Need advice on impacted colon - any thoughts?

Hi all

Just wondered if anyone had any thoughts on my current problem?

I have a malfunctioning loop ileostomy where a small proportion of stool bypasses the stoma and goes down the loop into my colon.

My colon has now been impacted with feces for at least 6 months now.

Even though the colon is not exactly 'in use', should peristalsis still be occurring if there is something in there? Will my colon become stretched and sort of flaccid if this stuff stays there, making it unlikely it will function properly if I have a reversal? Occasionally my rectum feels as though it may be full - but I am not getting that 'urge' to go to the loo - should I be? A glycerine suppository several weeks ago produced one hard pellet, mucus, and what seemed to be quite a bit of fresh blood. It used to just flow through up until about 18 months ago, when it just stopped (which was better for me to be honest as it was coming out of every orifice I had at that point). Now when it 'starts' moving, I am in agony and end up in the hospital - there I end up trying to explain to doctors who sometimes seem quite clueless, how I can shit when I have a stoma! Please jump in and be devil's advocate for me with any random thoughts or knowledge/experiences which may be relevant!

Thanks

Rach xxxxx

Well, I'm sorry I can't really help, just checking in before bed and saw your post.

I had a temporary loop ileostomy for 9 months and after a few weeks had to literally run to the bathroom with rather painful (following surgery and radiation) urges to pass what were pencil-thin greyish stools, ridiculously small for the drama they caused. I also passed a few staples.

My nurse said that it is quite normal for some stool to end up in the remaining colon and that I would probably always pass mucus - it became stool-like as it was so low in volume and the colon's job is, after all, to absorb liquid which is why it wasn't recognizable.

I now have a permanent loop (yes, sounds odd) transverse stoma and the colon remains - unable to operate and remove it, still contains fecal matter from prior to surgery on 6th Dec 2010. I am to have a tube inserted into the mucous side of the loop to flush this out at some point soon once I've healed enough to tolerate what is likely to be "quite uncomfortable with abdominal cramps).

Hopefully, your impaction is a one-off and things will settle down. I wonder if they could flush you through too and perhaps the inactive side of your loop could be stitched shut more?

Just thought it might help if you saw other people experienced something similar, hopefully your nurse can give you more answers.

Hi Loopy - thinking back, I always did pass mucus on a regular basis and did get the urge to pass it - now I am just not passing anything at all so presumably the mucus isn't moving either - so presumably even that is going hard ...?

I wonder if gentle massage on your tummy might help, maybe in the bath? It has to be (if looking down at yourself) up your right side, across and down the left to go in the direction of the colon obviously - can't see how that would hurt. That and exercise usually get things moving when things are connected.

I don't have a rectum or any sigmoid colon, so I had a shorter pipe - but I reckon an enema is the most likely option. My colon refused to work for 8 days after reversal (supposed to be a 3-day hospital stay) as if it had "forgotten" what to do sometime in the 9 months, and then the anesthesia affects me too. There must be others who've had the same issues?

I saw my nurse today and totally forgot to ask about flushing my redundant bit of colon! What an idiot. My usual nurse was on holiday who knows it's to be done. Best ring up tomorrow!

Hi Loopy - I have had a bit of a go at that .... however not sure that my colon is quite in the right place anymore as I can feel it all hard and lumpy on my right side starting at my waist and then going slightly downwards towards my stoma which is exactly as my hernia runs now ... it's tender there too when I massage it. Funnily enough, I did 'have a slight urge' this morning, got rid of a bit more mucus, another pellet and a bit more blood .... suspect I will have to have a sort of flushing out too ... something to look forward to in the new year, eh?

Thanks, Rach xxx

Hi

I have had serious constipation for a very long time prior to my colostomy. This resulted in a huge amount of pain, pebble poop, and a large amount of blood loss, amongst other things. When I finally went for help, one of the suggestions the doctor made was that I had got to a state where my body tensed up when I attempted to have a bowel motion. To ease the pressure and relax me, the doctor suggested that I sit in a bath of warm water or run warm water over my anus. I have a bidet toilet seat, so I was able to do this and it did help to relax my anal sphincter, and I was able to pass a tiny amount of pebble poop naturally. I was at the stage where I only pooped if I used an enema, and even then it was hit and miss.

I wonder if you could try a fleet enema too. These are very good, and the longer you can hold it, the more likely it is to shift whatever is left in there.

BUT

Given that you are having pain, check with your doctor before popping anything inside you. I would hate to make a bad situation worse.

Hope the water trick helps, 'cause it seems to me that the more you worry about it, the more tense you are going to get, thus compounding the problem. So maybe tricks to relax your bottom and anal sphincter would help.

Wishing you all the best.

Hi Rach, are there concerns that the impacted colon may develop an infection? I know my doctors were most concerned about stool lodged in my fistulas causing infection because they were not getting "flushed" by the normal flow through the colon. What do your doctor(s) advise on all your issues? How soon do you need to make a decision? XXXX Carolyn

Hi Carolyn - Actually, most docs cannot see how the anatomy of it works and I have to explain it to them! Bit pathetic, I thought when I had to do that!

No one seems in the slightest bit concerned about it at the moment - but apart from being uncomfortable, I am bloated and concerned that I am absorbing toxins from waste that has been festering in there for at least 6 months .... Is that what happens?

I am also a bit concerned about the disgusting taste in my mouth that has been troubling me 24/7 for the last 12 months now and wondering if it may be connected?

I know from past experience when I do have to shift it with Fleet or something equally horrific pre-surgery, it is going to be hell! My fistulas were actually so large in the latter stages of my 9 failed surgeries that it flowed through anyways. Nowadays, I am not even passing the mucus which I used to pass every 3 days or so ....... Even that is stuck! I am also starting to leak a little 'overflow' per rectum which doesn't really bode well either!

Hope things are settling down for you, my friend?

Take care, Rach xxxxxx

Regarding the bad taste in your mouth - are you taking Flagyl? I had to take it a while back and developed a very bad, metallic taste in my mouth. The doctor or pharmacist had said nothing about that being a possible side effect. However, when I checked it out online - there it was as a very common effect of taking Flagyl. Just a thought.

Hi there - not taking any Flagyl - but do take a myriad of other meds - however none of them were new when this taste came on exactly 1 year ago today! Ugh, it's rancid and foul - very conscious of it myself but others say it's okay .... xxx

I am having the same issue. Did you have the problem resolved? Did you find out what was going on?