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Gastroenterology (Expert Forum)
questions
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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questions
by lilwe, Aug 15, 2003 12:00AM
Could you tell me what this means please anorectal junction is at the level of the ischial tuberosities and changes to approximately 3cm below the tuberosities during defecation. the patient was able to empty almost all of the barium, there was some residual barium in a small rectocele. no evidense of prolapse and no evidene of obstruction. also moderate fecal retention throughout a somewhat redundant nondilated colon, no small bowel loop dilatation to suggest obstruction. Just want to know what this exactly means. I have had many pelvic surgeries, lots of adhesions also. i am on a high fiber diet now and drinking lots of fluids and take fiber supplements. i was straining to move bowels, lots of discomfort also in the lower back with flank discomfort. it feels as though something is pulling or stretching at times really bad, especially feel it before bowel movements and feeling of inflammation after. my doc said due to the surgeries i really need to retone my bowel. so i am trying, but my lower abs are swollen and the pain is bad. they also say my pelvic muscles need toned, i am too tight. could some of the muscles psoas be pressing on my colon if they are out of sink. i heard kegal exercises are good for the bowel also. also my sacro iliac is out of whack and am seeing a physical massage therapist targeting these muscles will that be helpful, weird though, after she did a deep massage on where the pain was i felt like i had to move my bowels right away and did. i had a plain xray of my spine yesterday and she said on the left side(where all the pain is) was just loaded with gas, i really don't pass hardly any gas. could i have entrapped gas from multiple laparascopic surgeries? at times i feel as though something is pushing on my spine and out my side, usual before bowel movements. any suggesions??
Doctor's Answer
by Kevin Pho, MD, Aug 17, 2003 12:00AM
, Aug 17, 2003 12:00AM
The report you describe sounds like a barium enema. I would think that it would be fairly non-specific, except for the moderate fecal retention.
For further evaluation, you may want to inquire about a colonoscopy, but it seems that there is a colonic motility problem.
One consideration to treat the fecal retention would be biofeedback. It can correct inappropriate contraction of the pelvic floor muscles and external anal sphincter during defecation in patients with pelvic floor dyssynergia.
There are various medications that can increase colonic motility, such as reglan, cisapride (since withdrawn in the US), and misoprostol.
If medications are not working, then surgical options should then be considered to help with the retention.
Regarding the gas, it would be possible that your multiple surgeries could increase the sensation of gas. You may want to discuss some of the colonic motility medications, or medications to reduce the amount of gas in your diet.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
For further evaluation, you may want to inquire about a colonoscopy, but it seems that there is a colonic motility problem.
One consideration to treat the fecal retention would be biofeedback. It can correct inappropriate contraction of the pelvic floor muscles and external anal sphincter during defecation in patients with pelvic floor dyssynergia.
There are various medications that can increase colonic motility, such as reglan, cisapride (since withdrawn in the US), and misoprostol.
If medications are not working, then surgical options should then be considered to help with the retention.
Regarding the gas, it would be possible that your multiple surgeries could increase the sensation of gas. You may want to discuss some of the colonic motility medications, or medications to reduce the amount of gas in your diet.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments (1)
by lilwe, Aug 17, 2003 12:00AM
Thank you for your comment. They told me to be on a high fiber diet, so I don't know how I wouldn't have the gas. I really am not passing gas, it just shows up. It's as though I can feel the fecal matter in my system and when and where it is getting stuck. Would a colonoscopy move the fecal matter and gas out of there? Even though they don't show obstruction, I have had many surgeries where they removed adhesions,,, I don't think xray would show adhesions, so that might be a possibility. I also feel nauseous at times. I have this pulling sensation. I had surgery and my utero ligament and vaginal cuff were shortened and sewn to each othe, my gyno says this might be causing the pain in my sacro iliac area, but what is weird is that I also feel the discomfort in my sacro area when I move my bowel, any suggestions?
