update on GI issues

I visited my GI again today to get some test results and talk about some therapies.

Results of my defecography that I got over the telephone were pretty vague to say the least.

My report reads: "large anterior rectocele which measures approximately 5 cm"
Also, my anorectal junction descends completely below view, at least 6.2 centimeters below the pubo****ygeal line (not supposed to drop at all).  Because it dropped out of view, they are unable to tell if anything ELSE is wrong beyond that (hopefully not).

Base of bladder drops 2.3 cm, possible cystocele
Extensive pelvic floor insufficiency

It's possible that I just can't poop because of this, so it all backs up ALLLLL the way up my entire colon to cause pain.

I've been referred to a colorectal surgeon.  The one my GI recommended couldn't get me in for over a month!  I made an appointment with an associate for this weds, but I NEVER have good luck when I see someone who was not recommended just because I could get in with them sooner.  I left message with my GI office to see if they will call on my behalf and try to get me in sooner...

I really don't know if anything can be done surgically about the pelvic floor.  Hope so!  I'm going to leave a copy with my gyno and I called my WLS as well.

Of course, it's completely possible that none of this will cure my constipation, but it's definitely not helping.  I really want to find treatment for the pelvic floor, the rectocele really doesn't bother me as far as I can tell.

 Kayla, I can't remember in any of your previous postings concerning your constipation, but did you have any issues prior to your DS? Or did all of this start after surgery? Have you always dealt with constipation?

I had some occasional bouts, nothing serious, nothing even worth mentioning.  I started having mega problems 1 year post op.

I never pooped as much as most people claimed to, but I actually had normal, cleansing BMs through the first year, then my gallbladder went bad, coupled with a horrible bout of bacterial overgrowth and got horribly constipated somehow (typical bacterial overgrowth is dhr--not in me).

Off and on I have bouts of total normal-ness.  I dunno--maybe the pelvic floor muscles magically find their way to the right configuration and let me poop.

Regardless of all this lower/rectum stuff, I also have a overly long and overly wide colon.  I am hoping that taking care of the rectum stuff will be enough and I can control the rest of the colon weirdness with diet.  My GI said that could be due to decreased amount of visceral fat opposing the colon in my abdomen caused the colon to kinda expand in size, but whatever, doesn't matter.  I bet it was big before surgery...lol

Anyhow, if what you're asking is if this is related to my DS--no.  The only part that the DS plays a part in is the fact that I have such a large amount of stool so when things back up, they back up quickly and in large amounts.

 I was reading your post of FB and the responses you got there as well. I saw the mention of the  weakened pelvic floor. I was going to mention this and it might not have any relevance at all. I have a friend that had the RNY several years ago. It was around her 1 year mark after she had lost most of her weight she started having bladder issues. Something about with all of the weight loss her bladder moved in it's position and she had to have some kind of surgery and they made her a "sling"?!?  I'm wondering if what they are mentioning about your pelvic floor is something similar to what happened to her. 

At any rate I am assuming all of it is interconnected and I'm just so sorry that you aren't getting definitive answers. I hope someone can get this figured out for you. It almost sounds like you might need explaratory, like Melody had, to get it all figured out.

I had a bladder suspension with an A&P repair about a year and a hal*****he A&P repair means anterior repair of the cystocele and posterior is the repair of the rectocele. Uro-gyn surgeons do these all the time.

Good luck.

I too had a rectocele and a cystocele back in 2003. I saw a gastroenterologist, who made me do that awful test which I think is the same test you had (so embarrassing!).

My problem stemmed from my hysterectomy that I'd had one year earlier. I was having a lot of trouble with constipation, and I had a vaginal prolapse as well.

I had my surgery done by my ob/gyn. The surgery was done vaginally, which wasn't bad really. Certainly an easier surgery than my open hysterectomy. But it will involve a hospital stay. I can't remember exactly, but I think the rectocele was treated with some kind of a mesh material (?) to reinforce it. My bladder, actually, ended up fused to the inside of my abdominal wall, but that was the result of some unusual bleeding I had during my surgery, that resulted in internal abscesses. One of which was on my bladder.

I haven't had any trouble with my bowels in the rectocele department since. No trouble with my bladder either. The weak pelvic floor can be strengthened by doing Kegal exercises. I've read that you can use some sort device that can be inserted vaginally prior to a bowel movement that will support the vaginal wall. That's a non-surgical way to go.

Hope this helps,

Lynda

Edit: Obesity actually is one of the causes of rectoceles and cystoceles...so is child bearing.

Thanks...

I am worried that the extent of issue with my pelvic floor won't be helped by therapy.  My muscles actually descended out of view!  I am going to start doing kegels...though I read that it can take months for significant improvement :(

I'm not sure about this, but I think that having your bladder and bowel reinforced, so they stay where they should, might help the pelvic floor as well.

I would ask your ob/gyn about what to do for a weak pelvic floor. Ob/gyns deal with this kind of thing all the time.

Good luck with this.

Don't have much to add other than to let you know I am sorry you are having to go through this and I hope it gets better for you.

Kayla, hon, I wanted to tell you that I heard the gyno on the "The Doctors" , tv show, talk about these pelvic floor repairs.  As Gail and Lynda mentioned, she indicated that it was commonly done.  Hope this makes you feel a little better.   -Hugs, Jenny