# Colace & rectocele



## smason (Jan 7, 2002)

Does anyone know if Colace is most effective on an empty stomach or with food? The bottle does not indicate whether it matters.I would prefer to take it with food because I'm prone to nausea when I take medicine on an empty stomach. However, I tried Colace for a few days with my meals (twice a day) and I didn't notice an effect.Also, has anyone here ever been diagnosed with a rectocele? I thought I found the answer to my problems when a GP I saw on call one night did a rectal exam and said I had a 3 cm. rectocele which would be making it difficult to eliminate. It then made sense to me why I have a difficult emptying my rectal area even when my stools are soft.He sent me to a G.I. doctor who did not find it during the rectal exam he did on me. He also did a colonoscopy a week later and said my colon was fine. When I went back for the follow-up exam, I was still feeling miserable so I asked the G.I. doctor again about the rectocele. He said they wouldn't have found it during a colonoscopy anyway. I was sure he told me on my first visit that the colonoscopy would show a rectocele if I had one. Anyway, I would appreciate any input regarding Colace and other people's experiences with rectoceles.Sarah


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## honeybee (Sep 12, 1999)

Hi Sarah, I was diagnosed with a rectocele a couple years ago and had surgery to fix it. My ob-gyn doc did the surgery and told me that they do many rectocele repairs because many woman get them after carrying a baby, but can also be caused by chronic constipation. Mine was very large (10cm) and was pushing the vaginal canal way out of whack. My rectocele was found with a test called a defacography, no colonoscopy found the rectocele, but my ob-gyn said he could feel it with just a vaginal exam. I did feel somewhat better after this surgery but I had so many other problems that needed surgical repair I still had very bad constipation after, I now have a new rectocele but it is very small in comparison to the other one and doesn't yet need surgical repair. I wish you luck and hope you get relief soon. ((((((Sarah))))) hugs to you


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## Tiss (Aug 22, 2000)

I was diagnosed this week with a rectocele although I already knew I had it because I had a huge bulge when I had a BM. My Dr. (gynoclogist) said to do whatever is necessary to keep the stools soft because you can get into real problems if you don't. He did not want to operate at this time but did put me on Estratest (combination estrogen and testoerone), progesterone, and an estrogen vaginal cream. The rectocele can get worse as you age because of the lack of estrogen. The vaginal walls become thin and the muscles lose their elasticity. He also said to do 20 minutes of Kegels everyday, which is hard to do but I'm slowly working on that. As for the Colace, I buy generic brand of docusate sodium (that's what Colace is) and take 200mg everyday to keep my stools soft. Colace brand is very expensive compared to the generic. ALso, the colonoscopies I've had never found the rectocele. It is usually diagnosed by your gynocologist through a vaginal and rectal exam.


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## smason (Jan 7, 2002)

Thanks for your comments, Tiss and Melissa.Do either of you know if Colace is more effective if taken on an empty stomach or with food?Sarah


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## smason (Jan 7, 2002)

Melissa,How long of a hospital stay did your rectocele surgery require? And was it a 6 week recovery? Thanks for any input.Sarah


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## Tiss (Aug 22, 2000)

I take my stool softeners at night so it's usually an hour or 2 after I've eaten dinner. I don't think it makes much difference. Just be sure to drink lots and lots of water.


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## honeybee (Sep 12, 1999)

Sarah, My hospital stay was 4 days and a 8 week recovery. The surgery was done vaginally so no abdominal incision. My repairs were very extensive, so you may not have as much recovery time. Keep in mind, do nothing after surgery and take plenty of hot sitz baths, very soothing! Also you will need to keep the stool very soft! Good luck to you!


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## smason (Jan 7, 2002)

Melissa,I looked up defecography and I have a general idea of what the process entails, but nothing I read indicated how you prep for it.Did you have to prep with laxatives the night before? Thanks for your help!Sarah


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## honeybee (Sep 12, 1999)

Sarah, the prep, as I remember, was the complete deal, drink the stuff, laxative at night and enema in morning. Do they do this test in your area? Very informative test, they found lots of stuff wrong with this test. Good luck!


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## smason (Jan 7, 2002)

Thanks for the info, Melissa.I don't think they do the defecography at my medical clinic here, but the clinic is affiliated with Mayo Clinic in Rochester which is about 70 miles from here so they would probably refer me up there for it. That's where they sent me for my hysterectomy 4 years ago. This morning I'm as miserable as I have been almost every morning for the past 5 months. I have to get up at 4 or 5 in the morning and try to exercise some of the gas out of me that traps way low in my abdomen and rectal area or maneuver my body around enough to actually eliminate. I've been on the stool softeners for about a week and I notice the stool is softer, but I don't have any more luck eliminating. I still have to do push on the walls of my vagina back toward the rectal area to effect any sort of bowel movement at all. I also notice a bulging of the perineal area (where they snipped me to get both my babies out years ago) whenever I try to eliminate. It's almost like my rectum is pushing into that area or into my vagina rather than towards the anal area. It's almost like I have a trap door down there. I have to be extremely careful about what I eat because if I eat something that starts the peristaltic action through my colon the left side of my colon gets horrible cramps. It's like it's trying to push things through and there's no where to go.I'm at wits end. As I mentioned before, the GI doctor found nothing in the colonoscopy. What kind of doctor should I go see now? I was thinking about seeing a GYN, but most of my symptoms are related to the bowel movements and gas. What's leading me to consider the GYN is the way I have to manipulate the vaginal area to have the bowel movement. Also, I think you and Tiss both mentioned seeing a GYN for your rectocele issues. Last week I spoke on the phone with the GP who thought I had a rectocele before the GI doctor did the colonoscopy and told me he couldn't detect one. The GP looked at my chart while I was on the phone with him. He reiterated that the GI doctor didn't find a rectocele but that he had noted on the chart I had a thinning vaginal wall. The GP told me he thinks my problem is spasms in the rectum. How come it doesn't feel like my rectum is spasming? I sure know when my colon is spasming.Right now my rectum feels very full and my lower abdomen also feels very full. I have no sense of spasms in the rectum. Go figure!Anyway, thanks for your help, Melissa. I appreciate the info you and Tiss have shared with me.Sarah


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## Tiss (Aug 22, 2000)

I would definitely see a gynocologist. I thought the colorectal surgeon would find it but he didn't. It was finally diagnosed by a gynocologist.


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## Elizabeth Bucchieri (Jan 24, 2002)

Hello Sarah, I am a new member but maybe I can help you out a bit. I underwent an extreme prolapse in 1997, everything was falling out: bladder, partial bowel, thru my vagina. Was discover by me for a very long time like a hugh basketball between my legs. Went to my Gyn for exam, he told me that surgery was necessary. I had a rectocele, cystocele etc. I had to have reconstructive surgery done. Was out of work for six weeks. I was told to drink plenty of fluids, which I still do, but still have a major problem with constipation. I was also on colace, which helped to an extent. Surgery was done by a Mayo Clinic doctor who told me that in the future I should not strain, which in time may harm the repairs and to take Philips Milk of Mag. if necessary. Could take everyday it would not hurt you. I am still battling constipation and would greatly appreciate any suggestions as to food, meds. etc. Thank you and I hope I was of some help to you. Elizabeth


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## smason (Jan 7, 2002)

Elizabeth,Wow! You've been through quite an ordeal!Prior to your total prolapse, did you have any clues that things were changing internally? Or did the total prolapse happen suddenly?I wish I could give you some clues about the constipation, but I'm not having much luck myself.Good luck to you! I'll keep you in my prayers.Thanks for writing.Sarah


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## Tiss (Aug 22, 2000)

I noticed the 'bulge' when I had a BM getting worse as I got older (started around age 40 and I'm 45 now.) It gets worse as the vagina lining gets thinnner as estrogen decreases, which makes a rectocele worse. My vagina was literally falling into my rectum and anus. My Dr. told me that many women with rectoceles must manually push inside their vaginas go get a BM started. I didn't have to do that but I got to the point where it felt like my anus was literally being turned inside out having a BM. It's a weird feeling. He does not want to do surgery now but put me on hormones (estrogen, progesterone, and testosterone) including estrogen vaginal cream,which has helped tremendously. And I do lots of Kegels everyday.


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## 22171 (Aug 14, 2006)

> quote:Originally posted by saraheleanoroes anyone know if Colace is most effective on an empty stomach or with food? The bottle does not indicate whether it matters.
> 
> I would prefer to take it with food because I'm prone to nausea when I take medicine on an empty stomach. However, I tried Colace for a few days with my meals (twice a day) and I didn't notice an effect.
> 
> ...


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## 22171 (Aug 14, 2006)

Hi Sarah, my doctor said you can take your Colace with or without foods. I had surgery for a rectocele May 11. I was taking it 3 times a day and took it with my meals but you don't have to. Colonoscopy does not show a rectocele, I asked my gastroenterologist also. My gynecologist did my surgery and he says it's a 12 week recovery time. I was only in the hospital overnight and went home the next day. But now it's coming back. It does sound to me like you have a rectocele. Have you pushed your bowel back in through your vagina when having a bowel movement? That's what I used to have to do. My rectocele has come back but isn't nearly as bad as it was but I may need surgery again down the road.







You should get into a gynecolologist as soon as possible. And you want to go to one who's done a lot of these surgeries. I asked and was referred by my Urologist. Good luck hon.


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## 13711 (Jul 27, 2006)

Toni,I just had a rectocele repair done last week and I am really suffering with no bowel movement. They have switched me to colace+milk of magnesia (2x max rec. dosage) AND Miralax. I was surprised to see 12 week recovery on your post. Can you give me a little info? I have been back to the ER to check for obstructions because the pressure on my tailbone is so bad. I got desperate yesterday and removed a bad "clog" pushing on my tailbone...much to my husband's dismay. The pain when I try to push at all causes me to black out. Any words?


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## 16366 (May 28, 2006)

Hi all,I haven't posted here in a while, but I do check in once in a while. I had a baby in February and developed a rectocele in the process. This whole issue is complicated by the fact that I also have pelvic floor dysfunction (non-relaxing puborectalis). I've got a couple of recommendations for you that may help you decide how to proceed with your treatment.1) try to find a urogynecologist. This is a subspecialty of gynecology and they specialize in pelvic floor dysfunction. Though my OB/GYN identified the rectocele, (and volunteered to do the surgery--I decined) she did not find my pelvic floor dysfunction, or the granulation tissue that I had to have cauterized by the urogyne. Neither did she suggest or prescribe physical therapy/biofeedback. I mean no disrespect to gynecologists here, but if you have a rectocele and it is symptomatic, you want to be seen by someone who deals with the management of them all day long, you know? 2) If it is strictly mechanical failure due to the rectocele (stuff getting stuck in the pouch that bulges forward into the vagina), then surgery may fix the problem, BUT if you also have issues with the muscles and nerves in the area, you might be better off tyrying to address that issue with biofeedback before going under the knife. (that's what I'm doing now.)I just had my first Physical Therapy evaluation this past Friday and I will be returning in a week. Since I still have healing happening (yep, even 6 months later)and I also have granulation tissue at the site of a couple of my tears (actually on the vaginal/rectal wall), I'm going to have to do some PT to try to soothe the irritated puborectalis muscle and local nerves before I can proceed to biofeedback strengthening and retraining.







So this isn't going to be a quick fix by any means.Still, I'll try to pop in here and let you all know how my battle against rectocele and PFD are going. There seem to be a number of people popping up on this board with these issues all of a sudden!Best to all and keep your chins up


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## 15483 (Aug 20, 2006)

I try to not take colace more than every other day and even then I want to go for several days without taking it because I was concerned that it would lose effectiveness. Also, sometimes it makes my intestines feel sore, which I hate.


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## 13711 (Jul 27, 2006)

Litgirl,THanks for your info. I went back and listened to the entire recording that we made at my appointment before surgery. He did say (a urgogyn specialist!) that if it was a 2cm rectocele that emptied out if the stool was liquid, that he'd try biofeedback first. However, he said I had a minimim 5cm grandaddy of a rectocele that would actually not empty even when liquid...until it just decided to.I am going in Thursday to follow up with surgery from 10 days ago...and hope to get into biofeedback right away...as it seems like I'm just pushing the rectocele right back again.Beth


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## 22171 (Aug 14, 2006)

Just Me,Hi, your story horrifies me! I had a bowel movement the very next day. The night of my surgery I ate some scrambled eggs, some stewed prunes, and something else. I was on stool softeners for a couple of months before the surgery and for a little over 3 months after the surgery. But I am doing really well now. I make sure to eat an apple every day. I have a fruit smoothie with brown rice protein powder and ground flax seeds for breakfast. I also have been eating watermelon and cucumber and my bread is Orowheat lite wheat. It has 7 gms of fiber for two slices. My stools are staying soft and I got 2-3 times a day. I use Prep H wipes. Those also help as I get very sore down there. It really did take a full 12 weeks recovery before I could return to normal exercise and lifting. Do you know another thing that causes this...coughing! I have a problem with pills getting stuck in my throat and after the surgery I got an infection and had to take antibiotics and I think that tore some of the stitches out. Now my rectocele is back but it's very small compared to what it You really do have to eat a lot of fruit and fiber to keep the bowels moving. It scares me that you almost pass out. Did you tell your doctor that? Good luck hon.


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## 13711 (Jul 27, 2006)

Thanks Toni!Now things are "the opposite" with uncontrollable bouts for 4-6 hours...usually from 10-4am. I think that if it takes my body 4-6 days to process ANY FOOD...that it would make sense that it won't let laxatives through any faster...so when it builds up...it goes overboard the opposite direction. My doctor had me cut the Miralax/Milk of Magnesia regimen in half despite the fact that I have terrible diarrhea now. He says that I need to keep things moving at any cost for the first six weeks so they can keep the stitches in place and give my colon a rest. At this point, I made a promise that if I EVER went again without passing out...that I wouldn't complain...so here I sit and smile!I am trying though, to see if anyone ever thought to get an xray from the side. I think there's something wrong at my tailbone that is blocking anything larger than a pea.Thanksfor listening. Do you ever eat FiberOne? I found it was much easier on my system than flax and has very few calories for the huge amount of fiber. A friend gave me a recipe for "haystacks" made by mixing fiber one and melted milk chocolate and putting into cookies shapes. They were "ok".Beth


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## 22171 (Aug 14, 2006)

Hi Beth,No, I don't eat processed foods and that might possibly be part of your problem? The ground flax I use has more than fiber, it's got lots of good stuff for our body. It does sound like you have an overload of laxatives in your body. I now just use Colace if I'm having a meal that doesn't have a lot of fiber...but I try to be really careful about that and make sure I do eat my apple every day among other fruits and veggies. I have pain in my tailbone too Beth...it's very painful to sit for long periods. I have a squishy donut pillow but that's not as comfortable as one of those foam pillows...you know the kind where your handprint stays in it? That is great for the car and sitting here at the computer. Good luck hon!


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## 13711 (Jul 27, 2006)

I'm surprised that you take colace as a "replacement" for fiber. Did you know that it doesn't have any fiber or fiber benefits...it's just to soften things up? The doctor from my weight management program suggested that I have "benefiber" chewable sugar free tablets and if any of my five small meals don't have a good serving of fiber to chew a tablet...up to four a day. I mentioned it to my URO/GYN today and he said that Benefiber and Metamucil can be taken as often as I need, but that I should definitely continue with 3 colace & a dose of Miralax every day for 12 weeks. I'm in a hospital based weight loss program because I couldn't seem to lose weight with healthy eating and exercises(150# 5'1")...that's when we realized that my colon wasn't working.I'm really excited that I am returning to "normal"...and I don't even mind that the doctor restricted my activity for another four weeks!Thanks so much for your information.


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