# What do you think caused my IBS-C and Redundant colon?



## Stardock (Nov 8, 2012)

Hi, I'm a 21 year old male. I was diagnosed with IBS-C, Redundant colon and Slow Colonic Transit. The Gastroenterologist told me that my colon is abnormally long and floppy for my age. He initially thought I had Sigmoid Vulvulus because during the Colonoscopy, my colon had flopped to one side which made it look like it was twisted. He said my colon is similar that of an elderlies.

I asked him what causes it and he told me that it's something you're born with. But I find that hard to believe because I didn't have any problem with constipation growing up until April this year.

Here is a timeline of what happened to me this year:

*End of February*:
Food poisoning(vomiting) after eating takeaway sushi that was for sale since the restaurant was about to close. The sushi had salmon roe.

*Mid March*:
Long story short, I had an accident at work and caused many damages(which wasn't all my fault). I was in extreme stress and anxiety for 30 minutes. I was tensing my stomach really hard in response to the stress.

*21st of April*:
Started having bad sleep/wake pattern due to random shift calls from work since I work as a waiter.

*30th of April*:
Travelled to Sydney. My stomach was fine and I could eat normally. I accidentally scratched the inside of my anus with my nails when I was wiping but I don't think that can lead to constipation.

*1st of May*:
After I got back home from Sydney, I went back to bad sleep/wake pattern and eating past midnight due to random shift calls from work since I work as a waiter.

*Before 10th of May*:
drank between 30 ml - 70 ml of 8 month old bottle of unrefrigerated opened red wine that was stored sideways in a hot room and the liquid was touching the aluminium lid. I realised that the red wine tasted like vinegar and within 5 minutes, I started getting intense burning upper abdominal pain which lasted for 10 minutes.

*10th of May:*


I started getting abdominal pain after eating baked beans with eggs so I went to the doctor saying that I think I have IBS after telling him that I'm experiencing abdominal pain after eating and constipation. He told me "It's nothing. You don't have IBS, you just have a stomach pain." and prescribed me an antispasmodic medication(Buscopan Forte) for 3 weeks.
The medication only temporary treated my abdominal pain during the day and the pain came back as soon as the medication weaned off. While on the medication, I strained a lot in the toilet in a squatting position because of constipation. And while straining, I felt my lower abdomen physically drop down and at the same time 3 cm of my rectum popped out. It wouldn't go back in so I had to push it back in using my finger. This was probably when I've developed rectal prolapse, could this be the cause of my redundant colon as well?

*13th of May*:
After developing rectal prolpapse, all of my symptoms worsened significantly. I started getting severe constipation, feeling of incomplete evacuation, mucous discharge and abdominal pain whenever I ate food. I went back to the doctor but they told me to get a blood test done and have 3 days worth of stool samples.

*9th of June:*
I drank a sip of carbonated drink which caused my lower abdomen to become suddenly get bloated like a balloon for 5 minutes. It was extremely painful that I thought my colon was going to explode. But after 5 minutes, the gas escaped somewhere and the inflation subsided. But I'm afraid my lower abdomen might have been damaged from this incident.

*10th of June:*
When the result for the stool sample came back, the doctor said "your result for parasites and bacteria in stool was negative". He smiled and was about to dismiss me. I couldn't believe how unconcerned he was about my abdominal pain after eating so I told him in a angry voice, "then why am I still getting stomach pain after eating?". So he said "Okay, I'll have a look at X-ray of your stomach then..."

*24th of June:*
The X-ray showed that I had impacted colon and the doctor looked a little surprised. I asked him "Is this dangerous?" but he didn't tell me anything and he prescribed me stimulant laxatives and dismissed me.

*Until 22nd of August:*
I continued to get constipation and abdominal pain after eating. But for the next 2 months, no matter how many times I went to the doctor for my abdominal pain after eating, they continued to prescribed me stimulant laxatives and told me to "come back in 3 weeks and see how you go."

This is how much stimulant laxatives I've taken overall:

Bisalax 5MG (Took a total of 52 tablets)


42 tablets within 3 weeks(2 tablets every night) when I was first prescribed
10 tablets(1 - 2 tablets at night) occasionally when I became incompetent.

Coloxyl and Sena 8mg Senoside (Took a total of 40 tablets)


30 tablets in 2 1/2 weeks(2 tablets every morning and night) 
10 tablets(2 - 4 tablets a day) used occasionally after been prescribed a second bottle.

*22nd of August:*
Finally got fed up with doctors from the first hospital not doing anything about my abdominal pain after eating so I went to a different hospital that's more popular among locals to see a new doctor. At that hospital, I was treated better and I was immediately put on Nexium and Psyllium husk which my doctors never did from the first hopital for the past 3 months. The PPI finally cured the upper abominal pain that I've been having after eating. I've learnt a hard lesson to never go to a 24 hour hospital in my town because a lot of tourists goes there so the doctor often tries to dismiss you asap so they can get through everyone. Although my upper abominal pain had been cured, I continued to get chronic constipation, feeling of incomplete evacuation and mucous discharge. Psyllium husk did help though.

*24th of October:*
Had a Colonoscopy.

*Present:*
Diagnosed with IBS-C, Redundant colon and Slow Colonic Transit after Colonoscopy. The Gastroenterologist told me that my colon was abnormally long and thin/floppy for my age. He initially thought I had Sigmoid Vulvulus because during the Colonoscopy, my colon had flopped to one side which made it look like it was twisted. He said my colon is similar that of an elderlies.

I think my IBS and Gastritis was caused from either food poisoning, extreme stress at work or drinking old red wine. And I think my Redundant colon was caused from impacted colon/chronic constipation/excessive straining/rectal prolapse.

If my Redundant colon was caused from impacted colon/chronic constipation/excessive straining/rectal prolapse, will it return to normal length over time or is it going to stay elongated permanently?

The only symptom I get now is the need to pass mucus all the time and feeling of incomplete evacuation and slow bowel movement(every 3 to 4 days).

I'm able to relieve my other IBS symptoms using FODMAP diet, Probiotics, Digestive Enzymes, Peppermint oil, Slippery Elm and Psyllium Husk. But are there any way to treat slow bowel movement caused by a Redundant colon?


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## aaltimas1 (Aug 15, 2010)

I too had many of the experiences that you describe, thank goodness that you are finding some relief with your FODMAP diet etc. As far as what causes IBS-C, redundant colon I think is really hard to say, I believe for myself in was a whole combination of things but there is also an element of mystery? I have always believed that there must be some reason for the IBS-C to effected me so badly. The main reason why I think I got IBS-C so bad is I had become so out of line with in myself about who I was, and at times really out of step with my insides, I never paid my body any attention and just kept going at light speed trying so hard to be something? This IBS-C derailed my life and now I am on a totally new path with the hope that someday, I may develop an attitude of peace within my body and mind. Thanks for sharing it helps to have support I think.


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## Maegwin (Nov 11, 2012)

My IBS-C started when I was 10 and caused me a lot of pain and discomfort as a kid. As far as I can remember my colon worked great before 10 but I remember having the runs a lot between the ages of 8-10. It would hit me while I was at school and I had some embarrassing accidents. I remember trying to hold it in for as long as possible by really clenching my gutt muscles. I was terrified of having another accident but didn't want to run to the washroom constantly either as kids made fun of me for that as well.

By 10 my bowel movements became less and less frequent until I was only going once a week, sometimes only twice a month. I could no longer get my bowels to work naturally even when I wasn't clenching. It was an extremely painful time.

Doctors shy away from treating IBS because it usually stems from something psycological. I've come to have a huge chip on my shoulder when dealing with doctors now. They never take my symptoms seriously nor understand how painful and dibilating constant constipation can be.

My IBS definitely came from psycological events when I was a kid. However, my old diet and lack of exercise didn't help either, nor my previous stressful jobs. I've gotten rid of all of the recent inhibitors of my IBS but it's hard to reprogram your wiring after 20 years. I have hade the rare week in my life in which my bowel works amazingly well. I can eat anything without consequences. It's usually been when I'm really happy without any worries ahead of me. A rare occurance, maybe twice or three times a year but random. I know it's possible to undo those 20 years of programming. I just need to figure out how get to that state on purpose without having to win the lottery or something.









With your floppy bowel, have you considered having it shortened?


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## oceannir (Mar 6, 2012)

Stardock, the elongated bowel is something that you will find alot of people suffer from and its not always the cause of these problems. I'm not sure I want to say without any evidence, but it seems unlikely it could go that way in such a short period of time.

Unfortuntaely for most of us here, the constipation is just caused randomly by an event and just stays with us. Almost as if one event happened and its set off a chain reaction.

Mine began with a stressful event in my teens and became worse with a batch of food poisening almost like two distinct events with two stages of the 'disease'.

I think most of us find it similar to what you did, poor doctors care and advice, no suggestions, no help. Little empathy.

Unfortunately I don't think anything you done is particularly wrong. I'm sorry that we can't give you hope of normality, but in many ways acceptance makes it easier to cope.


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## Stardock (Nov 8, 2012)

Is it possible that I may have developed Post infectious IBS after food poisoning? Because I encountered an extremely stressful situation within 3 months of food poisoning. I also had moderate anxiety issue from April to May which I didn't mention it because it was only moderate. My sleep/wake pattern was also messed up due to working as a waiter.

This article says that



> IBS-PI appears to be more likely to develop in individuals who experienced higher levels of anxiety and/or stressful life events in the three months leading up to the initial infection.


http://ibs.about.com...b1/a/IBS-PI.htm

But I'm not 100% sure if I have IBS-PI since I came back negative for bacteria and parasite infection in stool test. I also did UREA breath test but I don't know what the result was. And it is said that vomiting cuts the risk of IBS-PI as much as 50% and I did vomit when I had food poisoning. Is there any way to test that my IBS was caused by food poising? I'll probably go back to the hospital and ask the doctor what my result for UREA breath test was.


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## Stardock (Nov 8, 2012)

Okay, I made an appointment with the family doctor today and he told me that I didn't have a Redundant Colon but instead an Sigmoid Vulvulus. I'm starting to get confused now, maybe he misread the Gastroenterologist's report. Because the CT scan showed no evidence of bowel obstruction and my gastroenterologist told me he *thought *I had Sigmoid Vulvulus because my colon had flopped to one side during colonoscopy.

These are the results from the tests:



> *ENDOSCOPY REPORT*
> 
> *Findings*:
> Digital rectal examination: No masses felt.
> ...





> *CT Abdomen*
> 
> *Clinical Information:* Worsening constipation. Unusual twist in the sigmoid colon reminiscent of a Volvulus/extrinsic compression? Extra colonic mass or compression in abdomen. No previous films however are available for comparison.
> 
> ...





> Specimen: *RANDOM COLOIC BIOPIES*
> 
> Macroscopic: (JM/PC)
> 
> ...


So if I don't have a Redundant colon, what exactly do I have?

I thought I had Internal hemorrhoids or Mucosal prolapse but the gastroenterologist didn't mention it and it wasn't on the colonoscopy report.

Is the colonoscopy report telling me that my entire colon has poor bowel tone with a degree of "floppiness"?

Also, the gastroenterologist told me that he doesn't want to do anything yet and wants to see if I get better or worse until next year. What is the likely outcome if my condition doesn't get better. Is it surgery?


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## oceannir (Mar 6, 2012)

Mate, the colonoscopy results rarely explain the constipation. Ask some of the members with the more severe symptoms, Sean etc. They look relatively normal in the exam.

How bad is the slow transit? As in when you took nothing how often did you pass anything?


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## Stardock (Nov 8, 2012)

oceannir said:


> Mate, the colonoscopy results rarely explain the constipation. Ask some of the members with the more severe symptoms, Sean etc. They look relatively normal in the exam.
> 
> How bad is the slow transit? As in when you took nothing how often did you pass anything?


You mean my bowel movement? I get them every 3 to 4 days. When I drink coffee I get my bowel movement few hours later but the stool won't be consistent. Coffee causes my stool to become narrow or mushy.


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## oceannir (Mar 6, 2012)

Stardock said:


> You mean my bowel movement? I get them every 3 to 4 days. When I drink coffee I get my bowel movement few hours later but the stool won't be consistent. Coffee causes my stool to become narrow or mushy.


If you're passing bowel movements every 3-4 days (full complete movements?) its not colonic inertia. People with that go way longer.

If you drink a daily coffee do you get a daily incomplete movement?


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## Stardock (Nov 8, 2012)

oceannir said:


> If you're passing bowel movements every 3-4 days (full complete movements?) its not colonic inertia. People with that go way longer.
> 
> If you drink a daily coffee do you get a daily incomplete movement?


Actually if I think about it, I don't know when I get natural bowel movement any more. Because every third day, I'm relying on black tea or coffee to help me have bowel movements.

So if I don't use black tea or coffee my bowel movement might not come for a week.

When I used to drink a lot of prune and kiwi fruit juice and eat paw paw and papaya, I was able to have a bowel movement without the aid of caffeine.

And whenever I became constipated, I would take stimulant laxatives for 3 days which helped my bowel movements start working again.

Also, every time I have a bowel movement and strain after using stimulant laxatives or coffee I can hear my lower abodmen(sigmoid?) make a gurgling sound.

So I think the main issue is I lost the ability to excrete the faeces stuck in my sigmoid colon. My sigmoid colon is somehow damaged from over-straining or I don't have the pelvic muscle to excrete any more.


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## oceannir (Mar 6, 2012)

You're very articulate for a 21 year old.

Have you been using laxatives for many years, or are you talking an episode of a few weeks as you spoke about earlier?

This quasi doctor stuff is not really helping. "Lost the ability" is not a medical term.

I basically rely on coffee for a morning bowel movement too. The question is if you go enough, incomplete evacuation is usually the worst "IBS" symptom.


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## oceannir (Mar 6, 2012)

Reading over what you have written. I think in many ways your IBS has possibly been caused by stressing about IBS if that makes any sense. You really remind me of myself at your age in that you over analyze most things and listed several fairly insignificant details and try and make logic jumps. You cannot say for certainty what lead to what lead to what etc. I can tell you there is little to no logic in your syllogisms.

What happens if you take no medications and sit down in the morning and drink a coffee to try and get things moving? Do you go enough to feel comfortable?


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## Stardock (Nov 8, 2012)

oceannir said:


> Reading over what you have written. I think in many ways your IBS has possibly been caused by stressing about IBS if that makes any sense. You really remind me of myself at your age in that you over analyze most things and listed several fairly insignificant details and try and make logic jumps. You cannot say for certainty what lead to what lead to what etc. I can tell you there is little to no logic in your syllogisms.
> 
> What happens if you take no medications and sit down in the morning and drink a coffee to try and get things moving? Do you go enough to feel comfortable?


Coffee helps me have bowel movements but it also causes increases tenesmus and mucous discharge for the rest of the day. So I try to avoid coffee.

Also, after straining today 3 cm of my anus popped out again and it wouldn't go back in on it's own. So there's no doubt that this is a rectal prolapse. My prolapse looks very similar to this picture that I found on google images.

I have no idea why they didn't realize I have prolapse during colonoscopy. I have been telling the family doctor and gastroenterologist about my suspicion of having prolapse all along but they don't take it seriously...I'm going to call my Gastroenterologist tomorrow about this.

I took a photo of my prolapse but I probably won't be able to upload it here.

But even if I show the picture to the family doctor to *prove* that I have rectal prolapse, he'll probably just tell me to go see a gastroenterologist.

So I guess my only option now is to wait until next year for my appointment with the gastroenterologist and ask him why he couldn't find my prolapse during colonosocopy..


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## Kathleen M. (Nov 16, 1999)

Well from what I can tell the tests for a rectal proplapse do not include any of the scopes. I don't think they can see it, and pushing the scope in probably pushed any prolapse back into place. Usually when I read about diagnosing those things the colonoscopy is for ruling other things out, not for seeing the prolapse as it is prolapsing.

Usually to diagnose a prolapse you want to visualize the rectum/anus while stuff is coming out, not while you are pushing everything back into the right place.


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## oceannir (Mar 6, 2012)

We don't want to see the picture lol.

The reason they can't see a prolapse during a colonoscophy is that a prolapse is only evident during straining. They are actually rather common when you strain.

You can only see a prolapse during a defeceogram. This is the area of a colorectal surgeon, not a gastroenterologist.


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## Stardock (Nov 8, 2012)

I see, so my family doctor was wrong when he told me colonoscopy checks for hemorrhoids and prolapse.

It seems like doctors don't really take patients concerns seriously.

6 months ago I told the family doctor that my anus popped out when I was straining but he wasn't concerned...

I even told my gastroenterologist that I think I have prolapse because my anus popped out while straining. But he just looked at me and skipped the subject...

I also told the doctor that I think I have IBS *8 months ago *when I first made an appointment with the doctor. But he wouldn't believe me and put me on Buscopan Forte which worsened my constipation.

But I guess prolapse is caused by over-straining so it's not really the doctors fault. But I still think it could have been prevented if he believed my self-diagnosis and not leave me constipated for 6 weeks straight..


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## Kathleen M. (Nov 16, 1999)

Well that medication would probably be given if he thought you had IBS, so I'm not sure what difference it made.









I just don't see colonoscopy as the definitive test for a prolapse, I suspect if severe enough you see something on the way in, but it isn't the main/only test for it.

I know the scopes see hemorrhoids, but how much the see of a prolapse, depends on how bruised up (or whatever they call it) happens when it goes out and how long that lasts.

The problem with IBS is if you only had symptoms for a fairly short time when you first go in they can't agree it is IBS as you don't know if the symptoms will be chronic or will clear up in the next month. No one can predict ahead of time. Not that a lot of doctors treat IBS anyway. Plenty of people get told IBS and learn to live with it so getting those words out of a doctor doesn't always make much difference.


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## Stardock (Nov 8, 2012)

Kathleen M. said:


> Well that medication would probably be given if he thought you had IBS, so I'm not sure what difference it made.


There is a difference. I was constipated when I was prescribed Buscopan Forte and I was constantly straining in the toilet. I told the doctor that I was having lower abdominal pain, less frequent bowel movement, pellet stool and frequent straining. But the doctor didn't do anything else other than prescribing me Buscopan forte for 3 weeks and after going back to him he told me to get my stool tested which took another 3 weeks During those 6 weeks of untreated constipation it lead to Impacted colon which caused me to strain in the toilet. And constant straining from severe constipation lead to rectal prolapse.

Anyway there's no point dwelling over the past now.

I finally convinced the doctor that I have a rectal prolapse and got a referral to a colorectal surgeon. But he didn't want to look at the picture I took though. He also believed me about the gastroenterologist telling me that I don't have Sigmoid Vulvulus. He just didn't know about it because he wasn't told anything else other than the report.

I decided to get my defecogram and possibly surgery at the public hospital because the private one apparently is very expensive. The public one is slow and It might take few years before it becomes my turn but I've already wasted so much money on colonoscopy and lots of other tests already. And besides it's not life threatening anyway, it's just going to reduce my quality of life that's all.


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## Kathleen M. (Nov 16, 1999)

My point was calling it IBS or not he prescribe what he probably would have prescribed if he had immediately called it IBS. Unfortunately there isn't a lot of treatments for IBS, and I just wasn't sure what you thought he would have given you. Unfortunately even when they call it IBS they don't, generally, begin with aggressive treatment.

Most of what they prescribe for severe constipation is available over the counter (osmotics, fiber or stool softeners). There aren't a lot of prescription medications for it, and he could have underestimated how constipated you were. And you don't know if someone is a person who will never get a rectal prolapse no matter how much they strain, or if they are one likely to get one really easily until it happens.

I get you had a bad outcome, but I don't think that hangs on if he named it IBS, they don't treat IBS much even when they name it that. Just if he called it IBS on that very first appointment he still probably would have just given you an antispasmodic and sent you on your way.


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## oceannir (Mar 6, 2012)

They won't do anything based on what you've said, a small prolapse isn't even out of the ordinary and most people don't notice it.


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## Stardock (Nov 8, 2012)

oceannir said:


> They won't do anything based on what you've said, a small prolapse isn't even out of the ordinary and most people don't notice it.


But my prolapse isn't small and it comes out every time I get tenesmus(need to defecate) or have bowel movement.

One of the symptom of Prolapse is tenesmus. This might explain why I get so much tenesmus throughout the day. And it gets worse after I have a cup of coffee.


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## Stardock (Nov 8, 2012)

Does anyone know why I get blood on toilet paper after I drink green tea or eat yoghurt? This doesn't happen when I drink coffee.

Also for some reason, I have been able to drink coffee without getting too much tenesmus and mucous discharge if I add milk to it. Does anyone know why? Could this be a sign that I have GERD and milk is helping to reduce the P.H. level in the stomach?


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## Stardock (Nov 8, 2012)

So I'm going to answer my own question here.

I've researched about the causes of IBS for a while I've come to conclusion that food poisoning was most likely the cause of my IBS.

I thought that my IBS was either caused by:


30 minutes of intense stress during work or 
drinking 30 - 70ml of 1 year old red wine which tasted like vinegar and gave me intense upper abdominal pain for 10 minutes

because those two incidents happened a month before I developed IBS. But I realised that's very unlikely because I couldn't find any study saying that alcohol causes IBS and I probably got the intense upper abdominal pain from drinking red wine because had developed sensitive stomach from food poisoning. So red wine probably just triggered the IBS symptoms.

And most people seem to develop IBS after an gastric infection(gastroentritis) which is usually caused by food poisoning.

It's still odd that it took me 3 months to get IBS symtoms from food poising though. But this is the only explanation I have for my IBS.


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## Stardock (Nov 8, 2012)

I have a good news.

All of my symtoms(food intolerance, tenesmus, mucous discharge and constipation) are gone after I had surgery for my rectal prolapse.

I was diagnosed with IBS-C by my gastroenterologist, but that might have been a misdiagnosis since I don't get that much IBS symptoms anymore other than occasional bloating after eating certain food like onions.

Rectal prolapse is a very debilitating and uncomfortable condition and I hope that no one gets them, especially at a young age.


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## oceannir (Mar 6, 2012)

Stardock said:


> I have a good news.
> 
> All of my symtoms(food intolerance, tenesmus, mucous discharge and constipation) are gone after I had surgery for my rectal prolapse.
> 
> ...


What type of prolapse was it and what surgery did you undergo?


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## Stardock (Nov 8, 2012)

oceannir said:


> What type of prolapse was it and what surgery did you undergo?


I think it was a full thickness prolapse and I had Perianal Delormes procedure. I wasn't recommended to have the keyhole surgery because I'm a young male and there's risk of impotency.


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## oceannir (Mar 6, 2012)

Stardock said:


> I think it was a full thickness prolapse and I had Perianal Delormes procedure. I wasn't recommended to have the keyhole surgery because I'm a young male and there's risk of impotency.


Does full thickness mean your large intestines were dropping down and covering the outlet? Or just a piece of the end bit was.

What was the recovery from the procedure like?


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## Stardock (Nov 8, 2012)

oceannir said:


> Does full thickness mean your large intestines were dropping down and covering the outlet? Or just a piece of the end bit was.
> 
> What was the recovery from the procedure like?


Defecography showed that it was just the end bit of rectum that was coming out and there was no structrual problem in the intestines.

I had my surgery a week ago so I'm still recovering for 6 weeks.

The procedure took 40 minutes and I felt a little nauseous from the anaesthetic but other than that I had no major problem.

The surgeon said I'd feel some heavy feeling around my anus but I don't feel anything other than occasional sting from the incision.

I'm more worried about my recovery because there's higher chance of prolapse recurrence through my type of procedure. And I have to avoid literally everything that causes me to strain which is hard.


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## oceannir (Mar 6, 2012)

Stardock said:


> Defecogram showed that it was just the end bit of rectum that was coming out.
> 
> I had Barium Enema X-ray as well and it showed no structural problem in the intestine.
> 
> ...


And this small surgery caused all of the IBS issues to go away and your bowel to become more responsive?


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## Stardock (Nov 8, 2012)

oceannir said:


> And this small surgery caused all of the IBS issues to go away and your bowel to become more responsive?


I don't think the symptoms I was describing is IBS, but yes the surgery cured all of them. Like I mentioned in my first post, most of my IBS like symptoms such as severe food intoleranes got better after the first 6 months. So it's posible that the old red wine caused my gastric inflammation since I started getting IBS like symptoms from that.

My constipation, tenesmus and mucous discharge must have been caused by the rectal prolapse itself. I don't know how but my reflux, random colon spasm and uncomfortable feeling after eating high fiber food is all gone as well. I still get mild heartburn after drinking one particular type of chinese green tea but I don't have a problem with any other kinds of green tea.

I have harder time withholding feces when I feel like going now especially after drinking coffee. Probably because I have a shorter rectum but I can live with that.


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