not to strain, so I use the liquid fleet and my BM comes out fine, until the very end, some still gets trapped. It's uncomfortable because I can't strain to get it out.. I do know that if you are straining - you're causing damage, so if your rectum seems to be working, do all you can not to strain! I think I went so many years.. I just ruined myself forever.
Chronic Constipation - last 20+ yrs.
Stage lll Pelvic Floor Prolapse ( rectocele, rectal, vaginal, bladder) Rectopexy, Sacral Colpopexy, TVT Sling - 8+ hr surgery - March 2009
Constipation increased, could not move bowels without excessive straining or laxatives - March 2009
TVT Sling Released - April 2009
Redundant, Twisted, Prolapsed colon found - causing mechanical obs

stuckin
New Member


Date Joined Nov 2010
Total Posts : 12
   Posted 11/26/2010 11:33 AM (GMT -6)   
Thanks for the information, its always helpful.
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