Constipation after Sigmoid Colectomy

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Amarie123
Posts: 47
Joined: Wed Nov 14, 2018 6:46 am

Constipation after Sigmoid Colectomy

Postby Amarie123 » Tue Dec 18, 2018 4:11 pm

I’ve read through many posts about constipation following a colectomy but still wanted to post. I feel like sometimes the food gets moving, but then seems to get “stuck” in the lower colon or rectum. It’s almost as if my muscles aren’t working like they did pre surgery (or pre obstruction, which I had before surgery). Does this sound familiar to anyone? I gave myself a fleet enema a few days ago which helped immensely, but I don’t want to get dependent on that. Since then, over a period of three days, I’ve taken three doses of miralax and one today of milk of magnesia. I feel things moving but nothing coming out. Also uncomfortable is a UTI that I seem to have and am taking antibiotics for. I’m wondering if this could be part of it too? The doctor said antibiotics usually cause diarrhea but that it’s not impossible. Does anyone have advice about what does and doesn’t work related to laxatives and stool softeners? I’m wondering if I should up the fiber intake and slow down on the meals, as my appetite is back and I may be eating too much/not moving enough (anemia has me feeling wiped out). Thanks for any advice!

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

Re: Constipation after Sigmoid Colectomy

Postby MissMolly » Tue Dec 18, 2018 7:21 pm

Annemarie:
See my response to the thread “Intense Mobility” by original poster pajama further down this page.

The intestine can remain swollen and inflamed for several weeks post surgery with what is often termed “post operative functional use disorder.” Translation: The motility of the fit in moving digested food material down and along is slowed/delayed or intermittent.

Use of a daily osmotic laxative (miralax or Milk of Magnesi) can be immensely helpful. Titrate the dose to meet your need. Initial dose may take 2-3 days to take effect with a bowel movement. You can use an osmotic laxative on a long-term basis without concerns of lazy colon or laxative dependence.

Stool softeners are often not sufficient. They add water to stool in the lower colon but with no motility effect to nudge the intestine into moving. The result can be stool that stagnates and sits like heavy cement.

Eat small amounts only or revert to liquids only when constipation is intense and fecal backup pronounced. You do not want to continue adding solid food retention.

Eating more fiber or high-fiber foods can be counter-productive as it takes more mechanical work to digest foods high in insoluble fiber.

Remember, your intestine is likely inflamed and a bit swollen. Treat it gently. Keep food portions small. Graze rather than consume large meals. Soups are often a good option - for hydration and ease of digestion.

Keep moving. The intestines are a muscle and depend on systemic body movement to keep humming and moving along. Yoga poses are a nice means to massage the intestines and promote motility. Basic, beginning poses are A-OK. You need not be a human pretzel.

Start with a small dose of an osmotic laxative. Daily. Other options: Aloe Vera juice about 2 tablesspoons a day acts like an intestinal lubricant; prune juice, 6-8 oz a day, warmed in the microwave; sprinkle ground wheat germ on top of cereal or yogurt, about 2 tablespoons a day.

Reduce intake of solid food until initial constipation clears. Then begin program of small portion sizes so as not to overwhelm the intestinal tract.
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.

Amarie123
Posts: 47
Joined: Wed Nov 14, 2018 6:46 am

Re: Constipation after Sigmoid Colectomy

Postby Amarie123 » Tue Dec 18, 2018 8:06 pm

Thank you for this response. I feel like I’m not doing a lot of the things suggested here and should revamp how I’m going about eating. I’m 4 weeks post op tomorrow and have started eating meals again, which I’m realizing is not helping. I was also taking colace quite often which did seem to produce that feeling of “cement”. Started doing some yoga poses the other day and will keep it up. Thank you again, your reply was so helpful and gave me a lot to work with.

Koreysue
Posts: 258
Joined: Mon Apr 30, 2018 2:36 pm

Re: Constipation after Sigmoid Colectomy

Postby Koreysue » Tue Dec 18, 2018 9:44 pm

Miss molly offers a lot of good tips! I have nothing to add except to say that I had the same trouble for awhile- it eventually gets better, especially if you are using some of these tips listed.
Make sure to drink enough water too!
Korey
Dx: 6/2017 stage 3 CC
Sigmoid, 2 nodes
CEA at dx: 6.1
Sigmoid Colectomy/folfox (last chemo (1/31/18)
CEA 4/2018: 2.4
CEA 7/2018: 3.7
Colonoscopy 8/18 clean
PET scan 8/20/18 NED
CEA 11/2018: 3.8
CEA 2/2019: 3.2
CT NED 6/18/19 / CEA : 3.4
CEA 10/21/19: 3.2
CEA 3/9/20: 3.8
CT NED /CEA 6/17/20: 3.8
CEA 11/4/20 4.6 <——— whyyyy? (will retest in a few weeks)
CT NED 12/1/20 CEA: 3.5
CEA 5/21 4.2
CEA 10/21 3.4
colonoscopy 10/21 10mm polyp
CEA 4/22 3.7
CEA 7/22 3.8
CEA 12/22 4
CEA 1/22 3.2 and NED 5yr scan


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