intense motility

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pajamas35
Posts: 2
Joined: Fri Dec 14, 2018 9:04 pm
Facebook Username: PJ Russo Schramm

intense motility

Postby pajamas35 » Fri Dec 14, 2018 9:30 pm

Hi I am new to this forum. I was diagnosed stage 3 in 2014. I had one lymph affected. I had a removal of the colon cancer, colostomy and was reconnected. I had 6 months of 5FU and oxciliplatin. Lately I have been having fairly intense movement in my intestines. It's a magnification of the normal peristalsis. It seems my pattern is going #2 in an emptying sort of way, then going very little the next 2-3 days or so and during those days I'm not going is when the intensity begins. After I go #2, it's a lot and I don't hurt anymore. The pattern of going hasn't changed since shortly after my surgeries, but the intense movement is what is new. Also, not to be gross, but I can actually feel the waste traveling (as my fascia is shot from all the surgeries). At first I thought the cause was spicy food, but I've ruled that out. Then I thought it was heavy, rich buttery types of food (like mashed potatoes). I spoke to my primary who said it's likely acid because sometimes there is burning. So I've been taking Pepcid AC before meals each day. This has reduced the intensity, I think. I am wondering if my body is reacting to those days of going little and pushing harder to expel and that perhaps a laxative or stool softener would be helpful. Has anyone else had this problem or can anyone else shed any light on this for me. I would appreciate it. Thank you.

Lee
Posts: 6207
Joined: Sun Apr 16, 2006 4:09 pm

Re: intense motility

Postby Lee » Mon Dec 17, 2018 5:18 pm

Sorry no one has responded earlier to you question.

First welcome,

Sounds like your Dr may be on to something. The only thing I could possibly add, up you intake of water. See if that might help. If you have to push to get stool to come out, I'm wondering if you constipated. And yes, laxative or stool softener might help too.

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 - 16 years and counting!

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: intense motility

Postby MissMolly » Mon Dec 17, 2018 7:46 pm

Pajamas:
From your narrative it seems that you are experiencing some form of a functional or motility issue with your intestines. That is, the normal manner in which the intestine functions to move digested food material down the intestinal tract is acting up.

Adhesions can play a substantial role in intestinal dismobility, often years after the initial abdominal surgery. Adhesions are scar tissue, a normal response to healing. Thick, dense bands of scar tissue can tether a portion of small bowel to another section of small bowel, causing a kink or narrowing. Adhesions can also tether a section of small bowel to the abdominal wall or to an adjacent organ.

The net effect can be intermittent episodes where the flow/movement of the intestines is interrupted, often felt as rolling waves of fairly intense pain. Digested food material (called chum) begins to back-up, distending the small bowel immediately above the area of narrowing/restriction. As infra-intestinal pressure builds, the body will reflexively exert more forceful contractions of the intestinal smooth muscle, more oomph and vigor to release the log jam. This is likely what you are experiencing in the intense and forceful cleaning out episodes. Your body is marshaling recruited contractile force to clear what it rightly perceived to be a partial obstruction.

The next 2-3 days following the clean-out find your intestine calm and acquiescent. The partial kink or narrowing has cleared and harmony has been restored.

Until . . . Until there is another instance where scar tissue becomes problematic, lending to repeat the scenario above.

The small bowel is particularly vulnerable to intermittent obstructions by scar tissue. The small bowel is in constant motion, 24-7, under the moist and fatty apron of fat called the omentum. The small bowel slithers like a snake, constantly squirming, propelling digested food material. This slithering makes it easy for filaments if scar tissue to become entrapped and is the basis for many small bowel obstructions.

So . . . What to do? Ideas include:
1. Take an osmotic laxative or magnesium supplement or dose of aloe Vera juice daily.
The goal is to make the consistency of fecal material less dense/bulky so that it can pass with greater ease through narrowed intestinal passageways. Titrate a daily dose that provides you with the effect you need (you are in hr eighth track as repeated episodes and symptoms resolve).

Individuals plagued with abdominal adhesions will take Miralax or similar daily as a pre-emptive measure. The thinner the fecal consistency the easier it is to pass.

Aloe Vera juice is analogous to intestinal lubrications. It is found at pharmacies, holistic grocery stores (Whole Foods), and Amazon.

2. Daily stretching for abdomen and pelvis
Stretching (elongation of the torso, rotation of the torso/pelvis, side-bending, etc) has benefit of stretching and mobilizing scar tissue. Basic/beginning yoga poses are also quite effective. Deep tissue massage by a licensed masseuse or physical therapist is also beneficial.

3. Keep to a fiber diet lower in fiber (lower in insoluble fiber, in particular) and keep portion sizes small/moderate.
Although many people increase fiber intake in hopes of relieving constipation, insoluble fiber can be add to constipation because fiber can difficult to process and move along when the intestine has a functional or dysmotility problem. Think of long strands of celery that get tangled in a sink’s garbage disposal. Low bulk, low volume foods are easier to digest. You can certainly enjoy a fresh salad, but have a small appetizer salad rather than a hearty dinner sized Cobb salad. Cut fresh greens and veggies into smaller pieces to aide the mechanical work of digestion and chew, chew, chew well before swallowing.

Keeping to small portion sizes also helps when intestinal motility is slow or when the intestine has areas of narrowing. You do not want to overwhelm the intestines with food overload. Soups and foods with a liquidity base (stew, chowder, chicken pot pie) are wise food choices.
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.

pajamas35
Posts: 2
Joined: Fri Dec 14, 2018 9:04 pm
Facebook Username: PJ Russo Schramm

Re: intense motility

Postby pajamas35 » Thu Dec 20, 2018 6:26 pm

thank you both for your replies. I posted on Friday and Monday evening I was in the ER. I couldn't eat and I was in great pain which was generalized throughout my intestines. The doctors put in an "NG" tube through the nose to the stomach, gave me diladid (sp?) for the pain and zofran for the nausea as I was throwing up a lot. I was monitored over a period over nearly 3 days. CT scan and x rays with contrast were done. CT scan showed bowel obstruction. Initially they thought it was due to adhesions. Later the doctors agreed it was due to my hernia. They all agreed that once it happens, it continues to happen and does so more frequently. They suggest the hernia repair with a mesh would greatly reduce this from happening again. The x-ray with contrast showed no obstruction. They explained that this could have been cleared by the NG tube or the contrast. It might have even been cleared the night I was admitted through the ER as I had a bowel movement there that seemed to be a bit of an "emptying" one.

So it seems my options are to endure this time and time again or to have the hernia repair. My fear of reoccurance is great. because I am just out of the hospital and already am feeling "symptoms" and that NG tube was quite traumatic for me. The surgery scares me due to the risk of more scar tissue/adhesions. Also the hernia repair I had left me with a collapsed lung and double pneumonia. It was very rough. I am quite confused and am making the effort to do more liquid, smaller meals, much like MissMolly suggested.

MissMolly- all that you said makes great sense. I am wondering where you obtained such great information. Are you a survivor or a health care professional or other? Thank you again.


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