# Colin transit study tomorrow..



## Mlc2010 (Mar 29, 2016)

31 yo male. Constipation for few years tried all laxatives. Some work. Some don't

Went to see a private gastro who scheduled a transit test I have my xray tomorrow. Haven't passed any stools so they will all be there

Take enemas a lot. I find when I do an enema the poo is located right in anus. Could a weak pelvic floor do this? I have a weak pee stream when I'm. Constipated too and always used to strain

Not going to second guess but I bet my xray tomorrow will show the markers right at lower end

What is the treatment for weak pelvic floore. He suggested a colonoscopy but I don't want such an invasive test just yet

Thoughts?


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## annie7 (Aug 16, 2002)

that's good you're having the transit study done.

i've had chronic constipation most of my life and had to take laxatives to go. i finally had a colonic transit study done and i didn't have a BM the entire time. all the markers were still in there--mostly in the rectum and sigmoid colon (the lower end). my gastroenterologist thought as well as slow transit, this indicated possible pelvic floor problems or other outlet problems so he had me take a defecogram (defecatory proctogram). this test showed i had pelvic floor dysfunction. my pelvic floor muscles were too tight and didn't coordinate properly to allow a complete BM.

i was then referred to a biofeedback program at a local hospital. biofeedback can help a lot with pelvic floor problems. it teaches you to relax those tight muscles and hopefully to coordinate them so you can have a BM.

https://my.clevelandclinic.org/health/diseases_conditions/hic_pelvic_floor_dysfunction

and it's not just a woman's problem--men can have it too:

http://www.mccc.edu/~behrensb/documents/pelvicfloordisorderpresentation.pdf

i learned a lot from my biofeedback physical therapist. this u-tube video covers a lot of the things she taught me:






one of the most important things is not to strain. straining is counterproductive. instead of pushing from the rectum, do what she says in this video and "make your waist wide" and push from there--the abdomen.

also--sometimes putting your feet up on something like a footstool or shoe box or squatty potty helps. elevating the feet while sitting on the toilet straightens out the anorectal angle and allows a more complete evacuation. sometimes it takes some experimentation to get the right height. i started with a footstool, then tried a very large shoe box and then bought a squatty potty.


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## Mlc2010 (Mar 29, 2016)

Thank you. Did you have any left leg pain when you was constipated?


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## annie7 (Aug 16, 2002)

no i didn't.


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## Mlc2010 (Mar 29, 2016)

I don't want to self diagnose but whenever I take senna I can feel it in my anus almost at end of Tract. Then when I do an enema it comes out instantly almost like it's blocked.


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## annie7 (Aug 16, 2002)

i know what you mean about self diagnosing. sounds like the stool is all backed up in the rectum and lower end. it's good your're having this test and it will be interesting see where the markers are and what your doctor says about it.


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## Sean (Feb 8, 1999)

Hi Mlc2010. I suspect that you are right about having pelvic floor issues. The response you describe to enemas would seem to indicate that. In any event, the results of the transit test will give your doctor important clues. If the markers are all located in or near the rectum, it would seem that pelvic floor issues rather than colonic inertia (slow transit constipation) are your problem.

I have had two colonic transit tests. In both, I failed to have any kind of bm for the entire five days of the study. The markers were pretty evenly distributed throughout my transverse and upper descending colon. That, plus the fact that there was no stool in my rectum, even after five days of no bowel movements, led to the diagnosis of colonic inertia or slow transit constipation as it is often called. I never seem to have any stool near the rectal outlet. Even when I do an enema, I pass only water for a few minutes before finally passing any stool. There is nothing ready to be immediately evacuated. You seem to have a completely different experience.

I am thinking that your gastroenterologist may be reluctant to give you a diagnosis without doing a colonoscopy. If you have insurance, it would not be a bad idea even if you don't really want to have it done. No one really wants one, but it is considered an important part of a work up for otherwise unexplained chronic constipation. The test itself is relatively painless because of the heavy sedation.


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## flossy (Dec 8, 2012)

Mlc2010 said:


> 31 yo male. Constipation for few years tried all laxatives. Some work. Some don't
> 
> Went to see a private gastro who scheduled a transit test I have my xray tomorrow. Haven't passed any stools so they will all be there
> 
> ...





Mlc2010 said:


> 31 yo male. Constipation for few years tried all laxatives. Some work. Some don't
> 
> Went to see a private gastro who scheduled a transit test I have my xray tomorrow. Haven't passed any stools so they will all be there
> 
> ...


You probably having trouble urinating because there is fecal matter still sitting in your rectum, and it pushes against the bladder (and prostrate).

Do you know if you have any internal hemorrhoids? That could also lead to having problems evacuating.

I bet if your doctor prescribes you something it will be either Linzess (linaclotide) or Amitiza (lubiprostone). If you want to go the natural route, this has worked pretty well for me (click on below link to read):

http://www.ibsgroup.org/forums/topic/239065-finally-a-product-i-can-recommend/

Good luck and keep us posted!


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## Mlc2010 (Mar 29, 2016)

Sean said:


> Hi Mlc2010. I suspect that you are right about having pelvic floor issues. The response you describe to enemas would seem to indicate that. In any event, the results of the transit test will give your doctor important clues. If the markers are all located in or near the rectum, it would seem that pelvic floor issues rather than colonic inertia (slow transit constipation) are your problem.
> 
> I have had two colonic transit tests. In both, I failed to have any kind of bm for the entire five days of the study. The markers were pretty evenly distributed throughout my transverse and upper descending colon. That, plus the fact that there was no stool in my rectum, even after five days of no bowel movements, led to the diagnosis of colonic inertia or slow transit constipation as it is often called. I never seem to have any stool near the rectal outlet. Even when I do an enema, I pass only water for a few minutes before finally passing any stool. There is nothing ready to be immediately evacuated. You seem to have a completely different experience.
> 
> I am thinking that your gastroenterologist may be reluctant to give you a diagnosis without doing a colonoscopy. If you have insurance, it would not be a bad idea even if you don't really want to have it done. No one really wants one, but it is considered an important part of a work up for otherwise unexplained chronic constipation. The test itself is relatively painless because of the heavy sedation.


actually, sometimes when I do an enema, I have that issue too. It depends really how far along I've gone without going

The colonoscopy is under GA, I'm very reluctant to do that, and I would rather we do the defocagram or balloon expulsion test before an invasive procedure, and no insurance, I would have to pay for it!


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## Mlc2010 (Mar 29, 2016)

flossy said:


> You probably having trouble urinating because there is fecal matter still sitting in your rectum, and it pushes against the bladder (and prostrate).
> 
> Do you know if you have any internal hemorrhoids? That could also lead to having problems evacuating.
> 
> ...


I can almost guess I have internal piles, just judging by my enema situation and yes, I thought prostate issues also. This may sound TMI, but I find when I'm really backed up, my penis and testicles dont hang free, they almost go tight.. which is a sign of a prostate issue


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## Mlc2010 (Mar 29, 2016)

flossy said:


> I bet if your doctor prescribes you something it will be either Linzess (linaclotide) or Amitiza (lubiprostone). If you want to go the natural route, this has worked pretty well for me (click on below link to read):
> 
> http://www.ibsgroup.org/forums/topic/239065-finally-a-product-i-can-recommend/


I have tried two of ingredients in that.. senna, which worked great, restored bowel movements.. and then stopped working

cascara or the one I have aged cascara, worked brilliantly also, then stopped working


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## annie7 (Aug 16, 2002)

senna quit on me, too. although cascara sagrada did not as long as i took enough of it. i also took dulcolax (bisacodyl) . i alternated that with cascara. i did find that for me, taking a stimulant laxative like dulcolax or cascara along with an osmotic laxative (miralax or milk of magnesia) worked better than just taking the stimulant alone. one thing about this is that it's important not to take dulcolax at the same time as milk of mag--take them at least an hour apart or you'll get cramping.


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## Mlc2010 (Mar 29, 2016)

My results are back. The markers were scattered all along the entire colon which indicates slow transit constipation. The consultant mentioned a new drug i can try ( forgot the name ) which helps for motility. However he suggested a colonoscopy as a base to work from. If that is fine then we can then look at outlet tests and maybe biofeedback

I suggested a virtual colonoscopy. He was happy for that due to my circumstances but he did mention if anything is found they would need to do a regular one. Im fine with that

Im pretty nervous now about what the test will show but surely its better to know either way than not know


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## Sean (Feb 8, 1999)

Mlc2010, thanks for getting back with us. Welcome to the slow transit constipation club. Did the consultant actually give you a prescription for the new drug? If not, what did he suggest that you do in the meantime? Stimulants? Enemas?


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## Mlc2010 (Mar 29, 2016)

Sean said:


> Mlc2010, thanks for getting back with us. Welcome to the slow transit constipation club. Did the consultant actually give you a prescription for the new drug? If not, what did he suggest that you do in the meantime? Stimulants? Enemas?


not yet, he suggested we go down virtual colonoscopy route so it gives us leverage with my GP. I'm paying for this consultant privately, and the GP is on NHS, so drug would be considerably cheaper. I think my colonoscopy will be booked for next week


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## annie7 (Aug 16, 2002)

Mlc--yes, thanks for the update. and yes, like Sean said, welcome to the slow transit club although sorry you had to join it..

i wonder if the new drug is resolor (prucalopride) ? it's supposed to help with motility. it's not approved here in the usa but i know it's available in the uk and europe and in other countries too. it does help some people--hopefully it will help you.

and good luck with the colonoscopy. mine showed a redundant, twisted colon....


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## Sean (Feb 8, 1999)

Mlc2010,

Wish you the best of luck on the colonoscopy. It is a good idea to get that done if for no other reason than to rule out something truly serious. The prep is the worst part. The actual procedure is not nearly as bad as you might imagine. Because you have chronic constipation, you may want to ask for a more aggressive or thorough prep. Getting clean enough for the procedure has always been a challenge for me.

You may also want to ask the endoscopist if your colon is longer or more twisted than normal. Mine is about a foot longer than normal and has an extra loop in the transverse colon. Little wonder that nothing seems to make it through to the end.


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## Mlc2010 (Mar 29, 2016)

Sean said:


> Mlc2010,
> 
> Wish you the best of luck on the colonoscopy. It is a good idea to get that done if for no other reason than to rule out something truly serious. The prep is the worst part. The actual procedure is not nearly as bad as you might imagine. Because you have chronic constipation, you may want to ask for a more aggressive or thorough prep. Getting clean enough for the procedure has always been a challenge for me.
> 
> You may also want to ask the endoscopist if your colon is longer or more twisted than normal. Mine is about a foot longer than normal and has an extra loop in the transverse colon. Little wonder that nothing seems to make it through to the end.


he suggested a 2 day prep and I have 4 sachets of picolax on hand, that will sure be fun, I don't mind having a good clear out


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## Mlc2010 (Mar 29, 2016)

Is mucus normal for constipation? I dont really mean in the stood. After i do an enema. My anus has this clear white sticky substance. Somtimes with a shade of yellow. There is some in the poop occasionally


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## annie7 (Aug 16, 2002)

i got mucous like that whenever i did an enema.

and yes it's normal to have some in the poop, too.


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## Sean (Feb 8, 1999)

The same thing has happened to me with an enema. Sometimes the last thing that I evacuated was some slightly discolored mucous. I am guessing it is because the enema irritates the lining of the colon.


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## Mlc2010 (Mar 29, 2016)

starting to wonder whether these enemas are counter productive. I use slightly warm tap water, they are great as I feel it melts the poop

I might start adding olive oil and apple cider vinegar to them, someone mentioned soap or coffee, that seems well too harsh


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## Sean (Feb 8, 1999)

I would think that soap or coffee are only going to cause more irritation and, thus, more mucous. If plain warm tap water is working to produce a thorough bm, why change the formula? I agree with you that one of the benefits of an enema is that it softens the stool in addition to inducing the colon to contract and produce a bm. How often are you doing them and how much water do you use?


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## Mlc2010 (Mar 29, 2016)

Sean said:


> I would think that soap or coffee are only going to cause more irritation and, thus, more mucous. If plain warm tap water is working to produce a thorough bm, why change the formula? I agree with you that one of the benefits of an enema is that it softens the stool in addition to inducing the colon to contract and produce a bm. How often are you doing them and how much water do you use?


I probably do them once a week or so, I use a 2 litre bag, but its a challenge getting all that in me in one go. I normally have to expell the first pass pretty quickly


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## Mlc2010 (Mar 29, 2016)

my CT colonography is Tue, the instructions from hospital says I should start the prep monday. Due to my slow constipation, I'm wondering whether to start it sunday? eg : have my sunday dinner 3pm, then take one at 7pm sunday night, just to make sure

It also says I can eat toast with butter the day before, I can't believe that as I imagine sluggy bread is worst thing to eat


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## annie7 (Aug 16, 2002)

because of my slow colonic transit, my gastro ordered the fun-filled (not) two day prep. two days of broth only (clear liquids) plus i did a full prep each day. a couple days before all this started i ate only very soft foods--yogurt. soups boost.

but you want to ask your gastro about this and about any other prep questions you have. it's always best have your gastro doc's advice on how to prep. but yes, i agree with you. i'm not a doctor of course and just my opinion but in your situation it sounds like a full, two day prep would be best.


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## Sean (Feb 8, 1999)

I agree with Annie. A two-day prep would help insure that your colon is clean enough for the test. I always have to do a two-day one. In the past, my gastroenterologist has prescribed two-day preps which involve a liquid diet two days before the test but no laxatives until the day before. Given how hopelessly constipated I am, that two day prep did not help at all because there was no bowel movement until after I started laxatives the next day. For my last colonoscopy, the doctor had me take four dulcolax tablets two days before in addition to the clear liquid diet. That helped a lot. It seemed that the large volume prep the next day was more effective. I still wasn't very clean, but they were able to complete the test by cleaning as they went into the colon. Basically, the endoscopist injects water through the scope as it is advanced up the colon and then suctions it back out until the lining of the colon is clearly visible. You want to avoid that if possible, because it makes the procedure longer and makes it more likely that something of significance might be missed.


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## Mlc2010 (Mar 29, 2016)

Sean said:


> I agree with Annie. A two-day prep would help insure that your colon is clean enough for the test. I always have to do a two-day one. In the past, my gastroenterologist has prescribed two-day preps which involve a liquid diet two days before the test but no laxatives until the day before. Given how hopelessly constipated I am, that two day prep did not help at all because there was no bowel movement until after I started laxatives the next day. For my last colonoscopy, the doctor had me take four dulcolax tablets two days before in addition to the clear liquid diet. That helped a lot. It seemed that the large volume prep the next day was more effective. I still wasn't very clean, but they were able to complete the test by cleaning as they went into the colon. Basically, the endoscopist injects water through the scope as it is advanced up the colon and then suctions it back out until the lining of the colon is clearly visible. You want to avoid that if possible, because it makes the procedure longer and makes it more likely that something of significance might be missed.


I'm having a virtual colonoscopy.. a CT scanner so to speak


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## Sean (Feb 8, 1999)

Oops. My bad. They won't be able to clean up the intestinal lining during the procedure. Best to do everything possible to get properly prepped beforehand. A miserable exercise for those of us who are chronically constipated. Wishing you the best of luck.


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## Mlc2010 (Mar 29, 2016)

starting my picolax cleanse in one hour.. my colonoscopy is tuesday at 3.30pm, not going to eat anything solid tomorrow + another 2/3 picolax, might finish off with an enema tuesday morning


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## annie7 (Aug 16, 2002)

good luck with everything


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## Sean (Feb 8, 1999)

How is it going with the prep?


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## Mlc2010 (Mar 29, 2016)

Sean said:


> How is it going with the prep?


it's a doddle, started last night 9pm, had a enema too, bowel movement then. first thing this morning another one.. today I took picolax at 8am, had a bowel movement at 1pm ( seems to be yday dinner ) and took another picolax at 4pm so I can feel it brewing, will finish off with another enema

the worst part is that they have gave me some oral contrast to drink and its truly vile


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## annie7 (Aug 16, 2002)

hang in there--it's be such a relief when it's all over.

and oh yes--i've never had an oral contrast to drink that wasn't absolutely totally vile. seems to go with the territory.....

good luck with everything


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## Mlc2010 (Mar 29, 2016)

oh dear, nearly just passed out so I had 2 pieces of toast. the leaflet says toast is fine day before, however my colonoscopy is in 15 hours..  I just took another picolax


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## Sean (Feb 8, 1999)

Sounds like my preps. I feel for you. Don't forget to drink LOTS of water. That helps the picolax work and keeps you from getting dehydrated.


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## Mlc2010 (Mar 29, 2016)

went okay but wont know results til next week so wont know how clean I was

Since I got home my stomach and colon have been rumbling like mad, sounds like water sloshing violently all over haha


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## annie7 (Aug 16, 2002)

glad it went ok and good luck on the results.

oh yeah--sure am familiar with the rumbling and water sloshing. i always thought it felt like a washing machine stuck on the rinse cycle. hope it passes soon.


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## Sean (Feb 8, 1999)

How tolerable was the virtual colonoscopy? I have been thinking of requesting that instead of the actual scope next time. It is not invasive and does not require sedation. I was wondering how long it took and how uncomfortable it is? I understand that they blow you up with quite a bit of air and make you hold it in the colon for a time.


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## Mlc2010 (Mar 29, 2016)

sean,
it took about 20 minutes. the scans took seconds. took me in a room. explained the procedure and asked me medical questions. put a cannula in my arm and gave me some buscopan (sp?) relaxes the bowel.. stuck tube in me and filled me up with air.. which was a weird feeling but not ar all painful. i lay on my stomach.. scanned.. they put me on my back and injected iodinw which gave me a really warm feeling. all done

i did pass some water back into the air system but it collects it so it disposes of it. the radiologist says he will get a good look at my other organs too.. which is a plus


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## Sean (Feb 8, 1999)

Thanks so much. Sounds a lot easier than the invasive colonoscopy. I hope the doctors get to the bottom of your colon issues.


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## Mlc2010 (Mar 29, 2016)

Sean said:


> Thanks so much. Sounds a lot easier than the invasive colonoscopy. I hope the doctors get to the bottom of your colon issues.


tbh I'm more worried that they will find somthing outside of colon, ie lungs or a hidden tumour, damn health anxiety


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## Mlc2010 (Mar 29, 2016)

got results, all good! Radiologists note says, no polys, nothing.. great prep.. no extracolonic findings.. but I do have a small hiatal hernia, which he didnt seem too concerned about

so next step is testing my pelvic floor


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## annie7 (Aug 16, 2002)

thanks for the update. glad it's all good news--except for the hiatal hernia, of course but at least they're not too concerned about it.

good luck with the pelvic floor testing. those are good tests to have.


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## Mlc2010 (Mar 29, 2016)

yes I have a proctogram friday and some anorectal studies next week, if needed.. then some biofeedback and the gastro said he would give me some new drugs, which help colon motility, I forgot the name but If or When I get them I will let you all know what they are, and how they work


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## annie7 (Aug 16, 2002)

sounds like a busy couple weeks. i had the same tests and biofeedback too which did help some.

sounds like you have a good gastro doc--very thorough.

thanks for keeping us posted.


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## Mlc2010 (Mar 29, 2016)

had my proctogram today. they did the barium enema and nada. nothing came out and didnt feel the urge at all
he said there may be nerve damage or muscle damage. im having an anorectal mammometery test wednesday

does anyone have any idea if all this can be treated?


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## annie7 (Aug 16, 2002)

same thing happened to me with my proctogram. didn't feel an urge--nothing came out. they told to me strain in order to get the barium out which i did and finally managed to squeeze it out a bit.

based on this test i was diagnosed with pelvic floor dysfunction. i then had an anorectal manometry which dx'd me with rectal hysposensitivity and megarectum.

biofeedback can help with pelvic floor dysfunction and ballon retraining therapy can help with rectal hyposensitivity.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3479250/

i don't know if there is a different treatment specifically for nerve or muscle damage...


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## Sean (Feb 8, 1999)

Wow. That is amazing. Be sure to take something to help you pass the barium paste. You don't want that to stay inside you for days and harden.

As to whether your issues can be treated, I don't think anyone here is qualified to say. It seems you have a double-whammy of things working against you: slow transit and pelvic floor issues. A tough case to be sure. My advice would be to find the best private gastroenterologist available. Have you investigated MACE surgery? Not sure whether that would work given the pelvic floor problems.


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## Mlc2010 (Mar 29, 2016)

my anorectal test is wednesday so that should shed more light. i think the proctogram is flawed as i was in quite a strange position
my pee stream is weak too so that defo points to pelvic floor. im wondering how much biofeedbadk would help. wouldnt electrical stimulation be best to strengthen the muscles there?

sean. im already seeing a private gastro and all these results will to back to him


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## annie7 (Aug 16, 2002)

i thought the proctogram was flawed, too because yes it is a strange position. and also i had been used to putting my feet on a step stool or squatty potty. plus i've always needed privacy in order to have a BM--ie-- a closed bathroom door--and doing that in front of an audience made it hard for me to relax and go. .


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## Mlc2010 (Mar 29, 2016)

yep as soon as i got home i expelled it. im used to doing large volume enemas. they only put 180ml it was like nothing was there


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## annie7 (Aug 16, 2002)

yes you're right---180 means nothing to my butt ....


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## Mlc2010 (Mar 29, 2016)

Apparently I have Anismus. Going to try some biofeedback. He also gave me some senna and ducosate sodium.. 2 of them each per night, see if it helps.. then he says He can try me on some harsher stuff


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## annie7 (Aug 16, 2002)

good luck with biofeedback. i really think it's worthwhile. i worked hard at it and finally learned how to relax my muscles.

hope the senna and stool softener help.


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## Mlc2010 (Mar 29, 2016)

biofeedback in june

with senna and ducosate im going every 2 days now. the poop is hard and thick though. any idea why this is?


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## annie7 (Aug 16, 2002)

maybe instead of ducosate you need something like miralax or milk of magnesia. and of course drink lots of water....


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## missgolightly (Jun 8, 2016)

I'm convinced I have slow transit constipation as well, as I have regular BM's despite a fecal impaction that will not go away! Do these motility drugs really help?


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## annie7 (Aug 16, 2002)

we're all different when it comes to medication but yes, they do help quite a few people. it depends what else you have going on and how chronic your situation is. i have read and heard many success stories. it's always worth a try--that's the only way you'll find out if they will help you or not.


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## Mlc2010 (Mar 29, 2016)

I'm going 1-2x a day for first time in a long time, nice soft bowel movements, maybe too soft

with dulcoease x2 morning and night and 2x senna at night

My biofeedback session is tomorrow


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## annie7 (Aug 16, 2002)

that's good. good luck with biofeedback. hope it helps.


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