Colon and Rectal Surgeon Questions Colon and Rectal Surgeon

How to handle colon problems?

I just had a colonoscopy. The doctor said it was a difficult procedure because my colon is not shaped normally, it is more like a snake, probably due to bouts of constipation and straining which I have frequent trouble with along with the opposite end of the spectrum, bouts of diarrhea and not much in between. He says medication may help, but to treat constipation may cause diarrhea, and to treat diarrhea can cause more constipation and strain. What can I do?

Male | 63 years old
Complaint duration: 2 years
Medications: Symfi +, (for HIV) lisinopril, lipitor, multivitamin, low dose asprin.
Conditions: Prostate Cancer Twice, once treated with radiation, the second time by salavage radical prostetectomy, followed by complicatons of an anastamonic leak, urinary incontinence and eventually installation of an AUS, artificial urinary spincter. HIV (undectible).

5 Answers

ColonandRectalSurgeonColonandRectalSurgeon
Please make sure your diet contains enough fiber and that you drink plenty of water. If you were my patient I would do an anal manometry study, to make sure you dont have outlet dysfunction constipation as a possible side effect of your radiation therapy for the prostate. If that is normal and you are having enough fiber and water, you might have colonic inertia, so I would test you for that. Sometimes it may be necessary to respect a part of the colon to straighten it up or shorten it. All of the above would be your choice, depending on how much your quality of life is affected by the constipation. You should not have a colon section just to have an easier colonoscopy, unless you come from a family with very strong history of colon cancer. Best, R. Constantine, MD
If the constipation is the predominant symptom, then this should be the primary focus of treatment. But you need to find the right medicine at the right dose to treat it without inducing diarrhea. IBS is difficult because the colon cycles between constipation and diarrhea even if you do nothing. So it's important to realize that this pattern may continue whether treatment is given or not. The goal is to reduce the predominant symptom enough to keep it manageable and not affect your daily activities, but alterations in bowel habits are to be be expected from time to time.
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Treatment with medications can help your symptoms. Discuss in detail with your gastroenterologist please.
Consult a Functional Medicine Doctor. Radically change your diet to an organic, non-GMO, gluten free Mediterranean diet. Take Mood Probiotics daily. Juicing: carrot/beet/ginger with organic produce 1 glass daily. You need calcium and magnesium for the bowel motility to function normally. I recommend Vitamin D3 50,000 IU softgel weekly, NOW brand and Magnesium citrate 400-800 mg softgel daily, Carlson brand.
This can be a very difficult problem to handle. It is reasonable to follow the suggestions of your provider and see if there is any improvement.