Is the test ruined?

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TickledPinkTwice
Regular Member


Date Joined Mar 2011
Total Posts : 242
   Posted 4/2/2011 5:40 PM (GMT -6)   
So I am currently on day 4 of the Sitz Marker test. I took a capsule days 1,2 and 3. I have x-rays on day 4 and 7. I didn't get to see the x-ray but I was told the majority of the markers were on the right side today. Well,for the first time in and I can't remember how long, I had a small bowel movement by myself mad . Great timing,I know rolleyes   I am so scared that all of my markers are gone now. This never happens,did I just ruin the test?

esoR
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Date Joined Jan 2007
Total Posts : 4147
   Posted 4/2/2011 5:56 PM (GMT -6)   
No, whatever your bowels do they do. Don't worry about it. It was good you went. Besides, the markers travel along even if you didn't go all week. Hard to believe, I know, but from experience I know this to be true. After a pelvic surgery where my colon was basically scarred shut, I had to do the Sitz Mark test. Due to the colon being basically scarred shut just above the rectum, I of course could not move stool out. BUT, the markers moved along normally.

Hope this is of some help. Rosemary

TickledPinkTwice
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Date Joined Mar 2011
Total Posts : 242
   Posted 4/2/2011 5:59 PM (GMT -6)   
Thank you. I am just so stressed about this. The results of this could potentially change my life!

Alibee
Regular Member


Date Joined Oct 2010
Total Posts : 286
   Posted 4/2/2011 6:58 PM (GMT -6)   
I know exactly how you feel. I had the sitzmark test, manometry, balloon test/emg, and a hydrogen breath test all on the same day, and I am in the process of going through lots of other tests...and every time I have a test or a dr. appointment I feel like my entire life stands still. I hate that feeling! I have my next appointment on the 19th of April and the wait is torture.

I was so paranoid throughout my sitzmark test, I was sure that my body would rebel or I would eat bad food or get too anxious and my bowels would go crazy. I had to take 5 capsules over the course of 5 days and have an xray on day 6. I had a tiny bowel movement on day 5, but it turns out it was just old "stuff" from before I even started the test...on day 6 I still had all 120 markers in me. I've even heard of people having more than one bowel movement during the test and they still had all the markers in them.

I know it feels impossible but try your best not to stress out about it - I watched a lot of movies and things to try to keep my mind busy. I can so empathize with you and just wanted to let you know that I know how you feel and I know how stressful it can be.

TickledPinkTwice
Regular Member


Date Joined Mar 2011
Total Posts : 242
   Posted 4/2/2011 7:00 PM (GMT -6)   
Thank you so much. Hopefully none of the sitzmarkers were that far down. Good luck to you!
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
March 2011- Defacography and Sitz Marker

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/2/2011 7:46 PM (GMT -6)   
Tickled,

I TOTALLY hear you. UNfortunately for me I did not discover this site and did not know of all the tests I was supposed to have, 3 colorectal docs did not do them, then incorrect surgery done incorrectly (on a wrong read scan), I almost died, ended up with a permanent bag and will be lucky if it continues to work. You are lucky that you have the information and are being given the correct tests. BUT, do consider re-doing any test that is done. Results and techniques vary, not necessarily with the Sitz test, but mainly with other tests. Good luck, Rosemary

Alibee
Regular Member


Date Joined Oct 2010
Total Posts : 286
   Posted 4/2/2011 9:14 PM (GMT -6)   
Hi Rosemary, I've seen many of your posts and you truly are one tough cookie! I hope you continue to do well and you get everything sorted out soon. Your perseverance is really an inspiration to a lot of people who come to the site feeling like they are going through these things alone.

I had the sitzmark, and it was pretty much textbook: all markers remained, all spread out. Then I had a manometry and balloon expulsion test and they said my pelvic floor was a little tense. I also couldn't expell the balloon so I've been going to biofeedback therapy for a few weeks and I have my next appointment at UNC on the 19th, to find out what comes next, probably more tests.
---I wanted to ask you, what are the tests you think should be redone?

frostyboy
Regular Member


Date Joined Mar 2011
Total Posts : 272
   Posted 4/3/2011 7:14 AM (GMT -6)   
Tinkle,
It sounds like you are getting tests much more faster than I have had.  It seems to have moved very slowly for me.  I know soon that I will prob. be getting another transit study done, and I am glad I found this site, too.
Rosemary, I have read some of your posts, too.  You are one tough cookie-and I am glad that I found this site b/c it is given me insight on the appropriate questions and exams to perform before anything else is done on me.
 
2009-Diagonses with IBS after years of battling with constipation
2010- Had tests to confirm colon inertia
Feb. 3, 2011- laprascopic left hemicolectomy
Now have stricture from surgery
Still battling with painful gas and constipation

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 4/3/2011 9:48 AM (GMT -6)   
tickled,

if you still have doubts about the reliability of this specific test, you can ask for a repeated test. good luck!
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 4/3/2011 11:47 AM (GMT -6)   
Alibee,

Thanks for the kind words. part of my playing the good forward is to help others with the information I SHOULD have been given and was not. All our issues are different but there are fundamentals that SHOULD be followed in diagnosing all these issues with defecation. The best is an article written by Dr. Bruce Orkin at George Washington University Hospital. I will go get it and give you the names of the tests and where you can get ahold of this article.

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/3/2011 1:39 PM (GMT -6)   
Alibee,

Here is what you do to get the info I was referring to; it's really easy and the best patient article I have ever seen all summed up in two pages.

1. Google this: Physiological Testing of the Colon, Rectum and Anus.
2. Then there is a button to click to down load it for free.
3. Up comes Dr. Bruce Orkin's article and you can print it right out for free.

Bascially for defecation issues there are structural tests: xrays and scopes. Then physiological tests to check the function or how things work: Manometry, Balloon capacity and compliance, balloon evacuation. Neurological Tests: Pudental nerve terminal maotor latency, electromyography, Concentric needle EMG Single fiber EMG (the needles into the nerves can be skipped. Just as much info can be gained with electrodes that are pasted onto the anus and surrounding muscle. Colonic and transit studies such as you are having. Then the defecogram. Then anorectal ultrasound. This is an informational article and not meant to substitute for medical advice. BUT I was only given a defecogram and an MRI to look for structural things. Then THAT was misinterpreted and I went down the road I did. Turns out my transit was fine. Mine, as you know, was a result of mal-practice, but as a rule docs are honestly trying to find out how to really help a person. i for some reason, was one who got stuck in a whirlpool of those who were out to make a buck with very poor pre-op dx and no follow up to complications and surgery done wrong. This is not the norm. So get this article and ask your doc about all these tests.

If you could not poop out the balloon, it means that you have the outlet issue.. If this cannot be relieved by PT, then you need the nerve function tests. Sometimes a nerve that controls the puborectalis muscle may not be working right and any surgery done on the pelvic floor can make things worse. A botox shot into the end plates of the puborectalis muscle (while you are completely under deep general anesthesia) may be a good test to see if you truly have non-relaxation of the puborectalis muscle. This is the sling muscle that comes off the levator ani whcih encircles the rectum and controls rectal angulation. On a defecogram, if you have an indentation that holds the rectum at 90 degrees whether at rest, push, or evacuation, that means you have nonrelaxation of the puborectalis muscle. Mine prior to my 2006 original surgery for the sigmoidocele which wasn't, showed totally normal anorectal angle widening for defecation. Norms for this are approximately anorectal angle 90 at rest, 120 or so at strain and 150-180 at evacuation, then return to 90 degrees when done. These are only rough estimates, check this out on google and I did not have my results with me when I wrote this, but the idea is that the puborectalis mucle relaxes when you poop allowing the anorectal angle to widen, then it tightens and closes the angle for continence. In my case my levator ani was scarred or some nerve to it was injured so after the disaster surgery, the angle stayed closed at 90 degrees.

If you have this outlet issue that cannot be cured and you have CI (as in sitz markers not being moved through your colon), and you have normal small bowel transit, it is logical that an ileostomy would be the cure. Folks on here with CI who have had the small intestine hooked to their rectum still have issues as they also have pelvic floor issues. So be sure to get all the testing you need BEFORE doing anything. It is amazing how many docs of patients on here do not do or know of the full scope of testing needed. I know in my heart all these docs are NOT the way mine were and are trying to help people. I really think, aside from my case, the whole understanding of the gut system and intereactions with nerves/muscles in the pelvic floor is really still in its infancy. A prior hysterectomy can precipitate structural and neurological damage to everything. The HERS web site tells about all this. Unknown to me at the time I had what turned out to be the unneeded hysterectomy back in 1995.

Google anorectal angles for a printed explanation. Rosemary PS This post is just based on my own experience and not meant as medical advice as I have no MD degree.

TickledPinkTwice
Regular Member


Date Joined Mar 2011
Total Posts : 242
   Posted 4/3/2011 7:43 PM (GMT -6)   
Rosemary-You are definitely strong!
I appreciate all the responses. My digestion has been weird this week. So, it will probably show my transit time as faster than it usually is. I guess I will just do it again. I'm so ready to feel better:(
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
March 2011- Defacography and Sitz Marker
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