Constipation after reversal?

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Aqx99
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Location: Pfafftown, NC

Constipation after reversal?

Postby Aqx99 » Sat Feb 03, 2018 1:27 pm

I don't know what my bowels are doing. I started out after my reversal with the liquid lava, then moved on to several good days of semi-solid movements. The last two days I have pretty much been constipated. I am just eating and drinking normally, not taking anything. Has anybody been through this? Any suggestions to help me back to those semi-solid movements?
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Diagnosis, Age 39
2/21/17 CEA 0.9 ng/mL
3/23/17 - 5/2/17 Chemoradiation, 28 treatments
6/14/17 Robotic LAR w/temp loop ileostomy, ovaries & fallopian tubes removed, 2/21 lymph nodes positive
7/24/17 - 12/18/17 CapeOx, 6 Cycles
7/24/17 Diagnosed w/ovarian cancer
9/6/17 CA 125 11.1 U/mL
11/27/17 CEA 2.6 ng/mL
12/5/17 CT showed NED
12/13/17 CEA 2.9 ng/mL
1/11/18 CA 125 8.6 U/mL
1/23/18 Reversal
3/21/18 CT showed enlarged thymus
4/6/18 PET

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O Stoma Mia
Posts: 1202
Joined: Sat Jun 22, 2013 6:29 am
Location: Budapest

Re: Constipation after reversal?

Postby O Stoma Mia » Sat Feb 03, 2018 3:01 pm

I don't have any specific suggestions, except to say that most of my meals post-reversal used olive oil as a base (e.g., for making omelettes, etc.)

The MD Anderson website has several documents on constipation management. You might try some of their suggestions. The download links are at the right-hand side of the page below under Patient Education:

https://www.mdanderson.org/patients-family/diagnosis-treatment/emotional-physical-effects/bowel-management.html

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susie0915
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Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Constipation after reversal?

Postby susie0915 » Sat Feb 03, 2018 3:04 pm

Yes I became constipated and I worried I had another bowel blockage because I also had some pain. Went to hospital and was told I was constipated, kind of embarrassing because that was never my issue. They gave me magnesium citrate. Was not fun, but did take care of it. Mine was prob from taking immodium and lomotil to help with my clustering. You may want to try miralax, my GI told me to use this if I ever have an issue. Just stay close to bathroom. In fact it was one of the options my GI at the bowel control clinic suggested daily, to allow me to evacuate most at one time. I chose to do daily enemas as it gave me more control over when. Good luck I hope it gets resolved.
58 yrs old Dx @ 55
5/15 DX T3N0MO/ 2A
6/15 5 wks chemo/rad
7/15 sigmoidoscopy/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod onc feels scar tissue
7/17 no change lung nodule
10/17 Clear pel/abd CT
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule or scarring/inflammation

Lee
Posts: 5505
Joined: Sun Apr 16, 2006 4:09 pm

Re: Constipation after reversal?

Postby Lee » Sat Feb 03, 2018 4:31 pm

Ever since my diagnoses and after radiation, surgery and chemo, my bowels have never been the same. I can go from a solid BM to liquid in a single BM movement. I do know certain food do effect my bowels. Eating cheese will bulk it up, salad greens, especially spinach will pretty much give me the runs.

If you are not already doing so, keep a diary of food you eat and if it effect your BM.

Good luck,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

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susie0915
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Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Constipation after reversal?

Postby susie0915 » Sat Feb 03, 2018 5:38 pm

I have noticed even with doing enemas certain foods can make the process less smooth. Too much cheese is one of them. So yes since we are now so intone with our bowel habits now, keeping a food diary is a great idea. Before cancer we probably didn't think as much about it, now it consumes us, especially in the beginning
.
58 yrs old Dx @ 55
5/15 DX T3N0MO/ 2A
6/15 5 wks chemo/rad
7/15 sigmoidoscopy/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod onc feels scar tissue
7/17 no change lung nodule
10/17 Clear pel/abd CT
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule or scarring/inflammation

Aqx99
Posts: 383
Joined: Fri Mar 31, 2017 7:28 am
Facebook Username: aqx99
Location: Pfafftown, NC

Re: Constipation after reversal?

Postby Aqx99 » Sat Feb 03, 2018 7:58 pm

I have been keeping a diary of food and bowel movements since the first day. I'm eating the same foods, that's what has me so confused. I guess my intesines are still trying to figure out what they want to do.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Diagnosis, Age 39
2/21/17 CEA 0.9 ng/mL
3/23/17 - 5/2/17 Chemoradiation, 28 treatments
6/14/17 Robotic LAR w/temp loop ileostomy, ovaries & fallopian tubes removed, 2/21 lymph nodes positive
7/24/17 - 12/18/17 CapeOx, 6 Cycles
7/24/17 Diagnosed w/ovarian cancer
9/6/17 CA 125 11.1 U/mL
11/27/17 CEA 2.6 ng/mL
12/5/17 CT showed NED
12/13/17 CEA 2.9 ng/mL
1/11/18 CA 125 8.6 U/mL
1/23/18 Reversal
3/21/18 CT showed enlarged thymus
4/6/18 PET

MissMolly
Posts: 481
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Constipation after reversal?

Postby MissMolly » Sat Feb 03, 2018 7:59 pm

Ann/Aqx99:
Your reversal surgery involved handling and manipulation of the intestines by the surgeons. Intestines, as a general rule, are sensitive to touch and manipulation and easily irritated/upset by any surgical procedure. Slowing of intestinal motility is a common post-surgical by-product - i.e. constipation as one symptom.

MiraLax is a good choice. It is an osmotic agent that draws water into the large intestine with a gentle motility nudge. You
can titration dosing to meet your own needs, a little more or a little less depending on the outcome of your bowel movement (diarhea or loose bowel movement scale back on the MiraLax; constipation or hardened nuggets of stool add in additional MiraLax). You can use MiraLax on a regular basis, if needed for bowel management, without risk of laxative dependency.

Milk of Magnesia is another good choice. It is also an osmotic agent. Magnesia is a naturally occurring mineral in the body that plays an essential role in muscular contractions. Milk of Magnesia relieves constipation by giving the intestine a muscular boost along with flushing the intestine with a net positive influx of water.

Stool softeners are a less than ideal choice. Stool softeners draw water into the lower intestinal tract but nothing more. For a large intestine that has delayed motility due to surgical handling, the result is more aggravating than helpful in relieving constipation. Stagnated fecal matter in lower intestine becomes heavily weighted by the influx of water, and sits like wet cement. Constipation can be worsened with stool softeners in a slow to move intestine.

Simple yoga postures can be helpful in easing constipation. Elongating and rotating the torso in relation to the pelvis acts like a deep massage. You need not engage in overly complex postures or poses to derive benefit in mobilizing a slow moving intestine.

And never discount good old fashioned warmed prune juice or warmed 100% Concord grape juice (100% grape juice, NOT a juice blend and NOT a juice cocktail with added water) to ease constipation.

You are wise to try to stay ahead of troubling constipation before it becomes more than annoying. I hope that your lower intestine is soon humming along like a well oiled machine.
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

Aqx99
Posts: 383
Joined: Fri Mar 31, 2017 7:28 am
Facebook Username: aqx99
Location: Pfafftown, NC

Re: Constipation after reversal?

Postby Aqx99 » Sun Feb 04, 2018 7:51 pm

I took a dose of Citrucel today and it seems to have done the job. I have now swung to the clustering side of things. I'm just glad I don't feel the need to strain anymore, that had me nervous so soon after surgery. I guess I just need to find a balance.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Diagnosis, Age 39
2/21/17 CEA 0.9 ng/mL
3/23/17 - 5/2/17 Chemoradiation, 28 treatments
6/14/17 Robotic LAR w/temp loop ileostomy, ovaries & fallopian tubes removed, 2/21 lymph nodes positive
7/24/17 - 12/18/17 CapeOx, 6 Cycles
7/24/17 Diagnosed w/ovarian cancer
9/6/17 CA 125 11.1 U/mL
11/27/17 CEA 2.6 ng/mL
12/5/17 CT showed NED
12/13/17 CEA 2.9 ng/mL
1/11/18 CA 125 8.6 U/mL
1/23/18 Reversal
3/21/18 CT showed enlarged thymus
4/6/18 PET

ozziej
Posts: 218
Joined: Thu May 21, 2015 8:35 pm

Re: Constipation after reversal?

Postby ozziej » Wed Feb 07, 2018 8:17 am

As usual Karen your comments are spot on. Your post should be compulsory reading for anyone who had a low or ultra low anterior resection and is struggling with evacuation. So much more helpful than the standard 'eat more fibre' response.
Thank you :)
F 56 dx 11/14 Stage 1 RC (post EMR)
No neo-adjuvant or adjuvant chemo/RD
3/15 ULAR (open) temp loop ileo
5/15 ileo reversal
NED and hoping to stay that way!! : )

rockhound
Posts: 100
Joined: Fri Jul 14, 2017 5:00 pm

Re: Constipation after reversal?

Postby rockhound » Wed Feb 07, 2018 9:00 am

Aqx99 wrote:I took a dose of Citrucel today and it seems to have done the job. I have now swung to the clustering side of things. I'm just glad I don't feel the need to strain anymore, that had me nervous so soon after surgery. I guess I just need to find a balance.


I'm still working on that balance and my reversal was in late September! I have found that it takes time but improvement can occur. My first two weeks were liquid lava, then I started on metamucil and it instantly improved- so very much the opposite problem at first. I added 1/2 tab of immodium because I was flying (3.5 flight there not that good; 3. hr flight home with immodium, so so nice!) and have kept that up as well. Now sometimes I swing to more constipated side of things, so I'm trying to drink more water and also have upped the metamucil a bit more so that I'm now taking 1.5 to 2 tablespoons, per my surgeon's instructions. Food definitely affects things too- more salads, more fiber (bean burritos!) = more pooping. Anyway it's an experiment so don't be afraid to try things out, little bit at a time.
42 yr old male
Diagnosed December 2016, age 41
Stage 1/IIA rectal cancer - T2/3N0M0 via MRI (MRI indicates stage 1; onc/surgeon = stage 2a)
Lynch syndrome, MSH6 mutation, MSI
2 to 3/2017 Xeloda + Radiation
5/10/17 - Robotic LAR with temp. loop illeostomy, 0/20 lymph nodes
6 to 7/2017 - Six cycles Folfox @ full strength
9/20/17 - Ileostomy takedown
10/17 - Clear CT
1/18 - 5mm polyp removed during colonoscopy


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