Slow transit constipation and surgery

I saw a new colo-rectal surgeon who ordered the Sitz marker study as well as an X-ray defography. She had me do a colonoscopy prep a few days prior to the study so I was cleaned out before I had to start the period before I couldn’t take any of my meds. I had also
previously done a Smart Pill, but that only gives total transit time. She wanted to see if there was just one, specific spot in my colon where things slowed down or was it the entire colon.
I’ll admit, I was totally freaked about the defography. I had to do another prep, in a hotel room, no less. But it wasn’t nearly as bad as I’d imagined. And it was so fast. Other than drinking the barium and waiting the 20 minutes, the rest only took maybe 5 minutes or so. And it showed I don’t have pelvic floor dysfunction. Which means, when I decide I’m ready to go forward with surgery I can have a reconnection. No bag! The previous surgeon didn’t even bother to test me. Just assumed I had PFD and would need an ileostomy. So glad I got a second opinion!
I will tell you, in my experience, most doctors do not think much of a tortuous colon. Will tell you every woman with years of constipation has it from straining. A low fiber diet has been helpful to me.

@sallyw133

How good that you got that second opinion, and the doctor did the appropriate testing! Being your own advocate for health care is so important and you've proved the value of taking charge of your health. This is a wonderful example of being proactive.

When will you make a decision regarding surgery?

Right now I’m having pretty good results with the medication but have already had to increase the Miralax. This always seems to happen. Something will work for a while and soon my body seems to somehow adjust and it will quit working, I will go as long as I can before taking that HUGE leap. But once the constipation symptoms again dictate my life as before, that will be my deciding factor to move forward.

Morning Teresa ,
My GP has referred me to a gastroenterologist first , l have to go private and still it’s a few weeks wait for an appointment….
New prescription to try in the meantime ( Fybogel ) because he say it works differently in that it stretches the colon open ?
My question was ,if the colon is bunched up into a small space and full of bends , where is it able to stretch to 🤷‍♀️ but I’m trying it …..
My biggest worry moving forward…. If I end up in a care home or with dementia? In my eighties say ?
No one else could manage my bowels …….🥹
Only recently I read of a case exactly in those circumstances where a poor lady died of feacal compact…..in a care home 🥲
This is why I don’t want to have to rely on laxatives anymore ….apart from all the other negatives that arise from this abnormality….
Best for now Sheila

Ditto ! I have exactly the same problem.
Something works for a while and then it just quits !

Fybogel, just an un-pros opinion, is a high fiber drink that will draw fluid into your colon to help to bulk up the stool. So if you have hard, dry stool, it may help. Be sure to drink a lot of fluids while taking this or it will have the opposite effect.

I'm not sure what kind of diet you've been following, @sallyw133, but I've recently discovered that a low-residue eating plan has worked better for me than any high-fiber diet.

I've had three surgeries of the upper digestive tract so the cause of my constipation may be different than yours, but I read about the low-residue diet and thought it would worth a try. My thought was, "nothing ventured, nothing gained."

Do you follow any particular type of eating plan?

@sheilagreen

Constipation is certainly a problem that comes to us all during the aging process, and for some of us even earlier in life. Having family members and friends who can act as your patient advocate, if you are not able to is important.

Do you have patient advocates who could act on your behalf if you were incapable of speaking for yourself?

Low-residue and low-fiber I believe are pretty similar. I had a few sessions with the dietician at Cleveland Clinic. It was her advice for a tortuous/redundant colon as fiber tends to have a more difficult time making it’s way through all the bends and twists. I eat mostly chicken and seafood, as red meat is more fibrous. Limit fresh fruit and veggies, really hard this time of year!, except in smoothies. Salads are especially bad. You can cook anything. We grill everything, even fruit. The idea is to break up the fibers. Fiber laxatives are a no. If I have meat, I really chew it! No seeds, nuts, popcorn. Anything hard to
digest, including berries. Other things like cereals, crackers, snacks, look on box. No more than 2 mg of fiber per serving. I think that’s it. I followed this rigidly for months. Now I cheat a little more. I do think it helps.

I have had chronic constipation for more years than I can remember. I have seen dozens of GI docs and had every test that there is for my specific condition. I have been on Trulance which worked well for 4 years and then suddenly stopped working. I tried Linzess, motegrity, amitiza all with horrible side effects. I would get terrible bowel spasms and couldn't get comfortable and literally out of my mine with pain. Fast forward to where I am at today. My GI doc prescribed Ibsrella 50. I was always a coffee drinker, not excessive, just one cup in the morning. I decided to give up coffee or anything with caffiene completely and things started to move every day and no side effects. I believe is that the coffee was making my muscles tight and my whole body jittery which made the constipation worse. I am doing meditation every day, and it helps me so much...relaxed mind, relaxed body. I hope this helps someone.