Slow transit constipation and surgery

Has anyone had a colectomy or subtotal colectomy for slow transit constipation or redundant colon? I have had slow transit constipation for years and was referred for surgery 13 years ago. I never had the surgery because I was scared and because I wanted to start a family before having major surgery. I have my family but I am still living with this issue and struggle daily. For reference, my transit/marker studies show a transit time Of over 200 hours. And my reports list a redundant descending and sigmoid colon.

I don’t seems to have hard/dry stool. It’s more so that they never reach the rectum. So all of the meds that increase water, just make me feel like I am a walking water balloon. And fiber just creates gas that I cannot pass.

I’ve been on every medicine for this and am worried that i may need to seriously consider surgery.

I’m really looking for feedback from those who have this condition and have considered surgery or have had surgery.

Hi @kmc1124 and welcome to Mayo Clinic Connect. As you will see, I did add your discussion to a conversation that was already started about slow transit constipation and surgery. This helps members to connect better on similar issues. How devastating that you have to struggle with this on a daily basis, but I am glad you were able to hold off and raise a family.
I'd like to invite @hopeful33250, @engelee, and @bcstew to share their insight.

@kmc1124, what medication have you already tried and what type of diet regimen are you currently on to combat some of the symptoms?

Thank you @amandaburnett. In terms of medication, I have taken Zelnorm, Amitiza, Linzess, Miralax, and, most recently, Trulance. All of those medications increase liquid in the gut which I find extremely uncomfortable and all caused liquid BM which I could not always evacuate without a suppository. I found better luck with over the counter citrucel, stool softener sand glycerin suppositories. However, that regimen was never predictable and required hours in the bathroom. It also has resulted in an ulcer on the rectum due to suppositories. Things seem to move through my colon until they get to the left side. I have constant fullness and a sagging/pulling feeling there until I have a BM. I also have gas that seems to get stuck and stop there, which is incredibly painful. (I’ve had a normal defacography test- so if the stool/gas does get to the rectum, I am capable of evacuating it).

In terms of diet, I have tried gluten free and FODMAP. I also avoid dairy because I am lactose intolerant. I haven’t found those diets helpful. The only foods that really seem to make the issue noticeable worse are beans, whole grains, and dairy.

@kmc1124 - I am so sorry to hear what you are going through. I know constipation, but not like yours. I have motility disorder, but not like you. I know what you mean to feel like a balloon.
It sounds as if your major problem is with the left descending colon. Have you had biopsies from that area? There could be abnormal nerve supply. Some children are born like that and will have to have the abnormal part removed.
Let’s hope members with your experience will find your post and offer some information.

Hello @kmc1124

As @astaingegerdm posted earlier I am sorry to hear about what you are going through. I too, have a motility disorder and have slow transit constipation. Mine is not as severe as yours, but I do understand what it is like to think before eating and to try to get as much fiber and liquids as possible with everything I eat. It's a constant task to keep foods, liquids and fiber supplements in balance. I'm glad that OTC fiber products are helping.

You mentioned transit/marker studies. I'm not familiar with that. Could you explain a little more about that?

@astaingegerdm, thank you. Nobody had ever suggested biopsy of my colon but that makes sense, especially since I’ve had this problem since childhood.

@hopeful33250 For the transit study, you swallow capsules filled with tiny radiopaque markers. These markers can be seen on x-ray so that a doctor can track them through your digestive system to see how long it takes for them to come out the other end. You have to quit any laxatives while doing this to get a true picture of the transit time. This can be uncomfortable. For me, they ended the study after 10 days and allowed me to take medicines since the markers had not left. This was years ago. I think they end them after 5 days now, regardless of how many have passed. If you haven’t, I would definitely suggest doing the study. It will give you and your doctor a better idea of what is going on and where things are slow.

After reading your post I was wondering if you have any neurological problems such as walking, balance, etc.?

Also, wondering if you have ever been referred to a pelvic floor therapist. At one time, I thought this type of therapy was only available for female urinary problems, but it also is helpful for constipation problems. Just a thought.

Hi @hopeful33250. I have no neurological issues and I’m quite active. I have not seen a pelvic floor specialist. I will bring that up with my doctor. Thanks!

I have the chronic constipation also that is miserable. I take Miralax every day which helps and I eat almost all fruits and vegetables and potato chips when I have to have something. Gluten free, lactose free also. I first had an "attack" like someone punched me in the stomach many years ago and I just now am understanding it is a combination of things. The FODMAP diet is the best solution so far. I am really careful about not eating anything that is a "no" on that list. On top of it is onions and garlic, for example. Beans. This is my solution so far. Surgery won't help I know because it is a dietary and genetic thing. My mother had a bloated belly as long as I can remember and she was very thin. She ate mostly vegetables but I would see her eating raw onions. She was always gassy. My sister is newly diagnosed with celiac and it is known to be hereditary. That is my information thus far.