Slow transit constipation and surgery

@donnacarp,

Thanks for sharing your help with the FODMAP diet. Though it is not a perfect solution to chronic constipation it really helps a lot towards better digestive health.

For those who might be interested in more information about the FODMAP eating plan, please take a look at Connect's discussion on this topic,
https://connect.mayoclinic.org/discussion/fodmap-eating-plan/
Here is a link from Mayo Clinic's website, https://www.mayoclinic.org/search/search-results?q=Fodmap.

Lastly, here is a Mayo Clinic Newsfeed and video about the FODMAP diet. Dr. Wang is a registered dietician at Mayo Clinic and provides some great information.
https://connect.mayoclinic.org/page/gastroenterology-and-gi-surgery/newsfeed-post/what-exactly-is-the-fodmap-diet-dr-wang-explains/

Hi all! I was just curious. To all those who have had a colectomy or any other bowel surgery, when did you realise it was necessary. Was it emergency surgery or that nothing else was working? And how bad was it before you went through with it?😕😕😕

Hello @nattyd77 and welcome to Mayo Clinic Connect. I understand you are looking for feedback based on other members' experiences regarding at which point surgery was considered.

As you will see, I did add your discussion to an existing conversation that was already started about slow transit constipation and surgery. This helps members to connect better with you and provide feedback. I'd like to invite @hopeful33250, @engelee, and @bcstew to share their insight.

If you're comfortable sharing, how long have you had symptoms/complications and what if any medication/special diet have you been using?

My first surgery was an emergency, and I ended up with a temporary colostomy for 6 months. Had terrible lower left abdominal pain and had terrible trouble going to the bathroom. Felt like trying to squeeze toothpaste out of a clogged toothpaste tube. Cat Scan showed air bubbles in my abdomen, indicated that the bowel was about to rupture. Reversal surgery was a scheduled surgery, but then had another blockage in small intestine which led to 3 surgery 10 days after the reversal. Surgery 4 was scheduled after diverticulitis and blockage came back. I started having that low, left side abdominal pain again and was really having trouble going to the bathroom again. I just knew..... ended up with Deloyer’s Procedure. Surgery 5 was scheduled and that was a scar revision in the area where they took the colostomy out. Surgery 4 pulled that incision/scar and it was uncomfortable. This all occurred within a 13 month time frame.

Hello @nattyd77,

You have probably already read the post by @thull where she describes her surgeries.

I also have slow transit constipation, but it is the result of previous surgeries of the small intestine (duodenal bulb). There are many things you can do which include drinking lots of non-caffeinated liquids (water is the best). Also, get a list of high fiber foods and try to eat as many of those as you can tolerate. There are certain exercises and abdominal massages that you can do. These can be taught to you by a Pelvic Floor Therapist. This type of Therapist can be found in most hospitals in PT departments.

Has surgery been suggested? If so, what type of surgery?

Hi Amanda. Thank you for your reply. I started getting constipated when I was about 22 years of age. I am 43 now. I had a colonoscopy after my 2 children were born (30 y.o.) and they couldn't complete it. I was then diagnosed with a redundant colon. At about that time I was also diagnosed with Bipolar Disorder and put on medication. Nothing further was done with my bowel up until about 5 years ago when I had a colon transit study which showed a slow transit bowel, which didn't surprise me at all since I could go up to 15 days without even a "pebble". Increased dose of S. Pelligrino but over time it was making me unbelievably nauseous. I put up with it until I had a hysterectomy and with all the adhesion's and endometriosis (I never knew I had it) they removed I thought it would make a difference but it didn't. I tried a few GI specialists and eventually found a Colo-rectal specialist. We redid the colonoscopy (good result), transit study (very slow) and anometry (rectal muscles are fine). So my doctor wants to do everything he can before taking my bowel. I already take docusate 200mg/daily and 4 sachets/daily of Movicol, and 12 days ago I started on prucalopine 2mg/daily (Resotrans or Motegrity). That has done nothing except one small movement which, in all honesty, happened when I increased my Movicol. I take a number of psych meds and I know they slow movement however my constipation started before my bipolar diagnosis and I have since found out my Grandmother also had this issue and her mother died of a paralytic illeus and twisted colon in her late thirties, so I am guessing she also lived with this. I have only been eating a self imposed soft or liquid diet and graze throughout the day so I have lost a bit of weight. I am just tired all the time. I see my specialist again next week. I live in country Australia and my specialist is 4 hours away.

Hi Thull, thank you for responding. Wow, you have really been through a lot! What was your mental health like through all of that? One thing that does worry me about surgery is that I may then continue having procedures or maybe it won't work at all. I am not an emergency (yet) but I am getting worse and I am only comfortable if I don't eat. Not a great quality of life really. So how are you now? Have things calmed down at all?

Best of luck. I I can't find anyone to help have gastroparesis slow gut motility. Feel so hopeless. I have had both my PCP and GI doctors blow me off with my symptoms. Oh It is all due to the brain gut connection. End of story! SO someone fix it.So i use this site for the gastroparesis diet sources and find my own regimine of laxatives because when I hadn't gone for 12 days very naseated the GI PA told me to take 2 milk of mag and essentially blew me off. I have been a nurse for 32 years so I do have a smidgen of knowledge.

Hi Teresa, thank you for your response.

Surgery has been mentioned but my specialist wants to do all he can before going down that road. I am taking prucalopine (Resotrans/Motegrity) in addition to my laxatives but it is proving unsuccessful. He has also mentioned a MACE & Cecostomy (I think that's right) and a colectomy but we haven't discussed it in depth yet. Most of my trouble seems to be in my transverse colon - everything stops there. Truly though, I apparently have a good 7 feet of extra bowel, so I have been told. I have plenty to take! He has also mentioned working alongside my psychiatrist to review my medication (I live with bipolar) since they also slow transit time. This makes me scared as I have been on those meds for 10 years and I have generally been stable.

As for water, I drink about 3 litres a day as well as a few cups of coffee. I don't eat anything much at all so coffee is the one thing I enjoy. I was raised eating high fibre foods but over time I have not been able to tolerate many. Vegetables and fruit is all I eat now in that department but I still cannot all and they are better cooked so I eat a lot of vegetable soup and stewed or pureed fruit. White rice, potato, eggs, and soft fish. Ice-cream and dairy deserts. And any fibre replacements like Metamucil have always caused a lot of pain even with copious amounts of water.

I am just sick and tired of feeling this way.

I used to be a nurse too! Actually, that is when I noticed any constipation was in my graduate year. Busy ward, no breaks, no time for the toilet! I generally don't say that I was a nurse to anyone because I found that they WOULDN'T tell me anything assuming I already knew. I worked in Burns not GI. But we always know enough to know when something isn't right. The most annoying comment I have had from one GI doc was "What do you want me to do? You don't have to use your bowels every day you know!" I am well aware, but I think 15 days without even a desire to go is really pushing it. I hope things get better for you @ouchgut20 .