# Questions re. lopsided abdomen w/hx of abdominal surgeries



## dianajune (Aug 3, 2009)

I have a complicated medical history that includes multiple abdominal surgeries, inc. a total abdominal hysterectomy (open, for a borderline ovarian cancer) and two emergency hernia repairs. The hysterectomy was in '04, the first hernia surgery (along with a bowel resection) in '09 and the most recent hernia surgery last October.My history of mixed IBS has been ongoing for over 20 years. I'll be 50 this year.My IBS was diagnosed after a period of extreme stress in my life, and lower g.i. bleeding led to this diagnosis. I've had several colonoscopies, sigmoidoscopies and barium enemas. It's been awhile since the last time I had any of those tests, and because I'm almost 50, it wouldn't surprise me if my primary care m.d. recommends I have a colonoscopy.On to my questions - my abdomen has always been lopsided, with the left side being slightly larger than the right. I bloat easy because of my IBS. After my surgery last fall, my gut is more lopsided than ever. A couple of months after that operation, I saw my surgeon again because I thought I had a hernia recurrence. He said he believed that the contents of my abdomen have shifted over to the left side, hence my very lopsided appearance.I was told it would take up to a year and a half to heal from my surgery, like with the other ones. Well, it's been about 10 months since my last surgery. I'm going through another period of stress which is making my IBS worse. I read a news report out of the U.K. that claims patients with IBS can have considerable bloating during the day, almost doubling their abdominal girth. Is this true?Can IBS be making my lopsidedness worse, or could it be due to the hernias being on the left side, or both? All three incisions from the operations I mentioned are so close, they are indistinguishable.I have rectal bleeding from time to time as my backside gets raw (sorry about the tmi) and I have a history of hemorrhoids. Can hemorrhoids come back? Just a couple of days ago I had bleeding first thing in the morning but it cleared up almost immediately. I was sore the day before because I had to go so much. (again, sorry about the tmi).The last time I posted about my gut issues, I mentioned that the stress of all this was taxing on me and someone suggested I find a mental health professional to assist me. Believe me, I tried to do that, but I live in a rural area and specialists are hard to find up here. Being on a fixed income (I'm on disability) doesn't help as copays add up.Has anyone here had to cope with their IBS being aggravated by abdominal surgeries or vice-versa? If so, how did you cope? Have any of you had to deal with lopsided bellys, and what do you make of this bleeding? At no time have I noticed black stools, nor am I losing weight (even though I'm trying) or having a fever.I would appreciate some feedback. Thanks.


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## Kathleen M. (Nov 16, 1999)

Hemorrhoids can come and go, but if it is more than you usually get when they flare up, or more frequently than usual it may be worth getting it looked at.Not sure about the lopsided, but IBS can cause substantial bloating and if the insides are a bit lopsided I would think that could be more obvious with the bloating. That and depending on how things have scarred or what may be tighter after the surgical repairs. Can you tolerate shapeware? That may help keep things a bit more even than it wants to be on its own.


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## dianajune (Aug 3, 2009)

Kathleen,I can go for a long period of time w/o any symptoms of hemorrhoids, then I will have a flareup. I was diagnosed with them about ten years ago but wasn't sure if they can go away on their own or come back. Would having them in the past make it more likely to have them again?I have a history of adhesions, and since my hernias were both on the left, and because I have diastasis recti, it wouldn't surprise me if IBS is making my lopsided gut look worse. It's hard to tell if it's bigger now than after my surgery. Maybe not, because I have a tendency to worry alot about my symptoms (which probably makes my stomach look worse than it is) and I can get into clothes now that I couldn't get into immediately after surgery.What is "shapeware?" Would this be similar to a girdle? I'm willing to give anything a try.Thanks for listening!Diana


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## Kathleen M. (Nov 16, 1999)

My sense is they can calm down and become asymptomatic but they don't go completely away so can come back later on. I think once you have them those blood vessels are always going to be prone to them later on.Yep, Shapewear is the new girdle, usually a lighter weight more modern fabric and not as restrictive. Some IBSers can't take the pressure of something tight on the abdomen, but if you can it may help balance things out.Spanx is the major brand, but lots of other companies make the same sort of thing. I would go for something that isn't too tight but just provides a bit of support. With the bloating you don't want it as tight as possible.


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## AIRPLANE (Mar 15, 2004)

I have had several surgeries myself- one with a large bikini line incision and the others were done laparoscopically. I too feel somewhat lopsided but figure that it is due to adhesions. I definitely think that the restrictions adhesions cause- the pain, pulling, etc. can contribute a lot to IBS symptoms and make them more difficult to manage. And then the IBS can in turn create more discomfort.With me, I feel the adhesions on my right side more in the front and on the left side the problem is more toward the back rectal/vaginal/thigh/buttock area where one gynecologist said I probably had vaginal cuff adhesions from my hysterectomy but she didn't believe that they could cause me pain or problems. I sometimes feel like I get an abscess there as well. Sometimes my jeans don't fit real good because it feels like I need a bit more room in the left buttock area than I need on the right side because of the way the adhesions pull things down. My incomplete evacuation issue also seems to be on the left side where things get caught up as well- both in the rectum and in the sigmoid area so even when I feel like I'm done I'm not because things get stuck in the sigmoid even when I am able to empty the rectum. I was once told I had a small rectocele but many doctors claim they can't see it but the diagnosis was made after a defecography test several years ago. I haven't had hemorrhoids for awhile but I imagine I get fissures and an over-all rectal/anal irritation for which I do use ointments and suppositories because it gets too uncomfortable if I don't.I have also heard that adhesions- especially in the pelvic area- can cause pelvic congestion syndrome for which I've asked to be tested but never have been able to because my ankles don't appear swollen even though my legs feel VERY swollen! Pelvic congestion can cause varicose veins and also things like hemorrhoids because they share the same veins.Adhesions seem to be a very underappreciated problem although I do realize that they are very difficult to treat successfully. Still, it irks me when doctors dismiss them as a potential problem and won't consider them as part of the picture. I go to a massage therapist which helps some and also will be visiting a new physical therapist that was recommended by my doctor this week. These therapists seem to be the only people who are willing to acknowledge the pain and problems that adhesions can cause but it may take visiting several different ones to find the most effective treatment. One that I went to spent the majority of the session telling me to breathe and gave me postural exercises that didn't help at all for which she accused me of non-compliance. In cases like that you move to the next physical therapist!


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## rudibear (Jul 28, 2012)

dianajune said:


> Kathleen,I can go for a long period of time w/o any symptoms of hemorrhoids, then I will have a flareup. I was diagnosed with them about ten years ago but wasn't sure if they can go away on their own or come back. Would having them in the past make it more likely to have them again?I have a history of adhesions, and since my hernias were both on the left, and because I have diastasis recti, it wouldn't surprise me if IBS is making my lopsided gut look worse. It's hard to tell if it's bigger now than after my surgery. Maybe not, because I have a tendency to worry alot about my symptoms (which probably makes my stomach look worse than it is) and I can get into clothes now that I couldn't get into immediately after surgery.What is "shapeware?" Would this be similar to a girdle? I'm willing to give anything a try.Thanks for listening!Diana


I had a hysterectomy in January. They also removed a 2.5" tumor near my left ovary; it was benign. IBS like problems started occurring in April. Docs figure it is IBS. They write off adhesions. I think mainly because they are really hard to treat. The only way to be sure you have them is to have more surgery, which creates more adhesions. Most of my abdominal discomfort is on the left side. I also have hemorrhoids. Have had them since my 20's. Am 60 now. IBS has really made them flare up. Will see a surgeon on the 19th to see if they should be removed. Not sure I want to go through that process, but if it makes things more comfortable.... It also seems possible that hemorrhoids could make it more difficult to pass stool, and may even contribute to incomplete evacuation feelings. Not sure about all that though. Am just speculating. Its hard not to worry about your symptoms when they are always bothering you.


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## harmoiny (Jan 3, 2012)

rudibear said:


> I had a hysterectomy in January. They also removed a 2.5" tumor near my left ovary; it was benign. IBS like problems started occurring in April. Docs figure it is IBS. They write off adhesions. I think mainly because they are really hard to treat. The only way to be sure you have them is to have more surgery, which creates more adhesions. Most of my abdominal discomfort is on the left side. I also have hemorrhoids. Have had them since my 20's. Am 60 now. IBS has really made them flare up. Will see a surgeon on the 19th to see if they should be removed. Not sure I want to go through that process, but if it makes things more comfortable.... It also seems possible that hemorrhoids could make it more difficult to pass stool, and may even contribute to incomplete evacuation feelings. Not sure about all that though. Am just speculating. Its hard not to worry about your symptoms when they are always bothering you.


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## harmoiny (Jan 3, 2012)

Diana,I'm sorry you have been through so much. I, too, have been though a lot. I did not have a hysterectomy. However, in 1997, I had a resection of my sigmoid colon and in 2009 an incisional hernia removed. Cut vertically over the same scar. Recently, I asked my daughter if she can remember a time that I wasn't sick since the mid-'90's? Her reply was "No"! I have had several diagnosis over the years. I would have died if I had not had those operations. However, had my medical team listened to me consistently telling them where the pain was (lower left side of ab). For a year+ I was being tested for everything but diverticulitis! When I finally couldn't take the pain any longer, I went to the ER, well thank God I was admitted even though the admitting doctor said that only thing he could think of was the "appendix" Duh! That's on the right side. He threw that one at me as he was clock watching to get off his shift.. Sometimes u just gotta lol







In fact, I did almost die. But that was from what should have been a malpractice suit. My surgeon went on Christmas holiday and left me on self-administered morphine for at least 5 days! I too had a "glorious" holiday pushing that button whenever I felt like it. When he got back he abruptly took me off it. Four hours later, OMG. Nurses just let me suffer all night long. My total system had shut down and I ended up on stomach pump for a couple of days. But God is good. Over the years since then, I have seen every type of Dr. You name it, I been there. I guess it's been about 10 yrs or so that my "colitis" was re-named IBS. I was totally confused; yes I admit, I have the symptoms of IBS. It took a long time for me to even figure out what is this thing they call IBS? Where did that name come from? This past year, thanks to this IBS group and other research, I finally got to the bottom of it (I guess). Just found a new doctor and he believes I have colitis. Yeah! That's half the battle right there. My belly is also lopsided. I noticed it again recently since I lost over 20lbs. I even know what you are going through with hemorrhoids. I had mine removed say 6 yrs ago. Best thing I could have done for myself. I must tell you: It's a "vicious" procedure for recovery but well worth it. If you decide to get it done, make sure you tell the surgeons team to make sure you don't wake "IN PAIN". Words cannot express what THAT felt like immediately after. Once the pain meds kicked in, it wasn't too bad. It took about a month or so to completely recover always making sure to keep that area clean. Oh and get the donut pillow. It does help. In regards to adhesions, some years ago, I did have a specialist that admitted that they are a large part of the problem. He also told me that I "may" just have to live with it for the rest of my life. Seems like he was right. In Oct, I'll be 60 yrs old, My "Jubilee". And I have the nerve to be named after a Queen. Hah! Now that's a real joke







Can't even plan a thing cause I never know how I'll feel from day to day. For me, "food is the enemy"! For the past year or so, I developed a fear of eating and that's not good because I also have diabetes. My phobia must be OK w/ my system.. all blood tests came out "great". Go figure!Yes, it's frustrating; but I'm more frustrated always defending/explaining to my family why I can't come out to play! You'd think they would have "got it" by now (since 1996). Duh! They are supportive just don't understand or is it denial?I wish you well. Hope my story helps give you some comfort and understanding in your battles. Keep the faith! And try to have a sense of humor when you can!







harmoiny


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## harmoiny (Jan 3, 2012)

AIRPLANE said:


> I have had several surgeries myself- one with a large bikini line incision and the others were done laparoscopically. I too feel somewhat lopsided but figure that it is due to adhesions. I definitely think that the restrictions adhesions cause- the pain, pulling, etc. can contribute a lot to IBS symptoms and make them more difficult to manage. And then the IBS can in turn create more discomfort.With me, I feel the adhesions on my right side more in the front and on the left side the problem is more toward the back rectal/vaginal/thigh/buttock area where one gynecologist said I probably had vaginal cuff adhesions from my hysterectomy but she didn't believe that they could cause me pain or problems. I sometimes feel like I get an abscess there as well. Sometimes my jeans don't fit real good because it feels like I need a bit more room in the left buttock area than I need on the right side because of the way the adhesions pull things down. My incomplete evacuation issue also seems to be on the left side where things get caught up as well- both in the rectum and in the sigmoid area so even when I feel like I'm done I'm not because things get stuck in the sigmoid even when I am able to empty the rectum. I was once told I had a small rectocele but many doctors claim they can't see it but the diagnosis was made after a defecography test several years ago. I haven't had hemorrhoids for awhile but I imagine I get fissures and an over-all rectal/anal irritation for which I do use ointments and suppositories because it gets too uncomfortable if I don't.I have also heard that adhesions- especially in the pelvic area- can cause pelvic congestion syndrome for which I've asked to be tested but never have been able to because my ankles don't appear swollen even though my legs feel VERY swollen! Pelvic congestion can cause varicose veins and also things like hemorrhoids because they share the same veins.Adhesions seem to be a very underappreciated problem although I do realize that they are very difficult to treat successfully. Still, it irks me when doctors dismiss them as a potential problem and won't consider them as part of the picture. I go to a massage therapist which helps some and also will be visiting a new physical therapist that was recommended by my doctor this week. These therapists seem to be the only people who are willing to acknowledge the pain and problems that adhesions can cause but it may take visiting several different ones to find the most effective treatment. One that I went to spent the majority of the session telling me to breathe and gave me postural exercises that didn't help at all for which she accused me of non-compliance. In cases like that you move to the next physical therapist!


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## harmoiny (Jan 3, 2012)

PS Diane:Here's a copy and paste article I located in my file regarding adhesions. Sorry I thought you were the one addressing hemmoroids too! A fellow IBS sufferer told me that Pro-Biotics have been helping her. Align is supposed to be the best for IBS cause it has the good bacteria w/ the "B" strain.Abdominal AdhesionsInformation adapted from the National Digestive Diseases Information Clearinghouse, NIH Publication No. 09-5037, January 2009.Share What are abdominal adhesions?Abdominal adhesions are bands of tissue that form between abdominal tissues and organs. Normally, internal tissues and organs have slippery surfaces, which allow them to shift easily as the body moves. Adhesions cause tissues and organs to stick together.The intestines are part of the digestive system. Abdominal adhesions can cause an intestinal obstruction.Although most adhesions cause no symptoms or problems, others cause chronic abdominal or pelvic pain. Adhesions are also a major cause of intestinal obstruction and female infertility.What causes abdominal adhesions?Abdominal surgery is the most frequent cause of abdominal adhesions. Almost everyone who undergoes abdominal surgery develops adhesions; however, the risk is greater after operations on the lower abdomen and pelvis, including bowel and gynecological surgeries. Adhesions can become larger and tighter as time passes, causing problems years after surgery.Surgery-induced causes of abdominal adhesions include•	tissue incisions, especially those involving internal organs•	the handling of internal organs•	the drying out of internal organs and tissues•	contact of internal tissues with foreign materials, such as gauze, surgical gloves, and stitches•	blood or blood clots that were not rinsed out during surgeryA less common cause of abdominal adhesions is inflammation from sources not related to surgery, including•	appendicitis—in particular, appendix rupture•	radiation treatment for cancer•	gynecological infections•	abdominal infectionsRarely, abdominal adhesions form without apparent cause.How can abdominal adhesions cause intestinal obstruction?Abdominal adhesions can kink, twist, or pull the intestines out of place, causing an intestinal obstruction. An intestinal obstruction partially or completely restricts the movement of food or stool through the intestines. A complete intestinal obstruction is life threatening and requires immediate medical attention and often surgery.How can abdominal adhesions cause female infertility?Abdominal adhesions cause female infertility by preventing fertilized eggs from reaching the uterus, where fetal development takes place. Adhesions can kink, twist, or pull out of place the fallopian tubes, which carry eggs from the ovaries—where eggs are stored and released—to the uterus.What are the symptoms of abdominal adhesions?Although most abdominal adhesions go unnoticed, the most common symptom is chronic abdominal or pelvic pain. The pain often mimics that of other conditions, including appendicitis, endometriosis, and diverticulitis.What are the symptoms of an intestinal obstruction?Symptoms of an intestinal obstruction include•	severe abdominal pain or cramping•	vomiting•	bloating•	loud bowel sounds•	swelling of the abdomen•	inability to pass gas•	constipationA person with these symptoms should seek medical attention immediately.How are abdominal adhesions and intestinal obstructions diagnosed?No tests are available to diagnose adhesions, and adhesions cannot be seen through imaging techniques such as x-rays or ultrasound. Most adhesions are found during exploratory surgery. An intestinal obstruction, however, can be seen through abdominal x-rays, barium contrast studies—also called a lower GI series—and computerized tomography.How are abdominal adhesions and intestinal obstructions treated?Treatment for abdominal adhesions is usually not necessary, as most do not cause problems. Surgery is currently the only way to break adhesions that cause pain, intestinal obstruction, or fertility problems. More surgery, however, carries the risk of additional adhesions and is avoided when possible.A complete intestinal obstruction usually requires immediate surgery. A partial obstruction can sometimes be relieved with a liquid or low-residue diet. A low-residue diet is high in dairy products, low in fiber, and more easily broken down into smaller particles by the digestive system.Can abdominal adhesions be prevented?Abdominal adhesions are difficult to prevent; however, surgical technique can minimize adhesions.Laparoscopic surgery avoids opening up the abdomen with a large incision. Instead, the abdomen is inflated with gas while special surgical tools and a video camera are threaded through a few, small abdominal incisions. Inflating the abdomen gives the surgeon room to operate.If a large abdominal incision is required, a special film-like material (Seprafilm) can be inserted between organs or between the organs and the abdominal incision at the end of surgery. The film-like material, which looks similar to wax paper, is absorbed by the body in about a week.Other steps during surgery to reduce adhesion formation include using starch and latex-free gloves, handling tissues and organs gently, shortening surgery time, and not allowing tissues to dry out.Did This Article Help You?IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders.Our original content is authored specifically for IFFGD readers, in response to your questions and concerns.If you found this article helpful, please consider supporting IFFGD with a small tax-deductable donation. Do you have a topic you’d like to see addressed? Please send us an email with your suggestion.Last modified on January 3, 2012 at 09:28:16 AM


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## dianajune (Aug 3, 2009)

My thanks to all who responded! Kathleen: I'll look for the shapewear & will probably find a good deal online. I might not be able to wear them when I have a flareup, but this sounds like a good idea.Airplane: I didn't know about pelvic congestion syndrome until you told me about it. I'm not sure that I've got this now, but when I was diagnosed w/hemorrhoids, it was prior to the hysterectomy. Many of the symptoms listed in Wikipedia's article plagued me prior to my operation in '04, but so far I haven't been diagnosed with it. Pelvic pain is still a problem for me periodically, which I will address with my doctor the next time I see her. As for massage therapy & pt, I didn't know they helped with adhesions. I just stopped seeing a physical therapist who was helping me with back and neck pain. The copays added up so I couldn't continue our visits. If my physician agrees to refer me and my finances improve, I'll see if I can go back to her for help with adhesions. I'm certain that I have them again because they've plagued me for a long time.Rudibear: I'm glad that the tumor was benign!







Mine was borderline, but the prognosis is excellent. Since my ovaries were removed the chances of recurrence are minimal. How many operations have you had? I've been told that the more one is operated on, the more likely that person is to develop adhesions. Surgery to remove them can make them come back. However, I heard that a mesh has been created to supposedly prevent them in the future. If that's true, I wish it was used on me last year! You're right about how hard it is to not worry about symptoms when they're always bothering us!Harmoiny: I'm sorry that you've been through alot too! It's frustrating when doctors won't listen. I was in the ER the day before surgery complaining about stomach pains. The doctor on duty refused to order a CT scan even though I have a history of abdominal problems, plus the fact that my primary care provider had written an order for one and I showed it to her. I didn't have a chance to get it done prior to my ER visit. The first ER doc blamed my pain on what I had for lunch and I was sent home. The next morning I woke up with more pain & a fever, so back I went. Fortunately for me, the second ER doc ordered a ct scan and they did emergency surgery that evening. They thought I had a perforated colon but it turned out to be air bubbles in the mesentery. Only problem is, on top of that they found another hernia (this one was incarcerated), so that was fixed. I was in the hospital for about a week.At times I'm scared of eating too, which isn't good as I'm a diabetic and overweight. My diabetes doesn't require pills or insulin, and God-willing, I'll be able to lose more weight so it can be reversed. Since my most recent surgery I found that certain foods aggravate me more than they used to. I can no longer eat large salads. I don't tolerate corn very well. Or spinach, red onions (green onions don't bother me, and neither do yellow ones...go figure), cabbage, nuts, large quantities of tomatoes, etc. If I eat too many green beans my IBS kicks in. It tends to do that when I overdo it with dairy products too. As a baby I was allergic to milk, but to my knowledge I am not allergic anymore.If I have another operation, whether it be for adhesions, another hernia (let's hope there won't be another one) or hemorrhoids, I'll make sure they won't let me wake up in pain. I remember waking up in the recovery room after last year's surgery, shivering like crazy. At least they already took the intubation tube out! They were pretty good about putting me on pain meds, but this surgeon used less Dilaudid than his colleague, who operated on me on '09. I don't tolerate morphine at all. I'm not allergic but it has weird side affects on me.I don't know if I have hemorrhoids again or an anal fissure, but at times it hurts so much it feels like I've got a serrated dagger in there (sorry about the tmi). The bleeding I mentioned happened the next morning after what was a very very sore day. The bleeding hasn't come back since, so I suppose I can attribute it to that?Thanks for the adhesions article. Someone suggested pro-biotic supplements, and I picked up a package at a local store. Someone else suggested yogurt, esp. the greek kind. Only problem with the greek yogurt is the price. It's much more expensive than the others (esp. the store brands), but it seems to be lower in calories and has a better taste.







The "seprafilm" mentioned in this article sounds like the mesh I read about. If I have to have another operation....which I hope won't happen....I'll see if they can try this method to prevent another trip under the knife. They even took out my appendix the last time around just in case.*********Again, I appreciate everyone's input! Thanks for listening! God bless you all!


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## harmoiny (Jan 3, 2012)

Greetings Airplane,Diane and all fellow suffers,OMG! Is it fortunate or unfortunate that we have been connected in this forum because we suffer from this "mystery" disease and all that come with it. But it seems to give me a "mental" sense of relief in knowing I'm not alone in this daily battle. It's the similarities that connect us. Although I don't have a hystorectomy; our link seems to come from the after effects of (multiple) surgeries; abdonminal adhesions just may be the "key". I agree it is underrated. I have the mesh from last surgery "hernia". This was in 2009. Wonder why they didn't place one in you Diane. I cannot put my finger exactly on it exactly the pain from adhesions since my pain tends to emanate through my entire digestive system. Trapped gas/incomplete bowel movements. It's just a mess! I pray to God that I could afford to have an experienced "masseuse". Self-massage is the only "natural" thing that seems to help. I will admit that I take prescribed pain killers daily and have for years now. I can deal with anything but the "dreaded pain". So I wanted to share what I have do in order to move the poisonous venom out. I use my hands: fingers, especially my thumbs, knuckles, palms, fists to help move it out. I don't have actual stomach pain probably due to taking Nexium. I call it the miracle pill. Most times I begin to feel bad whenever food hits the upper intestines... I know in advance that it's gonna be awhile before it reaches my colon. When my body lets me know I am ready for a bowel movement, I vigorously begin my massage technique and follow from the top of my colon right underneath the right rib, continue on following the colon trail to the sigmoid, then rectum. I, too, experience the most pain in my back and base of my spine. Once it reaches into these pockets I dig deeply with my thumbs alternating each side and then I simultaneously begin sliding my thumbs/fingers/palms deeply into by sides and each side of my spine. Once it gets to the base of the spine and into the rectal area, I focus on that area by pounding with my fists and because I know there's the most blockage there. I helps get gas/feces out somewhat effectively using this method. I am IBS-D and C. I know the pain killers don't help when it comes to the constipation issue but like I said I can't deal with the pain.I am not recommending anyone do what I do. Everyone is different. I just found this effective for me to deal with it. I recently saw a video on "self-massage". Come to find out, I'm not as far out as it may seem. One warning was given: stay away from the liver, located right side slightly above rib area.Drinking a lot of water also helps but lately, it's been causing incontinence w/ diabetes. We have to pray for divine healing. Keeping in mind that doctor's are just as human as we are. However, there's no excuse for silent ears/rudeness; that seems to be "the happening thing" these days. Money and class is what determines your level of care in this 21st century. So sad.Thanks for sharing and sharing to all


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