# Who remove sigmoid colon?



## SpAsMaN* (May 11, 2002)

I migth be interest to get it out in the future so i better know who does it.It must help C.


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## 21731 (Jul 12, 2006)

SpAsMaN - You need to find a Colorectal Specialist/Surgeon in you area. I had my entire colon removed 11-09-06 due to a condition called Colonic Inertia (basically a paralyzed colon). The procedure is called a Total Abdominal Colectomy.The web has a lot of sites with this information, so many, I really can't just refer you to one.The procedure consists of removing either a portion or entire colon THEN reconnecting the small intestine directly to the rectum (avoiding a colostomy).Once you get in to see a Colorectal Specialist/Surgeion, they will advise you of the tests needed to be a candidate for the procedure.Hope this helps.


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## Kathleen M. (Nov 16, 1999)

I think they either do all or none.For colonic inertia removing a couple of feet is not going to make any difference. I think I saw a study that said removing less than all really didn't make much difference.It will not do ANYTHING AT ALL for the pelvic floor problems you have been diagnosed with.They would only remove a small section if there was something they could find wrong in that specific section, but they could tell the rest of the colon was OK.Like some with severe diverticular problems only have a short section effected, or in colon cancer.


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## 21731 (Jul 12, 2006)

Hi Kathleen, I don't want to overstep your word, however, they do BOTH "partial" AND "total" colectomies.For colonic inertia patients - most have their ENTIRE colon removed - only a few have a couple of feet removed, however, they later end up having to have the rest of the colon removed (within a year or two).Also, each surgeon has his/her own preference of performing the TOTAL COLECTOMY "open" or "laparoscopic" - surgeons who do "laparoscopic" MUST undergo a certain amount of hours of study and assistance in the actual procedure before they're board certified to practice "laparoscopic"You are correct in saying this type of surgery does nothing for pelvic floor problems - that's a totally different issue.Also, the "partial" colectomy is more for people that have severe diverticular problems and the "total" colectomy is more for Colonic Inertia.


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## SpAsMaN* (May 11, 2002)

IT'S NOT HAS BEEN EVEN PROVEN THAT PELVIC FLOOR DYSFUNCTION IS NOT A FEATURE OF GENERALIZED COLONIC CONSTIPATION.Think about that,what is the pourcentage of the constipated who have difficult evacuation?Perhaps 75%?


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## Kathleen M. (Nov 16, 1999)

Difficult evacuation DOES NOT MEAN that you can't relax the sphincter.Stool can be hard, dry and hard to pass even IF the sphincter opens.Removing the colon or a few feet of it won't do anything about a sphincter that won't open.Yep, when there is a diseased portion of the colon they will remove just the diseased part (like in IBD's, diverticular disease, colon cancer).What I read of colonic inertia you really have to remove the whole thing to get significant benefit.Spas, since you have normal transit time they aren't likely to chop out a few feet of colon.K.


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## SpAsMaN* (May 11, 2002)

Sitz markers aren't THAT reliable for extrem gas production.Gas taking all the bowel volume.


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## Kathleen M. (Nov 16, 1999)

Sitz markers cannot possibly in any way tell you a single blessed thing about gas volume. They aren't "unreliable" they are the WRONG TEST ENTIRELY!!Now the X-ray at the time may say something about gas volume in the colon at the time of the X-ray but that is completely different from what the sitz markers are measuring.They just tell you how fast the solids they are stuck in move through the colon.If you poop them all out in the usual amount of time you have NORMAL transit of stool through the system.If you want to be tested for abnormal amounts of gas production sitz markers are NOT the test you want.*sigh*What on earth makes you think losing a foot or two of your colon is going to change how much air you swallow or how much gas the bacteria in your colon produce.







It seems sometimes that you just won't be happy until you find someone who will slice you open. I really don't think the scar tissue from un-needed surgery will do you any good.K.


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## 21731 (Jul 12, 2006)

SPASMAN - I'm not sure what answers you're looking for here. As I stated before the "partial" colectomy is more for people that have SEVERE diverticular problems and the "total" colectomy is more for Colonic Inertia. This surgery wouldn't be an avenue to seek if you're looking for answers for pelvic floor dysfunction.As far as the sitz marker transit test, GAS has nothing to do with the test at all. Its sole purpose is to see how slow/fast things move thru the colon. I certainly had problems with difficult evacuation, so I can relate to that issue. My defagram revealed a 3/4mm rectocele. However, it has NOTHING to do with colonic inertia. I consulted my surgeon with the question of "fixing" the rectocele when he removed the colon only for him to say that once the colon is removed, the rectocele would take care of itself and would NOT need fixed and that held to be the truth.One of the tests they perform prior to considering one for a colectomy is an anal manomatry test - which tests the nerves and muscles of the rectum. I believe this determines if one is a candidate for a colectomy. What good would it be to remove the colon and attach the small intestine to the rectum that has nerve and muscle problems/damage. There would be NO purpose.


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## SpAsMaN* (May 11, 2002)

Remember that fixing the original problrm which is constipation resolve your anal problems.Something to think about.


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## 21731 (Jul 12, 2006)

No - fixing the original problem was fixing a paralyzed and dead colon - the anal (rectocele) was the least of my problem!!!


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## SpAsMaN* (May 11, 2002)

No.I said that colectomy in your case solve the anal problem.I reiterate that fixing constipation is the way to go in order to stabilize defecation.


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## Kathleen M. (Nov 16, 1999)

Rectocele IS NOT THE SAME AS pelvic floor dysfunction.


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## SpAsMaN* (May 11, 2002)

Of course but it share some similar symptoms.The thing who is really deceiving is that many research claim Bioffeedback as a cure for pelvic floor dysfunction but here no one seems to be cure by this.


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## flux (Dec 13, 1998)

> quote:The thing who is really deceiving is that many research claim Bioffeedback as a cure for pelvic floor dysfunction but here no one seems to be cure by this.


You have it backward. Researchers don't make claims; they do studies and present evidence. Here people can only make claims and that's only if they want to. Between the two, the evidence counts, the claims don't. (In adults, biofeedback does work: http://www.ncbi.nlm.nih.gov/entrez/query.f...=pubmed_docsum)


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## SpAsMaN* (May 11, 2002)

Regarding my case,the lack of motility is from the cecum to the anus.Not just difficult emptying.Even Eric think i may not have anismus coz i rarely feel stool stuck in my rectum but in my sigmoid or recto-sigmoid.I think i have a tigth anus tho.Is it THAT significatif to cause such devastating symptoms?I find it hard to beleive.Moreover,when i squat i usually evacuate better.The problem is the stool are small(being glue higher up somewhere) and i have to go 2-4 time a day.I live exacerbate by trapped gas.


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## Kathleen M. (Nov 16, 1999)

Yes, not being able to open the anus can cause big constipation problems.Squating will help you open the anus better. It won't change what is going on in your sigmoid colon.K.


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## 13863 (Mar 23, 2007)

Those darn sitz markers. I don't know how I passed that test but kinda wish I hadn't. They said they came out in the right amount of time.They told me to take more fiber, ugh.I had some test called a defagram or similar, almost like a barium enema but they take X-rays and pictures, yikes, it was awful plus the Cleveland Clinic did it which is a teaching school so they had 5 people watching me on video & in person.And they wondered why I couldn't go, hmmm.The only results I got from the Dr's assistant were that my colon is really long.Tiffany


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## SpAsMaN* (May 11, 2002)

I look in Pubmed and there is no mention of sigmoid removal for IBS.Where are the research that say it dosen't works or that it works?I'm still contemplating the idea of removing.


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## Kathleen M. (Nov 16, 1999)

http://www.ncbi.nlm.nih.gov/entrez/query.f...l=pubmed_docsumIs one thing.But it is used only in people who have a demonstrated anatomical problem with the sigmoid.Not because a patient thinks that part of the colon is the problem. They don't like removing parts just to see if helps because you can't put them back in.Something like 10% of people who get the whole thing out are still constipated and in pain and some people get IBS problems from abdominal surgery so this is not nearly as risk free as you seem to want to think it is.K.


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## SpAsMaN* (May 11, 2002)

From your link:


> quote: In patients with an isolated distended sigmoid colon, sigmoid colectomy has achieved good results.


Well it's interesting.Think about that,they remove sigmoid for diverticulitis and not for chronic problems?It look unfair.


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## Kathleen M. (Nov 16, 1999)

They need to know SOMETHING IS ACTUALLY WRONG with the sigmoid.In the link it was an obvious anatomical problem (just that part of the colon had become obviously and permanently distended, basically like mega colon only with one portion effected). With severe diverticular problems they can SEE something (and if they are infected they can burst and kill you, so it isn't just for the heck of it they take it out. Most people just get antibiotics when it gets infected becuse they are nowhere near bad enough to risk killing them during surgery and there is a risk of death every single time they cut you open from the drugs they use to put you under).I doubt you will find someone that will take it out because you think you can localize some pain or discomfort to that area. You may end up with way more pain from the scar tissue than you have now so the risk of that when there is no reason to expect benefit is something that is really unlikely for the doctor to do.I don't know why but it seems you are fixated on getting surgery. Even though the risks of scar tissue causing you way more problems than you have now is the second most likely outcome (first being it doesn't do anything at all).K.


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## SpAsMaN* (May 11, 2002)

> quote:They need to know SOMETHING IS ACTUALLY WRONG with the sigmoid.


If they were testing motility like they should,they would "see" the problems.Like here:http://www.blackwell-synergy.com/links/doi...04.03279.x/abs/


> quote:Methods: The electromyographic activity of the sigmoid colon was recorded transcutaneously in 18 patients with irritable bowel syndrome (49.6 Â± 10.2 years, 12 women) and 14 healthy volunteers (47.2 Â± 9.9 years; eight women) by applying three electrodes to the abdominal skin below the umbilicus. The sigmoid colon pressure was measured by means of a saline-perfused tube connected to a pneumohydraulic capillary infusion system.Results: Slow waves with a regular rhythm were recorded in the healthy volunteers exhibiting the same frequency, amplitude and conduction velocity from all three electrodes. Action potentials (AP) were not registered. The basal sigmoid colon pressure was interrupted by bouts of elevation. In irritable bowel syndrome, the electromyographic rhythm was irregular and the slow wave variables were higher than those of the normal volunteers and were not the same from the three electrodes; occasional AP were also recorded. The sigmoid colon basal pressure was significantly higher, and was interrupted by pressure bouts significantly higher, than those of the volunteers.Conclusions: Irritable bowel syndrome exhibited a 'tachyarrhythmic' pattern of electromyographic activity


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## Kathleen M. (Nov 16, 1999)

But I don't think that is isolated just to the sigmoid colon.IBSers colons do all the right things at all the wrong times. The risks of pulling out parts of someone colon are pretty high, which is why they don't routinely just yank it out.K.


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## SpAsMaN* (May 11, 2002)

I would even trade my condition for intermittent abdominal pain in order to eliminate trapped gas.I wonder if anyone in America is using surface electromyographic.Or perhaps it is more intere$ting to keep us sick if you know what i mean.You keep seeing hundred of patients and accumulate money...Hhmmm do they think we will swallow their #### till we die?Seriously,i'm NOT happy AT ALL how we are treated by gastroenterologist.I think we should ask Anderson Cooper to the rescue.I saw his show KEEPING THEM HONEST.-HONESTY ALSO MEAN IF YOU CHARGE PEOPLE,AT LEAST TRY TO HELP THEM BY RESEARCH.


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## Kathleen M. (Nov 16, 1999)

I'm not talking about an occsional twinge of pain after surgery. I'm thinking of the person we have had here that have continuous, untreatable, excrutiating pain from the scars of colon removal.That is the worst case they are comparing it to, and are you really so non-functional as you are that a 1-10% chance of being in that kind of pain really worth it? Additionally we have a lot of people here with adhesions and other scars that happen from any kind of abdominal surgery and I think you are really underestimating how much permanent pain you are risking.Not every doctor is capable of being a medical researcher. There is a lot of research into IBS and treating it. You just don't want anything other than research on cutting you open and pulling things out, I guess. Which they won't do when the risks are much worse than the likely total lack of benefit.


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## luckylou (Sep 22, 1999)

Spasman, don't consider having your sigmoid colon removed unless necessary.I am D, had emergency surgery 2 years ago for complications due to IBS, had my sigmoid colon removed. I went from being able to control the D with Immodium when needed, to uncontrollable D 24/7 15 - 30 times a day.


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## SpAsMaN* (May 11, 2002)

Luckylou,have you tried charcoal or rice diet.These thing slow the motility rigth?I don't know if i would trade my problems for uncontrolable D.At this point possibly.


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## Feisty (Aug 14, 2000)

Spasman......if you have your entire large intestine removed you will have D for the rest of your life. If you think going to the bathroom 4 times a day is the pits for you now, how in the world will you handle anywhere from 10-30 times a day? Plus, you will most likely have to get up during the night for more BM's. The stool will be liquidy, no matter what you eat or don't eat. There will be times when it will run right out of you and you will not be able to control it. Is that what you want? Not to mention, as Kathleen has stated, the high risk of scar tissue and/or bowel obstructions as a result of the surgery.You obvious do not have much wrong with your intestine. It is your anal sphincter muscle that won't open properly. Biofeedback CAN HELP......why don't you want to give it a try? OMG, if you want to know what it is like to NOT HAVE your large intestine, talk to my son. He'll tell you the truth. It isn't fun. It saved his life, but he wouldn't wish it on anyone.


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## SpAsMaN* (May 11, 2002)

No,just the sigmoid.I mean if i do it.I know a woman who did it for diverticulosis and she have a job.


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## Feisty (Aug 14, 2000)

> quote:just the sigmoid


How is removal of the sigmoid going to help your anal sphincter muscle?


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## SpAsMaN* (May 11, 2002)

I can deal with anal tightness as far as i know.


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## luckylou (Sep 22, 1999)

Spasman, please re read Feisty's post. She is 100% correct, if you have your sigmoid colon removed you will probably have liquid D 10 - 30 times a day no matter what you eat. I can also confirm that often D does come right out of you, you do not have control. I can't remember when I had a night's sleep without getting up numerous times in the past 2 years, sometimes I make the washroom, sometimes I don't. I doubt very much if that life would be one you would enjoy. FYI, the sigmoid removal part of the operation I had was for a diverticulousis rupture, can I lead a normal life, NO.


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## SpAsMaN* (May 11, 2002)

I was only curious about it.


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## luckylou (Sep 22, 1999)

Spasman, nothing wrong with being curious.Spasman,I was wondering if you exercise regularly? After reading your posts about your problems, I am thinking vigorous exercise daily might really help you.Just remember, if you don't need your colon out for a good medical reason, don't ever consider having it removed.


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## Feisty (Aug 14, 2000)

Yes, exercise is good. Lots of walking or running either outside or on a treadmill. Biking is good, too, but it seems the walking or running helps things move through better.


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