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What Causes Irregular Bowel Movements After Temporary Ilieostomy?
Question: hi.... i have been detected stage I Rectal cancer which has been completely removed on 17th march with temporary ilieostomy. iliostomy reversal done on 24th April... Since then I am having irregular bowel movements. Since last days I have been toilet for 50 times. It is not lose motion but very small amount of motion every time. Also my main problem is -- I am having very high burning and pain in anus and every 15 minutes, I am having sensation to go quickly. I am on Imodium 2 tabs per day, vibacd DS 2 Tabs per day.
Brief Answer:
symptoms likely due to inflammation
Detailed Answer:
Namasthe
Welcome to Healthcare-Magic
Greetings of the day
Dear Mr XXXXXXX
The urge of frequently going to pass stools with passing of little quantity of stools associated with pain is Tenesmus.
Tenesmus is usually seen in inflammation of the colon/rectum/anus.
I would require additional information for me to able to guide you further
1. What was the exact Surgical procedure done for Rectal Cancer: Was it Meso-rectal Excision( excision of only Rectum) or total Colectomy ?
2. Do you also have pain in abdomen?
3. Do you have fever?
4. Is there any distension of abdomen.
5. Was any Radiotherapy/chemotherapy given?
It would be helpful if you could upload the discharge summary containing the details including Operation Notes.
Do not worry things can be taken care off.
In the meantime I would suggest you to get a retention enema done in consultation with your operating Surgeon , it will treat the underlying inflammation and will help in evacuation of retained stools present above the site of anastomosis. A short course of antibiotic Like Tablet Ciplox TZ 500 mg twice a day for 7 days will be beneficial.
Do get back to me.
Keep me informed about the progress.
Wishing you happy and healthy life .
Take Care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Surgeon
symptoms likely due to inflammation
Detailed Answer:
Namasthe
Welcome to Healthcare-Magic
Greetings of the day
Dear Mr XXXXXXX
The urge of frequently going to pass stools with passing of little quantity of stools associated with pain is Tenesmus.
Tenesmus is usually seen in inflammation of the colon/rectum/anus.
I would require additional information for me to able to guide you further
1. What was the exact Surgical procedure done for Rectal Cancer: Was it Meso-rectal Excision( excision of only Rectum) or total Colectomy ?
2. Do you also have pain in abdomen?
3. Do you have fever?
4. Is there any distension of abdomen.
5. Was any Radiotherapy/chemotherapy given?
It would be helpful if you could upload the discharge summary containing the details including Operation Notes.
Do not worry things can be taken care off.
In the meantime I would suggest you to get a retention enema done in consultation with your operating Surgeon , it will treat the underlying inflammation and will help in evacuation of retained stools present above the site of anastomosis. A short course of antibiotic Like Tablet Ciplox TZ 500 mg twice a day for 7 days will be beneficial.
Do get back to me.
Keep me informed about the progress.
Wishing you happy and healthy life .
Take Care
Best Regards
Dr Deepak Kishore
MBBS,MS,MCH
Consultant Surgeon
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Sir,
Fortunately my urge to go has been reduced from today and also could have proper motion today morning. But it is very painful at anus while passing motion. My Doc has prescribed my Xylocane Jelly . Also pl find answers to your questions:
1. What was the exact Surgical procedure done for Rectal Cancer: Was it Meso-rectal Excision( excision of only Rectum) or total Colectomy ?-- It was Lower Anterior resection with use of Circular stepler. Only some part of rectum and adjoing lymphnodes removed .
2. Do you also have pain in abdomen?---No pain at all.
3. Do you have fever?--No fever at all.
4. Is there any distension of abdomen.-Not at all.
5. Was any Radiotherapy/chemotherapy given?-No Radiotherapy/ Chemo given yet.
Also as per biopsy reports, no involvement of nodes in tumour and also it was only local tumour. Also marginal resctions were free from tumour. Stage I- (pT1N0Mx)
Fortunately my urge to go has been reduced from today and also could have proper motion today morning. But it is very painful at anus while passing motion. My Doc has prescribed my Xylocane Jelly . Also pl find answers to your questions:
1. What was the exact Surgical procedure done for Rectal Cancer: Was it Meso-rectal Excision( excision of only Rectum) or total Colectomy ?-- It was Lower Anterior resection with use of Circular stepler. Only some part of rectum and adjoing lymphnodes removed .
2. Do you also have pain in abdomen?---No pain at all.
3. Do you have fever?--No fever at all.
4. Is there any distension of abdomen.-Not at all.
5. Was any Radiotherapy/chemotherapy given?-No Radiotherapy/ Chemo given yet.
Also as per biopsy reports, no involvement of nodes in tumour and also it was only local tumour. Also marginal resctions were free from tumour. Stage I- (pT1N0Mx)
Brief Answer:
Hot Seitz bath will also help
Detailed Answer:
Namasthe
Dear Mr XXXXXXX
As there has been anastomosis at the level of colon after resection of rectum, initially there were no stools in contact with it, as the stools were diverted outside by Illeostomy. In some individuals after the illeostomy is reveresed( anastomis done and closed), the stools are now diverted through the normal pathway. Contact of the stools with anastomosis may sometimes lead to accumulation of stools above the anastomosis, this causes intermittent release of stools ( till the anastomosis opens up fully and starts functioning). There could also be excoriation or raw skin around anus causing pain.
Its good to know that you have improved symptomatially, I would also advise you the following
1. Hot Seitz Bath: To a tub of lukewarm water add a handful of common tablet salt + 1 spoon of dettol. Sit in it for 15 - 20 minutes, thrice a day. This will reduce the muscle spasm and relieve pain
2. Apply Xylocaine Ointment after Seitz bath. Also apply it before and after going to stools.
Do get back to me for further updates.
Wishing you happy and healthy life.
Take Care
Best Regards
Dr Deepak
Hot Seitz bath will also help
Detailed Answer:
Namasthe
Dear Mr XXXXXXX
As there has been anastomosis at the level of colon after resection of rectum, initially there were no stools in contact with it, as the stools were diverted outside by Illeostomy. In some individuals after the illeostomy is reveresed( anastomis done and closed), the stools are now diverted through the normal pathway. Contact of the stools with anastomosis may sometimes lead to accumulation of stools above the anastomosis, this causes intermittent release of stools ( till the anastomosis opens up fully and starts functioning). There could also be excoriation or raw skin around anus causing pain.
Its good to know that you have improved symptomatially, I would also advise you the following
1. Hot Seitz Bath: To a tub of lukewarm water add a handful of common tablet salt + 1 spoon of dettol. Sit in it for 15 - 20 minutes, thrice a day. This will reduce the muscle spasm and relieve pain
2. Apply Xylocaine Ointment after Seitz bath. Also apply it before and after going to stools.
Do get back to me for further updates.
Wishing you happy and healthy life.
Take Care
Best Regards
Dr Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sir
Thanks for reply. Also pl let me know if going to pass stools frequently can affect staeches /stepler application at anatomosis. Will this pain reduce over a period as time passes. Also should I hold urge to go frequently and should not go every now and then to reduce strain on steaches inside .
Thanks for reply. Also pl let me know if going to pass stools frequently can affect staeches /stepler application at anatomosis. Will this pain reduce over a period as time passes. Also should I hold urge to go frequently and should not go every now and then to reduce strain on steaches inside .
Brief Answer:
Do not hold stools
Detailed Answer:
Namasthe
Follow this simple advise
1. Do not hold: Pass stools whenever there is sensation, Holding may cause more retention of stools inside
2. Do not worry about anastomosis, it would have gained enough strength till now. Do not worry about staples
3. Pain will definitely reduce over time
4. Ensure intake of 2-3 liter of water a day
5. High fibre: 2 servings of vegetable salad and 2 serving of fruits per day.
6. Avoid Maida( Biscuits, breads)
7. Hot seitz bath: it will definitely be helpful.
I hope there is no ulceration or raw area in skin surrounding anus
Regards
Deepak
Do not hold stools
Detailed Answer:
Namasthe
Follow this simple advise
1. Do not hold: Pass stools whenever there is sensation, Holding may cause more retention of stools inside
2. Do not worry about anastomosis, it would have gained enough strength till now. Do not worry about staples
3. Pain will definitely reduce over time
4. Ensure intake of 2-3 liter of water a day
5. High fibre: 2 servings of vegetable salad and 2 serving of fruits per day.
6. Avoid Maida( Biscuits, breads)
7. Hot seitz bath: it will definitely be helpful.
I hope there is no ulceration or raw area in skin surrounding anus
Regards
Deepak
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Sir
Hi
My stools are neither very hard nor loose motion. It is soft stool. Though I have not been to toilet as much as yesterday, still having burning like hot coal inside the anus while passing stool. Also , when I get sensation to go to toilet (Though much reduced frequency today), it is sharp pain from inside to anus like something is getting stucked. Also , till I go to toilet commode, the urge goes away and it is again painful to stretch for stools. THUS MY MAIN PROBLEM IS NOW BURNING LIKE HOT COAL INSIDE ANUS .Is there be inflammation of veins inside the anus and does this happen because of frequently passing stools (though soft stools) or whether it is common after reversal of ilieostomy. Now I get tensed when I have to go to toilet due to this burning and pain. Pl guide. I am applying cream called as "SMUTH" after every hour to anus.
Hi
My stools are neither very hard nor loose motion. It is soft stool. Though I have not been to toilet as much as yesterday, still having burning like hot coal inside the anus while passing stool. Also , when I get sensation to go to toilet (Though much reduced frequency today), it is sharp pain from inside to anus like something is getting stucked. Also , till I go to toilet commode, the urge goes away and it is again painful to stretch for stools. THUS MY MAIN PROBLEM IS NOW BURNING LIKE HOT COAL INSIDE ANUS .Is there be inflammation of veins inside the anus and does this happen because of frequently passing stools (though soft stools) or whether it is common after reversal of ilieostomy. Now I get tensed when I have to go to toilet due to this burning and pain. Pl guide. I am applying cream called as "SMUTH" after every hour to anus.
Brief Answer:
To rule out fissure
Detailed Answer:
Namasthe
Good evening
Dear Mr XXXXXXX
The burning sensation in the anus could be because of following two causes
1. Fissure/ Excoriation in the skin surrounding the anus
2. Retained secretion above the pelvic anastomosis done causing inflammation
I am very much concerned about every patient I advise , whether online or in my hospital. I always follow them up and their progress. So would request you to keep me updated about your progress.
If you had been my patient I would have done the following
1. Examination of anal region: Visual inspection would provide sufficient information
2. Digital rectal examination: It will give clue about any impacted stools present
3. Proctoscope: it can be easily done in out patient department
In the meantime I would suggest you the following
1. Hot seitz bath
2. Plenty of oral fluids
3. Liquid Paraffin: 5 ml twice a day
4. Tablet Ciplox TZ twice a day for 7 days
5. Retention Enema in consultation with your Physician: As the anastomosis is old enough , enema will not affect it's integrity
Important thing at present is to rule out anal fissure
It would be helpful if you could upload the clinical photograph.
Kindly keep me updated
Take care
Best Regards
Dr Deepak
To rule out fissure
Detailed Answer:
Namasthe
Good evening
Dear Mr XXXXXXX
The burning sensation in the anus could be because of following two causes
1. Fissure/ Excoriation in the skin surrounding the anus
2. Retained secretion above the pelvic anastomosis done causing inflammation
I am very much concerned about every patient I advise , whether online or in my hospital. I always follow them up and their progress. So would request you to keep me updated about your progress.
If you had been my patient I would have done the following
1. Examination of anal region: Visual inspection would provide sufficient information
2. Digital rectal examination: It will give clue about any impacted stools present
3. Proctoscope: it can be easily done in out patient department
In the meantime I would suggest you the following
1. Hot seitz bath
2. Plenty of oral fluids
3. Liquid Paraffin: 5 ml twice a day
4. Tablet Ciplox TZ twice a day for 7 days
5. Retention Enema in consultation with your Physician: As the anastomosis is old enough , enema will not affect it's integrity
Important thing at present is to rule out anal fissure
It would be helpful if you could upload the clinical photograph.
Kindly keep me updated
Take care
Best Regards
Dr Deepak
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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