# Is surgery usually required to correct torturous ( twisted ) colon?



## Mary S (Jun 25, 2013)

Hi, I was told that I have a torturous ( twisted ) colon. They couldn't complete my colonoscopy because of it and I had to have a barium enema. I have an appointment to discuss the results of the procedure on May 27th. Is surgery usually required to correct this? And if so how serious is it and what does it involve? I am really worried about this and just want it corrected so I can live my life.


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## annie7 (Aug 16, 2002)

Hi Mary

a lot of times the doctors try to manage a tortuous colon with laxatives like movicol and stimulant laxatives, diet and medications--the prescription meds are amitiza, constella (linaclotide) and resolor--i think resolor is called restoran in canada (prucalopride) and all this can often help. if it doesn't and you're still miserable then they can do surgery to remove your colon--a total colectomy with ileorectal anastomsis--the colon is removed and the end of the small intestine is hooked up to the rectum. sometimes the surgeon will leave part of the sigmoid colon in and hook the small intestine up to that. i don't know if they still try removing just part of the colon--from what i've read and been told by my gastros and my surgeons, here in the usa they generally prefer remove the whole thing not just part of it. although a lot of very thorough testing is required prior to this sort of surgery to make sure it will be successful for you.

my last colonoscopy showed i have a long a twisted colon. i've had chronic constipation since childhood and i also have pelvic floor dysfunction. i've been trying to manage it by trying the different prescription medications --which didn't work for me--so i take laxatives eat a low fiber diet. i actually did have half my colon removed last summer. it was emergency surgery because i developed a cecal volvulous --colon has become detached and twisted 720 degrees--so the surgeon removed the twisted part. he preformed a right hemicolectomy. but it the surgery did not help my slow transit problems--or my pfd of course-- (it wasn't intended to --it was to remove the volvulous) so i still have to take laxatives to go. and they don't always work.

i had read success stories about total colectomies and desperately wanted to have the rest of my colon removed because, like you, i just wanted it corrected so i can live my life, but the gastros and surgeons have all told me i cannot have this surgery because i have pelvic floor dysfunction.

i am so glad you will be discussing all this with your surgeon. he will be able to answer all your questions. good luck to you! wishing you all the best.


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## Kathleen M. (Nov 16, 1999)

It can be an asymptomatic anatomical variant, and is normally not treated with anything. Surgery would be very uncommon, and wouldn't be for the colon's length, only if the function is extremely disrupted.

Surgery for extreme constipation (slow transit constipation where people often have 2-3 BMS a month or less rather than the normal 2-3 BMs a week at the slow end of the normal range) is done regardless of the length of the colon. It is not only for people with extra length. They will do that surgery with a normal length colon is your constipation is severe enough.

Those who have constipation may have it a bit more severely because if your stool is moving slowly it has more colon to move slowly through.

However, you can have this and IBS-D so have diarrhea all the time, it is not only seen in the severely constipated. For IBS-D and IBS-A even the vast majority of constipated folks will never, ever have surgery for this.

You do have a couple of extra bends and bendy points do tend to be problem areas for IBSers (moving gas or stool around the bend may cause cramping pain).

For most people it just make screening for colorectal cancer in their elder years a bit more complicated (may need to do other tests rather than the standard colonoscopy).


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