Obstructive defecation

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zuzupetals
New Member


Date Joined Jun 2010
Total Posts : 6
   Posted 4/7/2011 7:54 AM (GMT -6)   
Hi,
 
I was reading and seeing that so many of you have this problem.  I was wondering if someone could give me a little advice. History: Hysterectomy, bladder sling , bladder sling reversal ( could not urinate ) Cystocele and rectocele repair, ovaries removed with adhesions, sacralcolpopexy and tummy tuck.  ( because of the mess from surgery.  I am havign problems with pelvic pain and incomplete bowel movements.  I have to go twice to empty ( if I can ) and then the pain is terrric.  I have had a couple defecgrams done: 1st:  Anorectal angle at 90 at rest.  The puborectalis muscle is prominent on rest.  Anterior rectocele abd intussusception and incomplete relation of puborectalis on defecation.  I went to Physical therapy and can relax better, but still having problems and pain.  2nd defecogram:  Norman anorectal angle and good postion of anorectal junction.  4cm anterior rectocel and grade 1 internal ectoanal intussusception.  i was able to empty this time. I had a anorectal manomentry study;    Normal restin pressures with very exaggeraterd squeeze pressure.  Sphinter relation is seen with bear down. but not consistently.  Rectal sensation inact bur urge could not be elicted with balloon distention. ballon expelled in 1 min and 12 seconds.  One colo rectal says obstuctive defecation and resection and rectopexy. But says that may not cure all my problems.  Can an intussusception and rectocele be the cause of the pain?  I don't want to have the surgery and be worse.  But I get this horrible pressure and pain. rectally and vaginally.  Could that just be the rectocele.  I have another appt with another colo rectal doctor next week.  i cannot find any one who gives botox in the puborectalis muscle, even though it seems to be better.  ANy advice.  It is a horrible way to live.  I have alot of pain by my belly button when I have to go but can't too.  I am sure I have adhesions too. ?  Any advice Thanks again.   Suzzane.

lifeinterrupted
Regular Member


Date Joined Mar 2011
Total Posts : 103
   Posted 4/7/2011 1:26 PM (GMT -6)   
Hi zuzupetals so sorry to hear of all your difficulties!!! There is a web site that a professor deya marzouk has he is a colorectal surgeon it's all about obstructed defecation look his name up and it should pop up...

I am sorry I don't have more answers but that web has tons and I know how hard this is I suffer from two different bowel disorders one diagnosed and the other the doctors aren't sure what it is...
I will pray for relief from this for you!
Please take care ;-)
Dee
dx with uc July '10
Current on going undiagnosed bowel disorder

Prov3:5,6

lifeinterrupted
Regular Member


Date Joined Mar 2011
Total Posts : 103
   Posted 4/7/2011 1:29 PM (GMT -6)   
Also I meant to ask did u already have surgey once for a rectal prolapse hence the sacralcoloplexy? On that web he talks about even if surgery can restore correct anatomy there is still often prolems with disordered sensations.
Just so you can look at that too.
Dee
dx with uc July '10
Current on going undiagnosed bowel disorder

Prov3:5,6

zuzupetals
New Member


Date Joined Jun 2010
Total Posts : 6
   Posted 4/9/2011 9:18 PM (GMT -6)   
No, the sacrocolpopexy just pulled up the vagina, but he said he would pull up the rectum, like a rectopexy, but did not. The disorder sensations is what bothers me, to have the surgery and still have these problems. I have been reading that some women have had their colon removed becasue of this problem. It is very depressing.

answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1325
   Posted 4/9/2011 10:01 PM (GMT -6)   
I also had a sacralcolopopexy and even though my pelvic floor was made almost perfect from the surgery, I still suffered with incomplete bowel movements.....Defogram revealed intussusecption, anismus, and a rectocele. I was unable to expel the barium paste despite repeated straining.

The colorectal doc gave me a shot of botox into the puborectalis muscle, but I never saw any improvement.

I also have colonic inertia.

A total colectomy was recommended by 2 colorectal surgeons, but they never addressed or seemed to care that I could not push down to have a bowel movement and had to disimpact 100% of all my bowel movements.

After many tests and after finding a colorectal surgeon that addressed the pelvic floor dysfunction, we decided on a dramatic surgery. He did a subtotal colectomy, removed the intussecpted part of my rectum, repaired the rectocele, and gave me a temporary closed loop ileostomy.
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.

lifeinterrupted
Regular Member


Date Joined Mar 2011
Total Posts : 103
   Posted 4/9/2011 11:09 PM (GMT -6)   
Tracy, is a closed loop ileo almost the same as an end one and how did he take out the Intussusception? Did he cut out part of your rectum or dissect and pull up I would like to know cause even after all that and you may be left the same as you were before the surgery.... That is what concerns me most as I've already had one surgery to remove my sigmoid because it was redundant and it might, might being the operative word here, help with my intermittent bm's all day. so I knew going in 50/50 chance it would not work, and it didn't!!! I can't imagine having to keep getting cut open trying to chase a cure when there isn't one!!!! That coupled with my uc is what I'm facing right now to make the decision about...
Tracy are you keeping your ileostomy?
Dee
dx with uc July '10
Current on going undiagnosed bowel disorder

Prov3:5,6

answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1325
   Posted 4/10/2011 11:34 AM (GMT -6)   
Dee, YES, I am keeping the ileostomy. I plan to have another surgery in June or July to remove the rest of the colon and he will then give me a permanent ileostomy. I have also developed a parastomal hernia and he will repair that at the same time.

Do you have trouble expelling bowel movements? Because that was my biggest complaint and the thing that left me with a serious quality of life issue. My entire life revolved around taking laxatives and sitting in the bathroom for hours each and everyday....YUCK....I worked, slept, and sat on the toilet. That was my life. My family had to speak to me through a locked door. And I am a mom to 4 kids and this is how we lived for YEARS!

I could barely eat food and at times could not even sip water. I stayed so bloated that I looked pregnant. As a matter of fact, my stomach stayed bloated for so many years, that my skin is stretched out and my now unbloated stomach hangs down. It is gross. I also had to sleep sitting up because I suffered such intense heartburn and nausea.

I am now a new person. I hardly ever feel bloated and NEVER look bloated, My stomach stays nice and soft
and flat. I can eat food now and do not have to limit fluid intake. I can sleep laying down. I walk 4 miles a day everyday and I have found I actually like exercise. I quit smoking the day I had my surgery and have no desire to start back.

I actually care about myself now. I think before my surgery that I just could not imagine, nor did I want to, live to be an old woman. Living my life with my bowel issues was no way to live and I, at times, even felt suicidal.

Taking care of my ileo is a breeze compared to going the "regular" way. I get more down in one day now than I did in one week pre-surgery....

Oh yes, my doctor removed some of the rectum and performed a rectopexy. So, did it help? Maybe a little. I can now expel 50% of an enema, but I still can not push down to rid my rectum of mucous WITHOUT an enema. I can not push down for some reason????? My doctor thinks I may have some type of nerve damage from so many surgeries. I had 2 pelvic prolapse surgeries, 2 anal fissure surgeries, and a hysterectomy.

What tests have you had? What are your symptoms?

My closed loop ileo looks like an end ileo. It has 2 holes, but is round like an end. The end has only 1 hole.
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.

lifeinterrupted
Regular Member


Date Joined Mar 2011
Total Posts : 103
   Posted 4/10/2011 1:52 PM (GMT -6)   
Hi Tracy, thanks for the info my situation is a little different. I have ulcerative colitis but it's not active right now some how though I seem to have intermittent bowel movements all day they dont move down easily its very slow and often gets interrupted,no ryme or reason and I have had a colonoscopy, defecography, all anal manometry tests and a barium xray test i've also had a rectocele repair and my sigmoid removed. This all started right after giving birth to my second child, not very big either he was 6lbs 14oz almost a year and half and it has taken over my life since it started to say the least always in the bathroom can't take my kids anywhere and my 4yr old daughter said to me a couple of weka ago mommy you have to have a doctor fix you so we can go to the beach this summer so you can imagine how that hurt!!! A couple of doctors have kind of chalked it up to probably some kind of nerve damage of some sort no way to exactly test for that. So like I was sayin I don't want to chase the surgeries I don't want to have to keeping going in and recovering and just to end up with the same sensations! I've pretty much made up my mind but am scared of letting go of my physical image of my self but I hate the bathroom and want freedom from it!!!! Does this make sense my kids who are young 4 and 17mo are always waiting on mommy and my husband this has been hard our relationship as you can imagine never feeling up to anything. I want to stop struggling with this descision 100% it's like 90/10 and really need to find peace with this!!!!!!!!!!
Dee
dx with uc July '10
Current on going undiagnosed bowel disorder

Prov3:5,6

answers4me2
Veteran Member


Date Joined Dec 2008
Total Posts : 1325
   Posted 4/10/2011 6:58 PM (GMT -6)   
Dee, I totally understand the kid thing. I have 4 kids, 21, 18, 15, and 12. If I knew then what I know now, I would of had the ileostomy 10 years ago. I wasted that many years sitting on the toilet atleast.

What has your doctor recommended?

You must be young. I am 41. Not young, but not too old either.

My husband could care less about the bag and we still have great sex. My stoma has even farted in the middle of sex and we both just laughed. No big deal at all. I even empty my bag while he is in the bathroom with me. It is not like real poop at all and has very little or no odor, atleast that is how mine is. If I eat a food that makes the output smell, I use m9 drops and that takes care of any odor.

What is your biggest fear with having an ileo? I insisted on a temporary, loop ileostomy because I was so terrified I would absolutely hate having a bag. Now that I see that my quality of life is so improved, I have decided that spending the rest of my life with the bag is the way for me to go.
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.

lifeinterrupted
Regular Member


Date Joined Mar 2011
Total Posts : 103
   Posted 4/10/2011 8:57 PM (GMT -6)   
Tracy I'm 32 and the ileostomy being so permanent is what scares me there is no back up plan and I'm a big back up planner and working out, the hernia thing picking up my son and being concerned about that all the time but I know it would be a trade off for taking him to the park. I miss going on road trips, I hardly get asked to go out and do stuff anymore because everyone knows I can't and my clothes mainly my jeans, I like my skinny jeans and my other jeans there not super low I've never worn those kind they come under my belly button but they are fitted and I've read from other posts that I should be able to where them the other ladies on here say they do, I guess it's the unknown. I meet with the colorectal at the end of this month I'm trying to wrap my head around this before I go in to see him. I do know I won't have to worry about my colitis if I have my colon taken out. Sorry for the rambeling as u can tell my reasons are all over the place!!! ;-/
Dee
dx with uc July '10
Current on going undiagnosed bowel disorder

Prov3:5,6

Post Edited (lifeinterrupted) : 4/10/2011 9:00:36 PM (GMT-6)

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