# Headed for subtotal colectomy...



## jodys (Apr 8, 2002)

Hi everyone, I am doing the transit study this week and have one more x-ray left on Friday. So far none of the markers have moved and seem to be stuck in the lower right colon. My Dr. said i already "failed " the test, but wants me to complete it for "documentation" what ever that means. I will meet with him next week to discuss my options, but there dont seem to be any except the colon removal... Help!! Who else here has had one? Thanks!!!!


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## 14978 (Feb 12, 2006)

wow I hope it doesn't get to that and there's something else they can do to help you--can I ask what kind of meds they have you on and for how long and how it progressed to the point that they may have no other option but surgery?good luck, and let us know the final test results and what the dr says... *hugs*


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## jodys (Apr 8, 2002)

Hi, I am 45 and I have to say this has been a life long problem. I have been on miralax, Zelnorm, senna, magnesium, colonics, and just about every product that is out there. They used to help, but over time nothing seems to be working at all. I guess the transit test Im doing proves that there really isn't any peristalsis in my large intestine at all. Surgery is the only answer.


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## 14978 (Feb 12, 2006)

I'm sorry hun--from what I'm reading if that is the way they have to go it seems people are having success with the surgery, if it turns out you have to have it maybe you'll begin to feel a lot better afterward... *hugs*


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## 16279 (Sep 3, 2005)

Jodys,Have you tried fleet phospho soda?Get a 3 ounce bottle no prescription is required. Take on empty stomach (no food for 12 hours before using). Take 1.5 ounces diluted to 1/4 glass of water. Follow with 3 full glasses of water within 30 minutes. Should do the job within 2 hours. Then go on 800mg magnesium OXIDE tablets before bedtime. Follow with 30 grams of Kellogg's All Bran (insoluable fibre) every breakfast. Stay with this protocol indefinitely. If you get C again start over with the fleet phospho soda.


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## jodys (Apr 8, 2002)

Hi, I havent tried the fleets, but I dont know if that is something you can take frequently over the long term. I had my last x-ray today, and all 24 markers were still in the large intestine. I dont know if I really have any other choices other than the subtotal colectomy. I guess i will find out on Wednesday at my apt. Thanks for all the help everyone.


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## Kathleen M. (Nov 16, 1999)

Stud-- if the colon really cannot move anything along anymore large amounts of daily fiber is generally not the way to go. All you get is all that fiber sitting in the first part of the colon not moving anywhere, I mean some people can get a weeks worth or more fiber just sitting there not moving at all.For standard issue constipation your advice is going to work for a lot of people, but for people with transit problems it is usually daily doses of a different osmotic laxative (Miralax) and a low fiber diet is the way to go. When the transit problems are mild fiber may help, but for someone at the point of talking surgery fiber typically is a bad thing rather than a good one.Once the colon's ability to move anything is poor enough about the only thing they can do is take some of it out so you have a much shorter distance to get stuff moved through.K.


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## 16841 (Sep 20, 2005)

Hi Jody, I had a total colectomy a few months ago due to ulcerative colitis. I have decided to go with a j-pouch, but am waiting until I'm ready for more surgery (mostly mentally at this point). I have an ileostomy right now and life is so much better than when I was suffering with the illness.You're saying "subtotal". Have they discussed a temporary ostomy or will they remove the section of your colon that needs to be and reconnect all in the same surgery? I just want you to know that there is life after surgery. Hang in there and don't hesitate to reach out for support.


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## jodys (Apr 8, 2002)

Hi Sandy, Thanks so much for your support. I know what you mean about being "mentally" ready. This would be my 3rd major surgery in 4 years. Hysterectomy, sigmoid resection, and now this. I feel angry that my dr.s never listened to me years ago, and just kept pushing more fiber and biofeedback. Which did nothing to help. They should have taken the whole thing out when they did the sigmoid resection. The subtotal is where they take out all of the large intestine and connect the small intestine to the rectum. Its done all in one surgery, unless there are complications. For some reason I am really scared of having another surgery. I just keep thinking about all the things that can go wrong, and a show I just saw where people wake up during surgery. I know its just my mind working overtime. Plus I dont know if I could handle another NG tube. Maybe I'd be so out of it i wouldnt know it this time. How easily did you adjust to the ileostomy? Thanks so much, jody


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## 22112 (Mar 11, 2006)

Commiserations, Jody, but if you stay strong I'm sure you'll get through ok.You've had more surgical experience than me, so far at least, but some of your comments chimed so accurately with my feelings that I wanted to add my thoughts. I also watched a programme on waking up during surgery, just a couple of days before a gut op last year; I forced myself to watch, since knowledge is power. And I learned that it wouldn't happen to me, and it certainly won't happen to you. My impression is that surgical anesthesiology is advancing at a phenomenal rate. The complicated has become the routine. Secondly, it was the NG tube that bothered me most after the surgery, and I was constantly pestering the docs to remove it. Meanwhile, I found the minimal knowledge I had of basic yoga meditation techniques helped me when the NG tube was driving me mad; so I can only recommend you brush up on some eastern meditation, or similar kinds of self-hypnosis. Finally, although I was terrified of the gut surgery, I actually sailed through it with little pain, and expert treatment from both doctors & nurses, so I'm sure you will too - should it prove necessary.Best wishes again.


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## 16279 (Sep 3, 2005)

Kath.To my way of thinking transit problem = constipation and constipation = transit problem.These two terms can be used interchangably. If you got c then you know the markers wont move right and visa versa. If you are so fed up that you are ready to face bigtime surgery why not give the fleet soda a try first? They give it to everyone before a colonoscopy whether they have or havent got c and are very confident that it will work. Its alot safer than surgery.If you try the fleet soda and thengo on to try the magnesium/fiber and the fiberblocks you up you can still clean out the block with the fleet soda.


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## Kathleen M. (Nov 16, 1999)

There is a difference between people who have hard dry hard to pass stools that still have relatively normal transit times and peole with what is called by the medical profession slow-transit constipation (I didn't make the name up, don't blame me)There are people who do not have anywhere near normal transit times. People that on their own might have a week or more transit time.Only the later are considered to have slow-transit constipation. They have a problem with the muscles in the colon being able to do their job. It isn't that they aren't moving stuff well, or the stools are hard to pass, but that the muscles cannot move stuff along well anymore. Regular constipation you pass all those markers in 5 days (a usual cut off for normal passage of them even in constipated people) and usually once you get stool constistancy right they pass stool normally. Slow transit like talked about here all the markers are still sitting at the start of the colon, does not matter what the stool consistancy is, it isn't moving anywhere.Taking an osmotic doesn't do them a whole lot of good, and they need it continuously, not just once in awhile. Large amounts of fiber are not a good idea if you are going to have 2-3 weeks of it sitting in your colon at a time. 2-5 days like most constipated people is fine.They never ever talk surgery with people with normal constipation, and usually by the time they get there they have already run through all the various osmotic and fiber methods of controlling the constipation. They often won't even test with the sitz markers until all the normal means of controlling constipation have totally failed.I dont' know how else to explain it to you so you will see there is a difference.Like I said, good advice for most people, but once the sitz marker test shows you don't move anything at anytime for any reason that advice isn't medically sound.K.


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## jodys (Apr 8, 2002)

Thanks for that explanation Kathleen, That describes it perfectly. If I do try something like mag. citrate or the fleets, it just turns the stool to water in my colon and I can hear it sloshing around, but it just wont move out. most of my markers were stuck on the right ascending colon with just a few that went through to the transverse. I just wish I knew what the long term sucess rate for subtotal colectomy was for real people who have had it done for colonic inertia. also, can anyone tell me what the difference is between regular magnesium oxide and Phillips M.O.M. capsules? Thanks everyone!


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## Kathleen M. (Nov 16, 1999)

Milk of Magnesia is just a different magnesium compound. I don't know if one is more effective than the other, but they work in similar ways.The link works through google but not direct go here and click the top article link. gives some results and there are fairly high satisfaction rates in these studies. There is a newer proceedure that is potentially reversable that is mentioned but it seems to have lower longterm satisifaction rates.K.


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## 16279 (Sep 3, 2005)

Jodys,Different magnesium compounds do not get absorbed as well as others. For the ones that get 100% absorbed the excess will be pea'd away. The others that don't will be pooped away (except for the small fraction that is absorbed). The unabsorbed magnesium that ends up in the poop (magnesium OXIDE) draws in water and stops constipation. So that's way you want to use the oxide.


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## Kathleen M. (Nov 16, 1999)

Milk of Magnesia is sold as a laxative, so I would think it also works the same way?????


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## 16279 (Sep 3, 2005)

Kath,If I had no poop after 5 days I would use the fleet soda before thinking about surgery. Once cleaned out I would experiment with solutions to resolve the problem other than surgery such as large dose magnesium oxide/large dose vitaminC/fibre. I would continue to fall back on the fleet soda as long as it continued to work. Surgery closes off too many options some of which may be just around the corner.


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## 18829 (Mar 20, 2006)

you sound just like me so much i find that sodium picosulphate puts the right amount of pressure in the upper part of bowel/colon to give me the most chronic of stomach pain and gas build up like ikm going to explode but no amount of pressure will shift what lies in the bottom part but it does manage to get things moving once ive done a manual evacuation to clear the compacted stuff away and i only realised this was a possibility after working with an individual who is paralysed who has to get a manual twice weekly as horrible as it sounds it does the trick and now ive introduced the home enemas over a week ago im really feeling the benefits after 20 or so years (im only 26 by the way so its no new thing to me) the last thing id want at this age is surgery im willing to go a bit more short term drastic before i go under the knife however you procede good luck and big hugs mel


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## 18829 (Mar 20, 2006)

p.s i forgot to say that i go every 2-3 WEEKS if i dont use the alternatives!!!!! and yes i eat veg fibre fruit drink plenty water take lactulose before bed every night take bisacodyl tablets/supps you name it!!!and now im going every 2-3 DAYS


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## Kathleen M. (Nov 16, 1999)

Yes, people should try other things before surgery, but some people will never ever again in their entire life have stuff come out in under a couple of weeks ever again in their life.No amount of phosphosoda will ever make anything come out of them ever again. Maybe 2 or 3 weeks later, if they are lucky.Those are the people they finally talk surgery with. If phosposoda EVERY day would keep things moving they would do that. But for a few people who no longer have muscles in the colon that no longer work AT ALL. I can't explain it any other way. Yes, surgery is a big step but based on this person's test results I think their doctor is right. You may not agree, you may never agree, but that is the way it is. No amount of phosposoda or miralax or any other osmotic will ever do them any good.That is why they finally when all else has been tried and the little rings get into the colon and just sit without moving for way way way too long they start talking surgery.I wish that it was as simple and easy as you believe, but it is not for EVERY single person. Most people, yes it is, but it is like telling someone who has a muscle-wasting disease they could just walk if they rubbed bengay on their legs because they are just a little stiff. It is way past that. The muscles in the colon in a few people just do not work anymore and no amount of phosphosoda will miraculously make dead muscles alive again.K.


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## Kathleen M. (Nov 16, 1999)

I do agree surgery is the last choice, but doctors don't even do the testing to see if you are a candidate for it until they have done exactly what you suggest and tried many other things over and over and they don't work.It is a very few constipated people that would ever need surgery, but please believe me when I say there are a few people for whom it is the only option left. No one takes someone who doesn't poop for a day or two under the knife.It is people who are so bad that sooner or later, and tending to the sooner they will get an intestinal blockage so bad they will die. I'd rather do the surgery before it is an emergency, but that is me. Usually things work best if you don't wait for blockages or other medical emergencies develop.We just had a teenager who is on this board die on the table from emergency surgery after severe life or death constipation. Please do not assume it is a minor non-life threatening issue for all people. For the vast majority it is not, but once in awhile it is and I'd hate to see someone not do what they need to do to survive because someone assumes the thing that worked for them is the cure-all for everyone. K.


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