# Feeling lost...



## Jotoo15 (Aug 27, 2016)

After almost 3 years of experiencing unusual and increasingly random bowel related issues (Most of which was rather bad constipation), I have also had several CT scans, abdominal scans, proctogram, colonic transit study and an endoscopy within this time, I began to get faecal impactions once every few months in 2016 as well as this year.. Generally I would alleviate this by using an assortment of Osmotic laxatives, stimulant laxatives and natural remedies alike (As well as a good gentle diet), but on this particular occasion it has completely gotten stuck in the lower left side of my sigmoid colon where a great deal of discomfort is emanating from. Now before I continue, I should mention that I am a 24 year old male that exercises regularly (2 hours each day), drinks between 2.5-3 Litres of water every day and I also include around 30-35g of fibre in my diet (Both Soluble and insoluble), I also use a proper foot stool when I use the toilet. I am both physically and nutritionally aware. What's more is that I have not had a normal BM for the passed 5 weeks, nothing I have done or tried has been effective at eliminating it. I have been admitted into hospital on a few occasions within that time due to the severity of discomfort (This includes a few other symptoms) and the fact that I cannot have a normal BM, they attempted to purge my colon with Fleet Enema, Movicol (10 sheets), senna and coloxyl x 4 and finally the strongest colon preparation they had, all of which did not work, xrays and CT scan showed that there was impacted stool in the lower left end of my sigmoid colon (Albeit not severe, but bad enough to block any matter from passing by). They would not do a surgery because of my age, but suggested that I continue taking movicol and senna every day until the impaction passed. I attempted to go on a liquid diet whilst taking around 8 movicol a day and switching out between osmolax and movicol, I even tried Magnesium citrate and oxygenated magnesium which did not help a great deal with the issue as well as many other things (Lemon, ginger, fish oil, flax seeds, bentonite clay, vitamin C, Triphala, probiotics, digestive enzymes (Creon and others), prune juice as well as other things). I than included Cascara and Castor Oil to see if it would help, but I only got a little bit of diarrhoea (From what leaked around the Fecal impaction I am assuming). I saw my doctor, he told me that there is absolutely nothing else he can recommend or do as everything has been tried and has not worked.. which left me feeling kind of helpless and lost.. It has completely ruined my life and has been getting gradually worse over time for each time this has happened, I have lost multiple jobs, missed countless opportunities and lost a lot of time suffering from these bowel issues, I do everything in my power to remain positive despite how debilitating it can get, I am by nature a positive person, ask anyone that knows me, I am sure they would also agree. But at this stage, what am I to do? When I have tried everything, done everything, absorbed and applied every bit of relevant resource I could get my hands on. I have even seen a Gastroenterologist and a colorectal surgeon to no avail, no one seems to be able to help. The only person that seems to show any kind of promise is Professor Thomas Barody, a gastroenterologist in sydney that has been known to treat many different incurable and strange bowel problems, although I will have to wait over a year and a half for a consultation due to people coming in from all over the world to see him. If I were to get an endoscopy though, I would be able to get a free consultation with him and he would be able to have a direct look at what might be causing the issues. But the issue is that I do not have the finances to pay for something so expensive much less money to actually get there and back (I live in hervey bay in Queensland). I have absolutely no idea on what to do, I would be really happy if anyone could provide some thoughts or advice on what direction I should take because I'm feeling pretty lost at the moment.


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## annie7 (Aug 16, 2002)

Hi Jotoo

i remember your post last year. i am sorry you are still having problems. suffering with chronic constipation is truly miserable.

you mentioned in that post that after testing, they told you that you might have a small rectal prolapse. do you think that is causing some of your problems? what did your doctor say after you had all your tests? you had quite a few, as i remember.

as for your current impaction, have you tried a large, quart size enema? those are a lot more effective than the smaller fleets enemas, especially for an impaction. you might want to add some mineral oil to it, to help with softening things up. i've had impactions in the sigmoid colon and higher up as well. the large volume enemas cleared those right up for me and cleaned me out.

do you take something on a daily basis to help you go? i was dx'd with colonic inertia, pelvic floor dysfunction and some other problems. because of this, i tended to develop impactions rather easily. in order to avoid this and keep things moving, my gastros told me it was important to take whatever i needed to go daily so i took a combination of stimulant and osmotic laxatives. they also had me doing half a colonoscopy prep weekly to make sure i wasn't getting too backed up. they told me that taking laxatives daily was far better than developing an impaction.

if your doc says there is nothing more he can do to help you, see another gastro doc and/or cr surgeon for a second opinion. often gastros who work in the gasterenterology department of a university hospital or a motility clinic are more knowledgeable, up to date and proactive about treating constipation than other gastros.

i wonder why your surgeon said that he didn't want to do surgery at your age. what kind of surgery was he talking about. there are different kinds of surgery they can do for severe and refractory constipation. surgery is a last resort but it can restore your quality of life.

have you tried any of the medications out there for chronic constipation?

i really don't know what else to suggest other than what i mentioned in your other post. i do hope things get better for you and that you can find some relief. wishing you all the best.


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## flossy (Dec 8, 2012)

Hi Jotoo15 -

I would try eliminating any extra fiber from your diet. Also you should take something every day to help you go, religiously. If that still doesn't help you should see what kind of surgery you could possibly get that could.

Please keep us posted & good luck.


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## DavidG (May 7, 2017)

Hello Jotoo

Since your impaction is near the sigmoid colon, is it possible that you are suffering from Pelvic floor dysfunction ? Maybe your sphincters are locked in a continually contracted state, preventing the stool from exiting. In your list of attempted remedies, you didn't mention whether you tried Physical therapy for this condition. I've heard that the success rate is about 70 %.

Maybe you should look into this ? I don't know my Australian geography too well, but Michelle Kenway is from Australia. Maybe you could contact her or she could recommend someone to you.

A US company called the Optimal Health Network sells many larger sized enema bags that might help you with your impaction issue. They sell one bag that allows you to pump fluid into the colon, hopefully dislodging the impaction. I'm not affiliated with them in any way.


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## Jotoo15 (Aug 27, 2016)

@annie7 Hey there, Annie, thank you for responding. After I had finished all the examinations and had the consultation with my colorectal surgeon, pelvic floor physiologist and dietition, it was concluded that I did not have have a small rectal prolapse. They suspected Pelvic floor dysfunction as I seemed to get reoccurring severe constipation at the time. Around six months ago after enduring 8 weeks of using a strange pelvic floor chair which actually toned the muscles around that particular area and also gaining knowledge about how to down-train my pelvic floor through my Pelvic Floor Physio. I started going fairly regularly not to long after that. But I would randomly get awful impactions always around the left side of my large intestine, specifically around the lower region of my sigmoid colon and no matter what I did, they would not budge. I used every relevant approach to attack it, but nothing worked. I even used Enema's, which absolutely destroys my pelvic floor as It appears to spasm out quite a bit after I use Enema's, so I obviously down train it to stop the spasms and to get it to function normally, so I have a tenancy to avoid enema's all together, I was told by my gastro' that enema's would not alleviate this particular impaction as it is to far up the colon and not close enough to the rectum for an enema to work it's magic and if anything is going to dislodge it, something oral based would. As for surgery, it would have just been a surgery to remeove the fecal mass at hospital.. but alas, it did not end that way, I was given a slap on the back, "you'll be right, there is impaction, it will probably block everything up, drink movicol everyday and take some stimulant laxatives, it'll come out eventually..". To be honest, I take 2 fish oil tablets, 2 flax oil tablets, I add 2 teaspoons of flax meal to every meal and than I have 3 teaspoons of Acacia Senegal Tummy fiber after each meal, calm magnesium twice a day and that seems to make everything easy enough to pass. But the impactions still persist, noone has the patience or the time to do a full scale evaluation.. And I don't really have the money to travel out of state at this point, so I'm pretty much at a impasse. Honestly on top of that, I have been taking stimulant laxatives off and on for the passed few months, my greatest fear for laxative use is having to dependant on them.. so I would like to wean myself off them as soon as possible.. The issue is that nothing I have tried has been able to get rid of this darn impaction which seems to be messing up my entire digestion and equilibrium of my gut. The issue isn't that I can't pass anything effectively, it's just as to whether or not the stool makes it there for me to be able to pass it, but at this point, nothing but tiny bits of watery stool is making it to my rectal area due to the fecal impaction further up blocking everything. Also, I have tried a great deal of different things for severe constipation, but if you have any suggestion, I am most definitely all ears.







Regardless thank you for your support, Annie~

@flossy I have attempted both a low residue diet and a high residue diet both in 2 month intervals, absolutely no difference in determining whether or not the impaction reoccurs. Thank you for your response though, I appreciate it!

@DavidG I have done physical therapy and it did help my pelvic floor a great deal, the issue isn't so much surrounding my pelvic floor as I have long since resolved these issues, I even started going to bathroom throughout the day regularly which was a milestone and a half since I wasn't able to go enduring the day for almost 2 years in a row, so I usually had to wake up early in the morning if I wanted to have a chance of going, this was resolved by commiting to a regime of using a pelvic floor chair and doing constant pelvic floor down training techniques. The current issue is a rather stubborn and reoccurring fecal impaction that is completely screwing up my quality of life, meaning I can't work, I can't go out, I keep missing opportunities, I can't spend time with people I care about, it makes it difficult for others to live around me since I use the bathroom constantly in an attempt to go and much, much more.. I mean I'm only 24 (Turning 25 in a few months), It would be nice if I could figure out how to deal with these impactions and to get my current one out so I can resume my life. At this point, I have a really stubborn fecal impaction that doesn't seem to want to dislodge no matter what I try or do and no medical professional seems to know what to do either, but surgery is out of the question (They made this quite apparent..), only little bits of stool can push around it. Here is a representation of where it is, albeit it isn't nearly as big as the one depicted in the picture

Visually, this is the location in where my fecal impactions occur... not pleasant at all.


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## flossy (Dec 8, 2012)

Jotoo15 -

Does IBS run in your family tree at all or no?

Again - and I can't stress this enough - you should take something every day to help you go. If more fiber and extra water do not work, sad to say chronic constipation rarely goes away on its own, and it looks like this is what you're hoping for.

That picture that you posted? That is the same place things seem to slow way down for me. I believe I have an imbalance in my gut flora right about there. I think a lot of us do.

I made this post a few months back, I hope it helps (click on below link to read):

http://www.ibsgroup.org/forums/topic/325690-the-abcs-of-chronic-constipation-aka-ibs-c/

Good luck & keep us posted!


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## annie7 (Aug 16, 2002)

Flossy is absolutely right--if you have chronic constipation, it's crucial to take something everyday to help you go and to keep things moving so that you do not develop an impaction. my gastros and my colorectal surgeons all told me this.

first you need to clear out the impaction. if you cannot do this on your own, go to the ER or to urgent care and they can do it for you. explain to them that you have tried the advice that your doc gave you but it didn't work. at the hospital, they have the large volume enema equipment and that WILL clean you out. believe me, i know. i have a friend who did just exactly this and it worked for her. her impaction was worse than yours and higher up, too. and i've read many posts from people who have said that's what they did and it worked. when i went to the ER with an impaction--it was lodged in the sigmoid colon and beyond, even--quite large--the ER doc told me that they could clean it out with their enema system or i could go home and do it myself with my large volume enema which i did and it cleaned me out very well. the smaller fleets enemas do not work with impactions this high up but the large volume enemas do.

it is important to get rid of this impaction so that it doesn't develop into an obstruction. an obstruction is most definitely an ER situation.

and then once you get cleaned out, take whatever you need to go daily.

good luck.


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## Jotoo15 (Aug 27, 2016)

@Annie7 I do take things to go each day, the problem is nothing is working at this point because I have an impaction that's blocking most of the matter from passing. As I said in my earlier comments, I have already been to hospital quite a few times, I have been informed directly by two different hospitals that the surgeons and doctors do not have anything else that could help. They gave me Senna and coloxyl, fleet enema, oral fleet, Glyco prep, Osmolax, as well as a few other things. They did a CT scan and saw some colon distension around the suspected area, informed me that I should continue to take movicol and stimulant laxatives each day until it passes, they also mentioned there is nothing else they can do other than surgery which they outright refused, they seemed adamant that they had tried everything and sent me on my merry way. This has happened a few times and at 2 different hospitals in the frazer coast area. So here I am progressively getting worse.


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## annie7 (Aug 16, 2002)

that's really a shame that the hospitals did not help you with a large volume enema (not a fleets or a small bulb enema) or tell you to try one at home like my hospital did. really, if i were you and wanted to clear the impaction, i would buy a large volume enema and try it at home. just my opinion. since you asked for advice. hope you get better.


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## Jotoo15 (Aug 27, 2016)

I really do appreciate the advice, I just can't believe they couldn't do more to help... This really is no way to live, I can truly sympathise with others that also have to experience these problems. Is there a specific type of large volume enema that I should use and if so where should I purchase it from? I have never used one so I'm a little nervous, is it completely safe as well? Sorry about all the questions.

Kind regards,

Jaye


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## annie7 (Aug 16, 2002)

here is one example. it's the two quart size--the big red enema bag. you can buy these at any drug store or you can buy it online. amazon should have them. or you can buy one from the Optimal Health website, as DavidG mentioned.

http://www.cvs.com/shop/personal-care/feminine-care/douches-deodorants/mabis-combination-douche-enema-system-with-water-bottle-red-8-height-x-2-width-x-13-25-in-depth-prodid-611012

it's safe. it helps to use a lubricant--like ky jelly--on the nozzle so it's easier to insert. just follow the directions on the box. don't force the nozzle into your rectum. relax your rectum and gently insert the nozzle.

the enama comes with a clamp so you can adjust the flow of water to your comfort.


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## annie7 (Aug 16, 2002)

when i was dealing with my impaction, i used two of the large size mineral oil fleets (not the small) to soften things up first and then followed that up with the large volume enema. worked a treat..

you could also go for a colonic if you don't want to administer the enema yourself. just tell the person administering it that you have an impaction.


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## flossy (Dec 8, 2012)

You could also buy an enema bulb...










...and just fill it up, squirt it inside you and then refill it and do it again. I had the kind Annie posted and used to use that, but found an enema bulb was much easier for me to deal with. I threw the other one away. Up to you though. Either way, one of them should flush you out.


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## Jotoo15 (Aug 27, 2016)

A colonic? I don't believe I've heard that term before, you have definitely given me some food for thought and will be trying it accordingly, so thank you. As for the mineral oil fleets, I have never tried mineral oil before much less the enema mineral oil, is it purely used for lubricating the insides of your bowels? Just wondering. I will have no issues administering it myself, I'll try it out and post back to let you know what results I got.


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## Jotoo15 (Aug 27, 2016)

@Flossy Thank you! I'll also give this a shot, it looks a lot easier.


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## flossy (Dec 8, 2012)

Sometimes people do coffee enemas too. Never tried it, but I bet it helps break things up inside there.


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## annie7 (Aug 16, 2002)

Usually when you have an impaction the stool gets hard and dry, making it difficult to pass. Mineral oil softens it up, making it easier to pass.


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## Jotoo15 (Aug 27, 2016)

Just wondering but wouldn't oral osmotic laxatives (along with a lot of water) have the same affect?


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## annie7 (Aug 16, 2002)

they can but when they don't work, then it's time to try an enema. with a large volume enema, you have more liquid in there to soften things and wash them out.

like the ER doc told me, when the impaction is located in the rectum or sigmoid colon, a large volume enema is the most effective way to deal with it.


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## flossy (Dec 8, 2012)

Jotoo15 said:


> Just wondering but wouldn't oral osmotic laxatives (along with a lot of water) have the same affect?


I agree with Annie, you should just attack this from the rear (pun intended!). I would think it would be best for you to just to do it and be done with it.

I used to give myself quick enemas every day before work, before I wised up and started taking something every day to help me go (Intestinal Formula # 1). Now I never do them anymore.

Use really warm water. They're easy to do.


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## Jotoo15 (Aug 27, 2016)

Is Senna leaf and cascara okay to take on a regular basis..? I thought that they would harm the bowel after constant use of it I'll give the enema a shot, what size should the enema bag be for attacking a fair sized impaction? Should I also add mineral oil to the enema bag with the warm water?


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## annie7 (Aug 16, 2002)

all the laxatives that were considered to be unsafe were removed from the market years ago. i remember when that happened.

we have a recent thread about laxative use. i posted some links on there as well:

http://www.ibsgroup.org/forums/topic/332250-need-help-please-laxatives-questions/

yes, you can add mineral oil to the warm water in the enema bag or bulb. as far as size of the bag-- like we mentioned, you can use the large volume enema bag or the bulb enema that flossy suggested. if you're going with the bulb enema, it's probably best to use the largest size. or if you use the smaller size, you can keep refilling it until you get the desired amount of water in your colon.


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## Jotoo15 (Aug 27, 2016)

Hey there, Annie. Should I be looking at having a Large retention enema done or just a standard large 2 Litre enema?


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## annie7 (Aug 16, 2002)

use whichever one you think will work.

x rays showed that my impaction (actually it was more like an obstruction) was in the rectum, sigmoid colon and the lower part of the descending colon. to clear it out, i used two large fleet mineral oil enemas plus the standard two liter enema bag.


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## Jotoo15 (Aug 27, 2016)

I have heard about how effective Mineral oil is, did you put the two large mineral oil enemas in separately first (Also how large were these?) or did you mix it with water in the standard two litres of water enema bag? Also, how long did you hold everything in for before going to the bathroom?

Thanks again, Annie.


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## annie7 (Aug 16, 2002)

i bought two of the larger size fleet mineral oil enemas. this was about five years ago at least, so i don't remember how many ounces they were. all i remember is that they were are larger size bottles, not the regular small ones.

i first used one and then the other . i didn't have to hold them in long. they worked fairly quickly on the stool in the rectum and a little higher up. then i filled up the enema bag with warm water and used that. i filled up my colon with as much water as i could and then the rest of the stool came out.

this is all very much YMMV (your mileage may vary) . but it worked for me.


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## Jotoo15 (Aug 27, 2016)

I might try holding a bit longer than normal, just to give it a little extra time to disimpact it since the stool is only further up the sigmoid colon. Cheers for being transparent about it all, Annie.


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## annie7 (Aug 16, 2002)

Sounds like a good idea.. good luck.


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## Soccerlifter (Mar 23, 2017)

Hey have you ever been checked for inguinal hernias? I have had two separate surgeries for those and one of the first signs of a hernia is constipation. I had a completely normal exisistence until my first hernia and then it was bowel issues off and on. If you have an inguinal hernia, the intestine or another organ, fat, etc. can twist the intestine in a way that it becomes like a kinked water hose. Obviously when that happens, you get backed up and it starts a viscious cycle.

One other thing to consider. There is a such thing as too much water, too much fiber, too much anything. Like many have mentioned here on the forum, fiber can be a bad thing for IBS-C. I have noticed just in the past few weeks that my life has improved by cutting out nuts, raw veggies, etc. For another person can be something else. Keep your head up and you will eventually figure it out. We are all like a bunch of Guinea pigs but can help each other.


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## Jotoo15 (Aug 27, 2016)

@Annie4 I have received the 2 Litre Enema bag in the mail along with the 2 365ml bottles of Mineral Oil, I have a few concerns that I need to put to rest... Wouldn't introducing 1-2 bottles of mineral oil into the colon cause severe rectal irritation? Parrafin oil (The Australian version of Mineral Oil) has been known to cause bad rectal irritation when taken in high doses. Also, I usually consume between 2-3Litres of water a day.. I'm a little scared of introducing 2 litres of water into the colon all at once through an enema, is there any dangers in doing this? What was the experience like for you? Is there anything that I should do or avoid doing when attempting a large enema? Sorry about all these questions, it's my first time doing this so I'm a little lost.. Thank you for your time. 

Kind regards,

Jaye


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## annie7 (Aug 16, 2002)

oh no--i wasn't talking about putting whole bottles of mineral oil in the enema bag. i just used the premixed fleets mineral oil enemas. i don't remember how much mineral oil was in them. there are probably mineral oil enema recipes online that will tell you how much to use.

you don't have to start with the whole two liters. you could just try one. or whatever amount feels comfortable. or try the bulb enema like flossy mentioned.

if you are scared to do this, then please don't. i don't want you to do anything that you are scared to do.


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## Jotoo15 (Aug 27, 2016)

@Soccerlifter Thank you for commenting.








I have attempted a low fibre residue diet and high fibre residue diets. insoluble Fibre makes little difference in maintaining quality of life compared to getting severe constipation. However it should be noted that Soluble fibre definitely helps, especially when I am really backed up. As for the inguinal hernia, I have already had an endoscopy done with numerous biopsies, all of which came back inconclusive, no hernia was found either. My issues originated at having a sprained pelvic floor, it than migrated to pelvic floor dysfunction and functional constipation and even after resolving the pelvic floor dysfunction and returning to good regular BM's, it still inevitably migrated over to fecal impaction, which is now what I'm battling every day of my life. The current impaction that I have is rather bad, it won't budge regardless of the amount of lubricating oils, osmotic and stimulant laxatives as well as many other things that I take, it refuses to budge. Doctors won't do anything to help and the hospital is just as unhelpful as all the doctors that I've seen. Feeling alone in this ordeal is the worst.. considering the longer it stays in there, the more dangerous it becomes. All the medical professionals that have seen me know this, but refuse to do anything about it. I couldn't imagine how everyone else on here would feel having to deal with their stomach and bowel related issues, it is just awful.. :/


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## Jotoo15 (Aug 27, 2016)

@Annie7 Although I'm scared, it has to be done one way or another.. I would rather attempt it and get it out rather than wait and have it get worse? I guess I was just hoping that large enema's were considered safe to do since so many other people in worse states than I have done it successfully and safely. I'll definitely look up the receipe for Mineral oil enema's.  Also, I did manage to grab a bulb enema as well. It can fit 224ml of water in it.


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## annie7 (Aug 16, 2002)

that's good that you have the bulb enema, too. you could start with that and see how that goes.

if it doesn't work (not enough volume) you could start with trying one liter of water in the big enema bag. it helps to lubricate the nozzle so that it goes in easier. relax your rectum when inserting the nozzle. do NOT force it in. use the clamp to control the flow of water. just go slow. try to remember to relax and breathe. if you develop cramping, stop the flow of water til the cramping stops. and if you get too uncomfortable, you can always just stop the whole procedure altogether and sit on the toilet and void the water.

again--the last thing i want to be doing is to try to talk you into doing something that you are too scared or don't want to do. because of your fears about this, i really would feel better if you had professional help with this from your doc or the hospital (although i know you said they wouldn't help you). or you could see someone who administers colonics.

there's a lot of good enema advice online to help you.

good luck with everything.


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## mpfiorv (Jul 4, 2017)

Jotoo15 said:


> @Annie7 I do take things to go each day, the problem is nothing is working at this point because I have an impaction that's blocking most of the matter from passing. As I said in my earlier comments, I have already been to hospital quite a few times, I have been informed directly by two different hospitals that the surgeons and doctors do not have anything else that could help. They gave me Senna and coloxyl, fleet enema, oral fleet, Glyco prep, Osmolax, as well as a few other things. They did a CT scan and saw some colon distension around the suspected area, informed me that I should continue to take movicol and stimulant laxatives each day until it passes, they also mentioned there is nothing else they can do other than surgery which they outright refused, they seemed adamant that they had tried everything and sent me on my merry way. This has happened a few times and at 2 different hospitals in the frazer coast area. So here I am progressively getting worse.


Why wont they perform a surgery??? is part of your colon off track or is it just severely inflamed?? or tangled ?? you mention colon distention so thats why i ask...thanks for a reply and sorry for your health problems


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