colonic inertia, pelvic floor insufficiency, rectocele -- what are my options here?!

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

redskittles
New Member


Date Joined Mar 2011
Total Posts : 2
   Posted 3/31/2011 11:09 AM (GMT -6)   
2 and a half years ago I suddenly developed a horrid case of constipation. I've been suffering almost daily since then. I am very confused when I have periods of complete normalcy...but I haven't had one of those in almost a year, so maybe I finally reached the point of no return.

My colonoscopy revealed an extra long, extra wide colon with very poor muscle tone. My GI dx'd me with colonic inertia.

My transit study didn't really back the colonic inertia. I only had 4 markers left on day 3, none on day 5. I think I might have messed it up by doing a lot of stress eating those days and that forced the markers out faster.

My GI thinks that since I did technically have "normal" transit study, that I am just all backed up because of an outlet problem. I'm not totally convinced by that. I still have a lot of pressure in my upper abdomen even after I clean out the lower colon with enemas and suppositories.

Defecography revealed a large rectocele (5 cm), and "extensive pelvic floor insufficiency" with severe decent of the anorectal junction 6.2 cm below the pubococcygeal line.

I used to get the urge to go to the bathroom and just couldn't, but since my most recent marker study, I've gotten worse and I don't really feel the urge anymore. I'm always constipated and tired unless I don't eat. When I fast, I finally have bowel movements and I have so much more energy despite not eating for several hours.

I'm not too concerned about the rectocele. I know it can be repaired. I'm worried about the pelvic floor thing. Is there anything that can be done? I can't get into the colorectal surgeon for probably a month or more (ugh).

I'm only 24. Am I destined for a bag? :(

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 3/31/2011 1:00 PM (GMT -6)   
hi reds and welcome to healingwell!

what do you mean by constipation? do you mean you go days/weeks w/o a bm, you don't feel the urge to go? or you feel the urge but just unable to expel it? with CI ppl go for long periods of time, like 1-3 weeks, in worse cases even more than a mon w/o a bm and all that time they don't feel the urge at all. with pelvic floor dysfunction ppl usually get the urge every day, but unable to expel it due to several causes. what do they mean by pelvic floor insufficiency?

your pelvic doesn't sound good. 5 cm rectocele is a big rectocele and the pelvic decent is concerning. do you have problems with peeing too? but even so, if they decide on removing the colon, they always give it a try first to see if you manage w/o the bag, but of course you have to take into consideration that if the colectomy with ileo-rectal anastomosis (removing the colon and attaching the small bowel to the rectum) doesn't work, you'll need the bag. you have to think whether your condition is bad enough that you can't live with and preffer to even have the bag for relief, or is staying just as you are is better?

for me, it was def CI, i had no quality of life. i was willing to have the bag (if there was no choice), cause things were starting to get worse in big steps and also my pelvic was starting to deteriorate. the colectomy w/ileo-rectal anastomosis didn't work, i guess mainly b/c of my anismus and i had to choose the bag, cause i was getting no quality of life still, so about 11 mons after the colectomy i had my ileostomy and i couldn't be happier. this isn't perfect and certainly not what i hoped for, but it's also not the end of the world and i can live with it, at least live better than w/o it.

maybe you should ask your dr to repeat the transit study, sometimes there's a need to repeat it to confirm.

hope you get all of this figured out and find the right solution.
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

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 3/31/2011 2:10 PM (GMT -6)   
red have you given birth multiple times or once and or been pregnant. Also have you had a prior hysterectomy.

Only asking because based on your answers I might be able to give you some info I have learned the hard way.

Rosemary

redskittles
New Member


Date Joined Mar 2011
Total Posts : 2
   Posted 3/31/2011 2:40 PM (GMT -6)   
I have NEVER been pregnant, actually! No hysterectomy. I have lost massive amounts of weight if that is helpful.

2b: By constipation, I mean - I have problem going to the bathroom and moving stool out of my colon. Every xray I have shows a large amount of stool. I've had 2 CT scans w/oral and IV contrast, MRI defecography, gastrograffin barium enema (wasn't able to move the fluid out...could hear it sloshing around in my intestines), colonoscopy, several series of xrays including the sitzmarker study, and MRI of pelvis and abdomen with IV and oral constrast with MRCP to check on pancreas and gallbladder (I have mildly high lipase and liver enzymes).

All my studies (except for the defecogram) came back as functionally normal, just MASSIVE amounts of stool in the colon.

Nothing works. Amitiza, miralax, colace, magnesium oxide supplementation, glycerin suppositories, enemas. Actually I feel like it makes my pain worse because it adds more liquid and bulk to my stool that just sits in my colon. The stools I pass are actually really soft and not hard...I just can't move 'em along, and if they are too soft, they actually come out pencil thin probably from the pelvic floor stuff.

Right now I am on misoprostol 4x/day, colace, milk of magnesia. I eventually do have bowel movements, never go like a week or a month like some stories I have read, but I am in pain or discomfort almost everyday and have fear of eating.

I am very depressed over this. Just really zapped of energy and feeling so "heavy" all the time.

No bladder issues--no incontinence or anything.

I just don't know how much longer I can deal with this. I know some people do it for 5, 10, 15 years...I just don't even think I can take another few months. I found out it was going to take 6 weeks to get in to the colorectal surgeon and my heart just sank. I'm just getting NO relief at all. I would probably be ok if I at least had something that worked (even if it were unpleasant), but nothing works anymore.

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 4/1/2011 12:47 AM (GMT -6)   
but if you don't take laxatives, how long does it take between bms? they did tell you not to take any laxatives during the sitz marker test, right? i think it'll be good to insist on repeating the sitz test. it does sound like you have a severe functional problem. try to see if you can have the sitz test again, and if they agree to repeat it, try not to eat too much during the week of the test. a healthy colon will move the markers forward even if the person is fasting.
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
New Topic Post Reply Printable Version
Forum Information
Currently it is Thursday, April 26, 2018 5:14 PM (GMT -6)
There are a total of 2,956,057 posts in 324,289 threads.
View Active Threads


Who's Online
This forum has 162265 registered members. Please welcome our newest member, UglyLoser.
338 Guest(s), 10 Registered Member(s) are currently online.  Details
goshawk, Wienie, kbad30, Serenity Now, Wotan, magoo2, OriolCarol, pmitra0123, G-Ju, Jterry78