# colon resection for constipation???



## jodys (Apr 8, 2002)

Hi everyone, I just came back from my uro gynecologist who is sending me on to a colon surgeon next week. It seems that I have rectal prolapse and perineal descent that is causing this severe constipation. I need to have my sigmoid colon removed and he said that this would help significantly with having no more constipation. I am interested in hearing from any of you who have had this done. Needless to say I am scared out of my mind!!!!!!! I had a hysterectomy a year ago for uterine prolapse. Boy, things just keep getting better and better. Thanks for any help any of you can give me. Jody


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## jodys (Apr 8, 2002)

ANYONE?????????


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## Feisty (Aug 14, 2000)

Jodys,Hi! A question. Does the Doc definitely mean *all* of your sigmoid colon (that would mean all of your large intestine)? If he does, then, yes, that would "cure" your constipation problem. But one thing to keep in mind is the fact that since you would only have your small intestines left, you would have very mushy to runny stool all of the time and you would probably "go" more often during the day.If he meant removing only some of the sigmoid colon (lg. intestine), then you may not have as many problems with constipation, but you would still have to be careful.I had a sigmoid resection 3 years ago, due to a large piece of the lg. intestine falling down and putting pressure on the pelvic floor---pushing the vagina and rectum off to the side. The piece that had fallen down (I had a hysterectomy 10 years ago) was full of diverticulosis and laying in an accordian shape fashion, which explained a lot of my on again/off again pooping schedule and some of the uncontrollable stooling. It had to be removed.The pelvic floor was very weak also and the sphincter muscle had only 1/2" of functioning muscle left---the rest had been damaged thru the years of constipation and giving birth to two children.Phase # 1: The sigmoid resection (bad part was removed), the vagina and rectum were straightened and tacked back in place--called a Vaginalpexy and a Rectopexy. And the intestines were tacked back up where they should be. I had to heal for 3 months.Phase # 2: The Levator muscles on the pelvic floor were tightened--called a Levatorplasty (like putting tucks or pleats in something) and the little bit of good sphincter muscle remaining was tightened in a snail type fashion--called a Sphincteroplasty. That took about 4 months to completely heal. It wasn't a "fun" operation, that's for sure, but it bought me 5 to 10 "good" years before I will need a Colostomy. And that's only because I have such a little bit of good sphincter muscle remaining. Hope that helps.







E-mail me if you would like.KarenYou're in Wisconsin? Me, too? Where is your Surgeon located? If you are close to Green Bay, I have a wonderful Surgeon to recommend to you. You would love him and he really knows his stuff. He's very kind, considerate and patient. And so is his staff of nurses.


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## flux (Dec 13, 1998)

> quoteoes the Doc definitely mean all of your sigmoid colon (that would mean all of your large intestine)?


No, the sigmoid is just a small portion of the large intestine. Presumably the problem is definable on x-ray where it can be pinpointed to a location and that is not a motility disorder.


> quotene thing to keep in mind is the fact that since you would only have your small intestines left, you would have very mushy to runny stool all of the time and you would probably "go" more often during the day.


Removing the whole large intestine would cure constipation from disordered motility, of course. However, some people who have it are also constipated in the small intestine as well and that could still be a problem.


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## Feisty (Aug 14, 2000)

You are wrong Flux.I know of noone who has constipation problems when they only have the small intestine left.The large intestines main function is to absorb back into the body the fluids from the foods and drink that are ingested and digested. That's what firms up the waste as it passes through to be voided out.The small intestine only has minimal ability to absorb some fluids---most are past on out of the body as stool. Hence, the more liquidy stool that is passed.


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## Feisty (Aug 14, 2000)

Flux,Unless you mean that the person has a serious "motility" problem; hence, the foods do not digest properly or pass through properly.


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## Feisty (Aug 14, 2000)

Flux,You are right about the sigmoid being a section of the large intestine. Sorry.Sigmoid section is a piece of large intestine between the rectum and the upper part of the large intestine.Did I get that description right, Flux? Correct me if I'm wrong.In my case, approximately 18" to 20" had to be removed. But let's remembered---the average person has what? About 5 ft. or more of large intestine. Am I right, Flux?


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## hiprise (Nov 19, 2002)

I've known two people who had some or almost all of their large intestines removed and I see a lot of the backs of their heads as they run to the bathroom. One had acute constipation and now has no problems since removing the colon, just a lot of loss stools. The other one has Crohn's and she is still very sick but no constipation. If I thought removing the colon would stop my IBS, I would do it in a second. I have not heard anything about this being a way to "cure" IBS yet.


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## flux (Dec 13, 1998)

> quote:I know of noone who has constipation problems when they only have the small intestine left.





> quote:Unless you mean that the person has a serious "motility" problem; hence, the foods do not digest properly or pass through properly.


Well, of course for a serious motility problem. That is what this topic is about, no? Because otherwise, unless you managed to borrow the alienï¿½s tracking device in Steven Spielbergï¿½s Taken and implant it in the relatively few people on Earth who have severe constipation, how could you possibly know the people who in whom this problem has or has not continued after receiving colectomy for it? It turns out that about a third of them suffer after the surgery. This is mainly because the disease also affects the small intestine.


> quote:The small intestine only has minimal ability to absorb some fluids


Big swing and miss. The small intestine normally absorbs *way more* fluid than the large intestine. The large intestine absorbs relatively little because it has already been absorbed by the small intestine. You are probably just fooled because you donï¿½t get see just how much fluid you begin with.


> quote:Sigmoid section is a piece of large intestine between the rectum and the upper part of the large intestine.


1 for 3.


> quote:the average person has what? About 5 ft. or more of large intestine


2 for 4. Getting better, I guess


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## Feisty (Aug 14, 2000)

Flux,I think you should spend an hour with my sons Gastroenterologist at Mayo Clinic. You are wrong about the samll intestine absorbing way more liquid than the large.My son has an ileostomy. His stool is runny. He has all of his small intestine, but does not have any large intestine at all. He must be sure to drnk far more liquids, especially wter in one day than you or I do. His Gastro has explained the function of the small intestine to us many times. His stool is runny BECAUSE the small intestine only absorbs SOME of the fluids that the body passes through. The small intestines main function is to absorb the nurtrients from the foods. It's the large intestines job to absorb the rest of the fluids and expel the waste product. Slow motility is not the only reason why a person has constipation problems, Flux. I am not going to spend my energy arguing back and forth with you. Why don't you make an appointment with a Gastroenterologist and let him/her explain it to you? Time spent wisely.


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## flux (Dec 13, 1998)

> quote:You are wrong about the samll intestine absorbing way more liquid than the large.












> quote:intestine only absorbs SOME of the fluids that the body passes through.


No, the small intestine *most* of the fluid that passes through the gut. The volume of fluid exiting the small intestine is just a *small* portion of the total.


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## flux (Dec 13, 1998)

> quote:the small intestine most of the fluid that passes through the gut.


Oops..that should say...the small intestine *absorbs* most of the fluid that passes through the gut. I wouldn't want to make a mistake, now


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## Feisty (Aug 14, 2000)

JodyS,I apologize for the arguing back and forth with Flux. He tends to be quite a pain in the "arsh" to most of us. And he thinks he is always right, about everything; when, in fact, he doesn't suffer from any of these things pertaining to this BB. He loves to argue and make everyone else look small. Just ignore him. Like I said, he's a pain in the "arsh".







Flux, to prove you wrong, I phoned my sons Gastro today (we had several questions of our own that needed answering also) and asked him about the small intestine----and guess what?! YOU ARE WRONG. The small intestine absorbs SOME of the fluids and, of course, most of the nutrients from the foods that are ingested. The sole purpose of the large intestine is to absorb back into the body the fluids that were not absorbed in the small intestine and to expel the waste.By far, the large intestine absorbs most of the fluids the body has taken in. Naturally, there are some fluids that are absorbed by the small intestine, but things move through the small intestine at a faster rate than through the large intestine. Therefore, those people who have to have all of their large intestines removed for one reason or another, have to be sure to have 2 to 3 times more fluid intake daily then if they had their large intestines. Otherwise, they become dehydrated very fast.I wrote this info down as Dr. J. Perrault was giving it to me and I repeated it back to him, so I have the correct info. If you want to take this argument up with him, by all means give him a call and talk to him. He's at the Mayo Clinic in Rochester, Minnesota.JodyS......Once again I apologize. Flux will probably post something back in response, so just ignore him.







Keep me post on your appointment next week with the surgeon, okay?


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## flux (Dec 13, 1998)

> quote:The small intestine absorbs SOME of the fluids and, of course,most of the nutrients from the foods that are ingested. The solepurpose of the large intestine is to absorb back into the body thefluids that were not absorbed in the small intestine and to expel thewaste.By far, the large intestine absorbs most of the fluids the body hastaken in. Naturally, there are some fluids that are absorbed by thesmall intestine, but things move through the small intestine at afaster rate than through the large intestine.


Perhaps the doctor misspoke or you misunderstood him or perhaps hejust really has his small and large intestine backward, butregardless, the above statements are







*The small intestine absorbs MOST of the fluid in the gut.*The large intestine absorbs most of the fluid that the smallintestine does not absorb.The small intestine normally absorbs about *four times* what the large intestine absorbs.


> quote:those people who have to have all of their large intestinesremoved for one reason or another, have to be sure to have 2 to 3times more fluid intake daily then if they had their largeintestines. Otherwise, they become dehydrated very fast.


This is basically correct, but it doesnï¿½t say anything but how much the small intestine absorbsrelative to the large intestine.


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## Guest (Jan 26, 2003)

http://arbl.cvmbs.colostate.edu/hbooks/pat...sorb_water.html


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## Feisty (Aug 14, 2000)

I could have sworn I wrote down exactly what the Gastro said, but obviously I must have written it wrong. I do apologize for that.4WillieC---I appreciate the "subtle" way you presented the facts. Thank you!Flux---Perhaps you can learn something here from 4WillieC. Do you think you are so much better than everyone else that you feel you need to shove it in our faces? (I'm talking about the blinking "wrong" neon signs that you feel you need to post in order to make your point---it really isn't necessary.) Why not try a more subtle approach?! But then, you wouldn't know what that is, now would you Flux!?







JodyS----Again I apologize for the "twist" your thread has taken. It certainly wasn't my intention.


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## Guest (Jan 26, 2003)

As I see it, we are all in this together..to learn and to share information in a supportive way...anything else defeats and demeans the purpose of this site...willie


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## Sues (Dec 5, 2001)

Thanks 4WillieC, Fiesty, and Jody, I never thought about having my colon removed as a cure to my horrible IBS-C until recently. Just came from appt with gastro doc. I came out of there with "if we don't find anything from these next tests, the only thing left to cure your constipation, gas and pain is to remove your colon......... He is done the procedure before and said with a smile on his face.."oh well you look good with your clothes on so what does it matter if you have a colostomy bag... I am willing to try anything to get fixed, but I wasn't prepared for that... So now I have another reason to try, try and try again to find something to fix this before I go under the knife for this drastic procedure..***Even though he assured me that the patients he has done this to all are living active lives..Something I haven't done in a while..Oh well,keeping on keeping on.. Sue


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## Guest (Jan 27, 2003)

Hmmm...it is really hard to believe that they are serious about doing a total colectomy just to cure constipation. I can see removing maybe a foot or so...but not the whole thing.Last Spring I had a foot of my colon removed as part of a polypectomy...I had a stage 1 cancer in there as it turned out...the neat thing besides catching the cancer so early was that I havnt had any constipation at all since the procedure...I had experienced constipation most all of my life prior to the operation.


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## Feisty (Aug 14, 2000)

I'm with you, 4WillieC. It does seem like a drastic procedure, but perhaps there is more to Sues constipation problem and that is why the Doc is considering this.I, also will need a Colostomy in a few years, but it is because I lack enough good Sphincter muscle. I don't have much control at all. Lots of accidents. It's better when I can keep things formed, but if I have a bout of looser stool for any reason, I can never make it to the bathroom in time---even if it's only 5 ft. away. I also lack "feeling" due to nerve damage, so a lot of the time, I don't feel much of an "urge" until it's too late. My Doc told me that when I loose the little bit of control he has given me back from the surgery 3 years ago, I will have to have the Colostomy.I do know of quite a few people who have Colostomies, and they are all active people and they say they don't mind it at all because they have their "Life back". And for a lot of people who need Colostomies, they can usually wear something similar to a "large bandaid" over their stoma when they are really active, like for swimming, etc. Some of them can go all day like that. Then they attach their pouch for nighttime and in the morning they irrigate to get things moving and then they are "on their way again. I know it's different for everyone, though. Different circumstances for different people.


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## Guest (Jan 27, 2003)

Wow, I can sure understand having such a procedure in a case like yours...if the bowel is truly functional but just causes discomfort, I surely can't see removing it....but when it creates a situation like you have..well, you do what you have to.


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## Sues (Dec 5, 2001)

Hi, I felt this was a drastic statement for the doc to make also. I asked him why he would want to remove the total colon and he said I have a motility problem. He said " it is not due to any disease that he could see, no strictures, no other causes. Again, when he told me, the only other option he had was colectomy, you could have picked me up off the floor.







But I am going to do the "ring" test on Tuesday. I beleive this is to test the lenght of time it takes for my bowels to move. He said there would be some more tests and he would tell me as we went along. I asked him "what if you took my colon and the problem was in my small intestine?"..He just assured me that the small intestine would be throughly checked to make sure the problem wasn't there also before we proceede to drastic measures... and without me saying a word to him..I most assurily would go for a second opinion. Thanks, Sue


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## mikeralph (Jan 27, 2003)

fiesty kept asking for the abuse. it is quite apparant that flux knows what he is talking about, yet fiesty kept subjecting herself by presenting one inaccuracy after the next. give it a rest fiesty


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## Feisty (Aug 14, 2000)

Sue,Keep in touch and let us know how your tests go. Your Doc sounds like he is doing everything he can to rule out other causes and to be sure the small intestine is not involved. That is good. He sounds very thorough. I also think it is an excellent idea of yours to get a second opinion. They're talking major surgery and major readjustments in your life if you do need this. The more you can understand the whys the better you will feel about it all and it will help you make the right decision for you.Would you explain the tests as you have them? There are a lot of people here who may never have heard of the tests, how they are done, why, and the results.Good luck to you and please keep us posted.


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## Feisty (Aug 14, 2000)

resting........


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## Sues (Dec 5, 2001)

Fiesty, I will most certainly keep the board posted on the tests as I have them done.... One very good thing about this doc is that he said "your constipation, and pain, etc is not in your head..you don't appear to be someone who is needing a shink". He didn't act like I was lying when I told him that I can go without a BM for weeks. He did not pass off the pain that I described as normal or the amounts of gas. He was first doc to go farther than the upper and lower GI's. After 30 plus yrs of this disease finally someone who validates everything I describe as real and very common in patients with IBS. Oh yes one other statement he made...I asked why all the other docs I have been to, acted puzzled when I described the symptoms, why the first thing that I was told was to stop obsessing about my colon.... He smiled and told me to "stop obsessing about the past and the docs in the past, lets concentrate on future.." So even though I know alot more docs, especially gastros, should be more informed because of the "harm" they do I will let this be the (hopefully) last statement on the "Lazy Incompetant Doctors that are still out there practicing medicine... WHEW. OK done..Sue


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## Guest (Jan 27, 2003)

mikeralph...with all due respect, this is NOT a place to get "abused" by anyone...


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## jodys (Apr 8, 2002)

Hi everyone, I just wanted to thank all of you for your replies to my colon resection post. I will be having about 12 inches out due to rectal prolapse and perineal descent. My Dr. seems to think that this will really take care of the constipation issue because you cant "GO" when your colon is not in the right position. Makes sense to me. I will let you all know what the surgeon has to say on wednesday morning. Jody


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## flux (Dec 13, 1998)

> quote:it is really hard to believe that they are serious about doing a total colectomy just to cure constipation. I can see removing maybe a foot or so...but not the whole thing.


Why would they would leave some behind? If you had cancer in the whole thing, would you leave some behind?


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## Nikki (Jul 11, 2000)

Feisty just got her facts confsued. There was no malice there. I agree, Flux knows what he is talking about (some of the time







) BUt he could present it in a less offensive way (love ya flux).


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## Guest (Jan 28, 2003)

Flux..logic being that if the entire length of colon was not diseased, but mearly an adjunct to a reduction in motility, only a small amount would need to be removed...intention being to "do no harm". If, however, there was positive pathology indicating that the entire colon was suspect or indicated as diseased, it would then be logical to remove it all. In the case of cancer, of course, if ALL of the colon was shown to be involved, it would indicate the need for total colectomy. In the case stated, we have seen no evidence presented where this is the case...only a lack of motility.... So it would seem that total colectomy to cure constipation would be sort of like performing a lobotomy for a case of dementia.


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## GailSusan (Dec 23, 2000)

Does anyone here remember Jody's original question?


> quote: I am interested in hearing from any of you who have had this done.


So, has anyone besides Feisty had this done? Speak up or else pipe down.


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## Guest (Jan 30, 2003)

Did you read my post? Though I didnt have my surgery for the purpose of relieving or preventing constipation...I did indeed have a colon resection..open surgery...I have a 9 inch scar to prove it...so I would say I qualified as experienced enough to say I wouldnt have this surgery unless it was to save your life....which is why I had it.


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## Sues (Dec 5, 2001)

Ok, I went to first test,,but it was my mistake, this was not the ring test. I had small bowel xrays with barium(ummmmmmm yummy)not! The day before starting at 6; I had to drink all total 13 glasses of water at specified intervals and only having clear broth for meals, at 5:30 pm drank Magnesium Carbonate, Citric Acid, and Potassium Citrate (instructions on packet said product generaly produces BM within 30 min to 6 hrs) then two hrs later I took 4 bisacodyl tablets (inst state tablets usually produce BM within 6 - 12 hrs) and a suppository in the morning, (inst state generaly produce BM within 15 to 60 minutes. Well gang, no BM anytime yesterday. This morning, a big nothing after suppositories, wound up taking enema, with very small output. Then went on to test this morning. I have still not had a BM.. **concerning the removing of total colon because of lack of motility*** Doc stated I have no peristalic movement..not lazy,not asleep, not slow motility, none.. He went on to explain peritaslic movement and I said I knew what that meant...he said, ok then You have none... When I took all the meds yesterday and drank all that water and; nothing.... it scared me, because I began to understand why he said the "whole colon" had to be removed... So here we are......I have wanted for 30 yrs to find out what the hell was wrong with me, why the pain,gas,headaches,abdominal distention lethargy. Doc said in first consulation severe constipation means fecal matter just sitting there fermenting, bacteria forming,gas, all of it affects whole my total health...... The only part that he didn't have an answer for was "Why" why did my colon decide to stop at age 16....? Sue


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## Feisty (Aug 14, 2000)

Oh, gosh, Sue. ((((((














)))))) Thanks for checking in. You must feel so miserable right now with not being able to go. And now all that barium is in there, too. Barium can cause extreme constipation if it isn't expelled. What does your Doc recommend to clean the intestines out?What is the next step? Have you ever had your intestines biopsied? I know exactly what you mean by the waste sitting in there and fermenting and then the bacteria builds and produces more bad bacteria then good. You must feel so miserable right now. My son was like that. The only difference is that he was born with Hirschsprung's Disease (the nerves in sections of the colon were dead, so the bowel couldn't produce the "milking action" it needed to push the waste through and expel it). He was a very sick baby. At 6 weeks they did emergency surgery and gave him a colostomy. At 15 months he had "supposedly" the corrective surgery, but his colon never functioned properly.He was so sick for so long. The first 7 years of his life he was in the hospital more than he was out. I finally told the Doc to teach me what I had to do to clean him out so that he didn't have to "live" at the hospital. For the next 7 years I irrigated him, gave him suppositories, etc. and still he kept getting sicker and sicker. He wasn't growing. The poor kid tried hard to keep up with everything at school and to be like a "normal" kid, but he was so darn sick.At age 14, he became deathly ill, spent 4 months at Mayo Clinic---most of it in Intensive Care. They biopsied and tested over and over again. He developed bacterial Endocarditis (bacterial infection in the heart----he was also born with congenital heart defects and had numerous corrective surgeries for that when he was age 3 and 5). After 4 tense weeks of treating him for the bacterial Endocarditis, they decided as a last ditch effort to treat him with Prednisone to see if it would stop the bacteria. It bought him a few weeks, anyway. They had to operate and remove the remaining large intestine and gave him an ileostomy. It's the only thing that saved his life. He missed his whole Freshman year of high school. To this day, he is only one of three children in the world with this same thing. They don't know what kind of bad bacteria destroyed the intestines. It was so bad it wouldn't culture. Mayo Clinic has not had another case like it and the other two boys are from Europe. His Doc said he had never, ever seen such a bad intestine as his.I do hope you can get to the bottom of this. Take care and keep checking in.


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## flux (Dec 13, 1998)

> quote:being that if the entire length of colon was not diseased, but mearly an adjunct to a reduction in motility, only a small amount would need to be removed...intention being to "do no harm".


Usually, the whole colon is believed to be affected and it is not uncommon for the whole intestine to be affected. However, there is some inference going on since the tests don't have resolution or means to examine all parts. Colonic manometry generally looks at the last half or third of the colon, for example.


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## Guest (Jan 30, 2003)

flux--that sounds plausible and interesting.Sues - wow, that is really interesting....sounds like an unusual phenomenon. I too would like to know why all of a sudden, at age 16, the natural waves stopped....keep us posted on the progress.willie


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## 16629 (Jun 7, 2005)

Sues- You are my twin sister!







I really feel your pain. I have been seeing dr's since I was 12 because of chronic idiopathic constipation & lethargy. What did they ever do for you?? Please post back I am soooo interested to hear the rest of your story.


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