Redundant / Tortuous Colon

Posted by onaquest @onaquest, Nov 7, 2018

Hello. Anyone else out there that has a redundant/ tortured colon? I was diagnosed with this a few years ago. I’m usually ok, but if I get constipated, I get sick for a week or two. Last year my gastroenterologist referred me to a surgeon for urgent surgery to remove some of my colon. The surgeon I ended up seeing (not on the recommended list by my gastro doc due to others not available for a long time) said he believed I could live with the redundant colon if I followed a low FODMAP diet. I tried the diet religiously, scientifically (I’m a scientist), and I found it’s not the food I eat that causes these bouts of constipation. The only item I’ve found that might cause the bouts is coffee every day. An occasional coffee seems fine. What has helped me stay regular in a big way is Benefiber (or any pure wheat dextrose generic) three times per day. Lots of fluid.

My gastro doc was upset with the surgeon and said I’d regret not having the surgery. He fears I will end up in an emergency situation. I have searched the Mayo site and don’t find anything about redundant/ tortured colon. Are any Mayo docs doing research or treat this condition? Anyone else suffer from this too?
Thank you! -Jayne

Is this the same condition as Diverticulitis?

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Hello. Sorry to hear about your diagnosed condition. Although I have not been diagnosed with your diagnosis I have had constipation problems, even had to go to the Emergency Room recently.
A seemingly simple suggestion is to make sure by way of a daily routine of drinking water so that your minimum is 40-50 ozs.–or more–EVERY day. It is extremely important for Crohn's Disease–which I have had since birth–since water passes through more with such IBDs. I tried other osmotic laxatives at my family doctor's suggestion but find it gives me a very significant rash so I have discontinued any such osmotic products (e.g., MiraLAX). Although water is contained in fruit, soup, coffee, many products, etc., there is nothing as good as straight water even if you want to say "in addition to" the other amounts of water from indirect sources. I recommend using a daily Reminder with an alert system to which you can cumulatively insert the on-going quantity total of water intake as the day progresses. Using time periods, for example, such as 8AM-1PM, 1PM-6PM, & 6PM-11PM where you can see how you are doing throughout the day, otherwise you may wind up drinking a large amount late in the day which is not the most beneficial way as compared to watching it in an on-going manner. The same water bottle or container of which you know the quantity is best rather then making many entries of amounts from various containers. It should be an easy-to-estimate by eye quantity measuring event (just take a guess at the amount) so it is not burdensome and therefore inclined to be resistant to getting it accomplished. Good luck.

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@carcar

Is this the same condition as Diverticulitis?

Jump to this post

No it is not. Redundant and tortured colon means you have extra colon (redundant) and twisted (tortured). I do have some diverticulosis, but I haven’t had diverticulitis.

Liked by courtneyt

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@flguy

Hello. Sorry to hear about your diagnosed condition. Although I have not been diagnosed with your diagnosis I have had constipation problems, even had to go to the Emergency Room recently.
A seemingly simple suggestion is to make sure by way of a daily routine of drinking water so that your minimum is 40-50 ozs.–or more–EVERY day. It is extremely important for Crohn's Disease–which I have had since birth–since water passes through more with such IBDs. I tried other osmotic laxatives at my family doctor's suggestion but find it gives me a very significant rash so I have discontinued any such osmotic products (e.g., MiraLAX). Although water is contained in fruit, soup, coffee, many products, etc., there is nothing as good as straight water even if you want to say "in addition to" the other amounts of water from indirect sources. I recommend using a daily Reminder with an alert system to which you can cumulatively insert the on-going quantity total of water intake as the day progresses. Using time periods, for example, such as 8AM-1PM, 1PM-6PM, & 6PM-11PM where you can see how you are doing throughout the day, otherwise you may wind up drinking a large amount late in the day which is not the most beneficial way as compared to watching it in an on-going manner. The same water bottle or container of which you know the quantity is best rather then making many entries of amounts from various containers. It should be an easy-to-estimate by eye quantity measuring event (just take a guess at the amount) so it is not burdensome and therefore inclined to be resistant to getting it accomplished. Good luck.

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Good ideas. I do push fluids, and I do notice when I don’t, I suffer. Alarms are a good idea for people like us. Thank you.

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Hi @onaquest @flguy @carcar,

A redundant colon is an abnormally long colon, especially in the final section (called descending colon). A redundant colon also has additional loops or twists. Other names for a redundant colon include tortuous colon or elongated colon. https://www.healthline.com/health/redundant-colon
I’m tagging @darlia and @rsinger22 who've written about redundant colon, and they may be able to share their experiences.

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I have this condition and used to have problems with constipation, bloating and abdominal discomfort. I tried taking a Metamucil-type (generic) fiber powder in water each day and it's made all the difference! I have regular bowel movements and feel greet. My GI doc has me undergo a colonoscopy every 18 months, as he's found a number of polyps and I have a family history of colon cancer.

Liked by courtneyt

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I had a colonoscopy today. I read the report and one finding was a redundant colon, but no polyps or twisting this time. I looked it up and found redundant meant a colon that was longer than normal for the body, so it takes more time to do the colonoscopy. Further research lead to the importance of self care to prevent impaction and twisting. Next, I read your great posted question. It made me wonder why the I had no poly this time. But I still have bouts of intense pain, and the other symptoms you mentioned. Mine csn over something as simple as a 3 hour car trip and eating in a resteraunt.
My history includes emergency room visits with the symptoms you described. My story includes concurrent Afib incident.
Through my gassy, boated, and sometimes severe pained adulthood, here is some of the advice I have received: My GP said take fiber. Eat whole grains. However I was alergic to over the counter fiber stuff, and grain sensitive. Ground flaxseed helps. My gyneccologist (of all people) prescribed a good multi probiotic. This practically solved the problem for a few years, most of the time. (Must take pill every time I ate.) My health coach sold me a natural ground walnut, barley greens fiber product that was helpful, but I became allergic to it and it caused sinus problems. The mistake I made was to smell it. My Naturopath sold me on digestive enzymes a year ago, that helped. And they are quite expensive. Then, last fall my medical doctor who is trained in Mexico City and is an Internist advised that I go to nutrition meetings his asistant leads for free. It turned out to be a Whole plant diet. This means plant food only. No meat, milk, no animal product of any kind, no eggs, processed oil, not even olive oil, no processed sugar or fake sugar. No fake vegetarian food laden with salt. 6 to 8 glasses of water a day. No other drinks, unless soaking my own seeds. Manufactured almond milk has salt. There has been testimonies of colons healed that once were polyp prone and now are polyp free. Hmmm, I did not have a single polyp this time. Raw nuts and seeds are ok! I do not think whole seeds are good for polyps though. Following that diet has helped the inflammatory other problems I have too. In a pinch I have used simethacone. Probably not good in the long run. As I age, (with only one kidney doing the job of two) I have reduced ability to process excess fluids. Chewing my food very well and not overeating, moving during the day helps, too.
My thoughts are for you to be healed and that you find relief. I thank you for the details you shared. Key words for me is faith and self-discipline to follow the diet consistently. I just retired from teaching special education. So I am hopeful the less stress, and extra time will help me be closer to using my food as the main medicine/ fuel. Being out of pain and free from the gas and bloating is motivating. Sorry this is so long, I hope my journey gives hope and encouragement to fellow people with redundant colons. May they even untwist and depolyp (THANK YOU SURGEONS) And May we all listen and follow our Great Physician.

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Welcome to Connect, @karena65 and @teresagiselle.

I thought you might be interested in reading this journal article, which offers an in-depth look at redundant colon: https://www.wjgnet.com/1948-9366/full/v10/i2/6.htm

@karena65, as you said, "Key words for me is faith and self-discipline…” So often we tend to equate self-discipline with deprivation, giving up things or sacrificing joy. I thought I’d share an interesting take on self-discipline – something I had read a while ago – where the author encourages readers to associate self-discipline with inner strength, resilience and not giving IN rather than giving UP.

@teresagiselle, I’m glad to know that the fiber powder has helped you find some relief. Since you mentioned family history of colon cancer, I encourage you to also take a look at the conversations taking place in the Colorectal Cancer group on Connect: https://connect.mayoclinic.org/group/colorectal-cancer/
Besides colonoscopy, has your GI recommended any other therapy or surveillance steps?

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I have had IBS-C issues for as long as I can remember, but about 7 years ago they became chronic to the point where I can go a week (or more) without any bowel movement if I'm not taking laxatives. I have had dozens of tests, and the only useful information I have received so far was from a visit to the Mayo clinic in Rochester a little over a year ago, where they discovered I have a "highly tortuous colon" and could barely complete a colonoscopy. The recommendations at that time included increasing my fiber, which doesn't help at all. Other tests have also revealed that I have a partially prolapsed lower colon, but not to the point where surgery would be a good idea. Taking fiber supplements makes me extremely bloated and becomes unbelievably painful, and Miralax makes me sick to my stomach and doesn't do too much to move things along. I've tried different things with my diet, and right now, I mostly eat white rice (brown is too hard to digest), vegetables, and small amounts of protein. I feel like i'm going a little crazy trying different things like eliminating dairy or other food restrictions, but I don't know what else to do. I completely avoid gluten. I've been very active my whole life…have run marathons and done lots of strength training and different types of endurance races, but recently I don't have the energy for the types of training that these events require. @karena65 Do you have a resource that you can share on the whole plant diet? Is there any other advice anyone can share?

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I had the same diagnosis re long, redundant , twisty colon and had awful constipation for my entire life. Colonoscopies were a nightmare back in the day when you were lucky to get a Valium. I am 62. 2 1/2 years ago I had a bowel obstruction from a cecal volulous and had to undergo emergency surgery (right hemicolectomy) to remove all of the ascending colon and then some. About 2 feet. It's been a long, hard recovery but with a good doctor, I've done pretty well with the bowel problems. Have been constipated twice since surgery. My colon had a rotated cecum– rare, congenital bowel malformation that no test can detect unless you obstruct. The surgery itself is an awful recovery but, I'm grateful to be alive since the mortality rate for a cecal volvulus is high. I don't know if the rotated cecum has anything to do with the colon being extra long and twisty.

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Hello Jayne,

I was diagnosed with a tortuous colon, earlier this year,
after many tests (to rule other things out), and *finally* a colonoscopy.
My doctor did not use the phrase "redundant".

My GI doctor recommended a low FODMAP diet,
five months before the procedure, and strongly reminded me after the colonoscopy,
that it was important to continue the diet.
So I might have been on the low FODMAP diet for a bit longer than you.

The worst part of the tortuous colon for me
was the pain part, as food travels through the gut.
That would keep me up at night, affecting sleep
so the next day's focus and productivity were affected.
I've lost weeks to this issue, too.
Also, with pain, if doctors suspect a mystery GI issue,
you have to be *very* careful with pain relievers.
(Ex. aspirin can worsen ulcers, etc. The Mayo clinic already has an article on this)
This is really important, until they can figure out the issue.

I *believe* the condition caused both sharp pains and dull aches,
for several years, which made diagnosis by my general practioner difficult.
Ultrasounds came up negative, but I think all doctors should do this,
to rule out other things. The pain wasn't that bad, at first, so I just tried
my best to ignore it.
As the pain got worse, and was making me miss a lot of work, in late 2018,
this was when I started really trying to get an answer why the pain was there.
I also had mild constipation, most days, in those months, but it doesn't sound like it was at the OP's level.

***The single most important thing my GI doctor has done,
was encourage me to see a psychiatrist.***
This was more important than even the diagnosis!

Because the psychiatrist prescribed an earlier type of drug,
called Amitriptyline. It's an antidepressant,
but it also attacks the enteric nervous system (the ENS, it's in your gut).
The first night I took it, I was knocked out for about 12 hours, (on a 25mg dose).
Later, my psychiatrist told me this was a *strong* reaction, to such a low dosage.
but the next morning, the pain level was halved (4-6/10 => 0-3/10), and more importantly,
the *areas* of pain shrunk down to ~70-90% of the original pain area.
Basically, I could function again, for most days of the week.
Enteric nervous system and amitriptyline, seriously, look them up.

I believe the best treatments could be related to
what caused the tortuous colon in the first place.
I have suffered from depression, anxiety, sleep issues, for many years,
but at this point, it's like the chicken and the egg.
Was the chronic pain the stressor to help cause the mental health and sleep issues
or was it the other way around?
I don't know, but I know Amitriptyline helped me get my life back.

Again, my constipation doesn't sound as bad as what you are going through, Jayne,
but I think with constipation, if the muscles in the gut
randomly tighten the wrong way around one (of our too many) bends in the colon,
this could cause hard-to-predict constipation or uneven absorption of water.
In theory, helping the nerves *around* the gut, from overfiring,
may help avoid as many muscles over-tightening, which could help reduce the chance
of constipation around the bends of a tortuous colon.
BUT I AM NOT A DOCTOR.

For the low FODMAP diet, or diet in general,
(or what happens after I put stuff in my mouth),
here are my thoughts:

—It is more important to eat *something* than to religiously follow such a
restrictive diet.
(Ex. Garlic and onions are not allowed in the diet,
but they are used in small concentrations in many seasonings in many foods).

So I'll eat food with *tiny* concentrations of unallowed ingredients,
not on the low FODMAP diet, in at least one meal of the day, as a cheat.
When I first started following this diet, I found I wasn't eating *enough*,
because I was so afraid of what I could *not* eat…
New food (with fiber) and water can help push the old food through,
so make sure you are eating enough to begin with. But still remember moderation.
My grandma was kinda right…

It's much better to think positively, about what you *can* eat, than what you can't.
So you can proactively find *more* meals to eat, for a more diverse diet.
To show you, I will first list what I regularly eat/drink, before the nono's:

——Fresh baby spinach leaves daily (*small* amount of leaves as a stabilizer, if necessary)
===>>> regulates amount of fiber (remember, not too little, not too much).
Keeping a paper towel inside the plastic box helps them last longer.
Also, the "fresh" part makes it easier to inspect the food, for bad leaves.
I bet some folks use kale, the same way. The dark leafy greens are healthy,
but some of the most difficult vegetables to clean effectively (i.e. remove pesticides or excess fertilizer (fertilizer which could still be poop)).

——Small daily amount of almonds or peanuts
===>>> I think *chewing* tough foods more thoroughly can help avoid pain, later on. Mechanical digesion, right?
But to be fair, I think some folks on the low FODMAP diet avoid nuts entirely, just to be careful. For me,
they are just too damn healthy to quit.

——Meat. A lot of meat is allowed on the low FODMAP diet.
I like baking fish or grilling chicken. No breading, of course, with this diet.

——Eggs

——Pedialyte or some electrolyte solution. Frequently.
===>>> I can't stress this one enough. Drinking water seemed to be the only
easy way to avoid pain, for me, for months. A colon with extra bends means
that water can get absorbed *too quickly* by the colon, causing portions of the stool
to harden earlier on in the tract. This is bad. Try to drink plenty of water
*with* the meal, not all at once, before or after the meal.
Sometimes, I sip a watered-down broth, just to be safe.
Beef broth has enough protein, for it to be worth it.

It is important to note, in most cases, as long as you don't have high blood pressure (hypertension),
it is safer to consume *too* much salt, than too little,
within reason (less than 7g / day). Healthcare Triage (on youtube) has at least two videos about salt. This doctor and his researchers are thorough.
The above opinion of salt, specifically sodium, is still contended.

But "Today I Found Out" (who does excellent research, especially if Daven
Hiskey is involved) agrees with the Healthcare Triage doctor, Dr. Aaron Carroll,
about salt in their youtube video, as well.
***Reading research studies is the best way to be sure though.

Suffice it too say, I listened to everyone saying:
"Drink more water" and
"Eat less salt"
But I think following these two pieces of common advice,
lowered the salt concentrations in my body, to dangerously low levels.

Find a brand you like, (for me, it was Pedialyte) then try to get the
powdered form of it, to hopefully save money.
I think the correct understanding of salt/water intake
in the GI tract is a critical point for people who have a tortuous colon,
but I don't want to get too far off topic.
Just make sure the brand has some *potassium* in it, not just sodium,
and that the solution is not *too* sugary.

Here's what I had to limit:
——Although many cheeses are allowed on the low FODMAP diet,
I had to reduce cheese consumption in order to help prevent
constipation.
——Although potatoes are allowed, I shouldn't eat too many potato *chips*.
It's convenient, but the grease, the lack of nutrition or fiber doesn't help.
——Greasy foods, in general. I use some olive oil in baking,
but honestly, that yellow/orange grease is the stuff I'm limiting.
It helps avoid the most common issue (acid reflux) in the *upper* GI tract,
but I think it also helps me in the intestines, too.
——Sugary foods / Acidic foods. (Ex. Soda, orange juice, etc.)
High fructose corn syrup is in a lot of things, but you gotta avoid it
in the low FODMAP diet.
——Apple juice is in a lot of other juices! I drink a *small* amount of
cranberry juice, just to get some vitamin C naturally, but to get it, without apple juice
and low sugar, in the US, I have to go for a diet Oceanspray cranberry juice
——Absolutely no Belvita breakfast bars. For some reason,
I consistently had discomfort, no matter how well I chew them…
Once I ate at least 3 or 4 of the packets (12-16 bars), and I was on the floor
in pain, unable to walk. Lots of sugar from syrups, and hard grains…

*Walking* and light physcial activity helps!
It really does.

This post was probably too late to help with your decision, Jayne,
but I hope it helps someone else later.

The low FODMAP diet is so complex, with the diversity of foods on/off the list and the *amount* of a certain type of food allowed,
that I am probably going to have to develop a meal plan soon, to reduce stress and for my safety.

Thanks,
Jack

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I was just diagnosed after a painful colonoscopy. Unfortunately, the doctor didn’t stop to talk aboutit so I am doing my own research. For the last several years, since my last coloscopy, I have had episodes where I cannot relieve myself then it feels like I am going to pass out, followed by a drop in blood pressure with cold sweats. These episodes take up to 30 minutes to finish and I have to lie down afterward. I am wondering if they are related. I certainly appreciate everyone’s experience and input.

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Welcome to Connect, @amyvb @jack222 and @lesliedenny. I’d like to invite @tracy430 @thull @bjs4984 @onaquest to this discussion as they might have more insights about your symptoms. You can read about their experiences with constipation in these discussions:

– Colon Resection for Diverticulitis and Chronic Constipation https://connect.mayoclinic.org/discussion/colon-resection-for-diverticulitis-and-chronic-constipation/
– chronic constipation https://connect.mayoclinic.org/discussion/redundant-tortured-colon/

I also found this one published study about "The correlation between diverticulosis and redundant colon” which might interest you. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635100/

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@amyvb

I have had IBS-C issues for as long as I can remember, but about 7 years ago they became chronic to the point where I can go a week (or more) without any bowel movement if I'm not taking laxatives. I have had dozens of tests, and the only useful information I have received so far was from a visit to the Mayo clinic in Rochester a little over a year ago, where they discovered I have a "highly tortuous colon" and could barely complete a colonoscopy. The recommendations at that time included increasing my fiber, which doesn't help at all. Other tests have also revealed that I have a partially prolapsed lower colon, but not to the point where surgery would be a good idea. Taking fiber supplements makes me extremely bloated and becomes unbelievably painful, and Miralax makes me sick to my stomach and doesn't do too much to move things along. I've tried different things with my diet, and right now, I mostly eat white rice (brown is too hard to digest), vegetables, and small amounts of protein. I feel like i'm going a little crazy trying different things like eliminating dairy or other food restrictions, but I don't know what else to do. I completely avoid gluten. I've been very active my whole life…have run marathons and done lots of strength training and different types of endurance races, but recently I don't have the energy for the types of training that these events require. @karena65 Do you have a resource that you can share on the whole plant diet? Is there any other advice anyone can share?

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I recently had colon resection for diverticulitis. Since then, I have no urge to have a bowel movement unless I take Linzess and Milk of Magnesia. My surgeon disregards my concerns and I'm terrified that if these things stop working, I'm going to end up in the ER. I've lost a lot of weight and I didn't have a lot to lose. I drink a lot of water. I try adding more fruits and vegetables. Nothing works. I have zero motility. At times I'll get bloated to the point that I don't want to eat and need to take Gas-X, but honestly, this is no way to live. This surgery was supposed to "give me my life back". It hasn't.

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@tracy430

I recently had colon resection for diverticulitis. Since then, I have no urge to have a bowel movement unless I take Linzess and Milk of Magnesia. My surgeon disregards my concerns and I'm terrified that if these things stop working, I'm going to end up in the ER. I've lost a lot of weight and I didn't have a lot to lose. I drink a lot of water. I try adding more fruits and vegetables. Nothing works. I have zero motility. At times I'll get bloated to the point that I don't want to eat and need to take Gas-X, but honestly, this is no way to live. This surgery was supposed to "give me my life back". It hasn't.

Jump to this post

How long ago was your resection? It can take a long time to heal from this surgery. What part of the bowel was removed and how much? I'm so sorry you are going through this. I had a resection (see my story above) and it took a good 18 months to get some sort of management going on. I've taken magnesium every day 800-1000mg for chronic constipation for 25 years. My constipation is now under control since my surgery 2 1/2 years ago.

Liked by graceandpeace

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