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How Should Chronic Constipation Be Managed?

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Posted on Thu, 30 Jun 2022
Question: I saw my Gastroenterologist regarding long term constipation. A number of colonoscopyS all showed clear. Recently I went to see him. My 10 year follow up is due oct 2020. I had an xray of my abdomen. The radiologist said there is a suggestion of possible soft tissue density exerting mass effect on the more medial air-filled air-filled bowl. I can feel the mass pushing slightly through my skin of my stomach , slightly lower than my belly botton. I have had two fatty lipomas removed in the last ten years. Internist thinks its another fatty lipoma . It is at the same level as the top of my pelvis -about 5 o6 six inches from the very right side of my pelvis. I had the catscan and the radiologist said 'a possible abnormality was seen in the right mid abdominal laterally . This corresponding to the ascending colon on the current CT scan. There is no evidence of mass or other abnormality in this region. - SINCE THEN, I have sen my GI Dr who says see a dermatologist. He says -probably a lipoma but it may be attached to bone and it should be left alone. See a surgeon. Two surgeons say its a Dermatologist issue. MY internist felt the bulge and just asked if it is getting bigger. MY GI DR does not seem to be concerned and does not think its affecting my bowl since it did not show on
Cat Scan. I still have constipation problems. I DO NOT KNOW HOW/ WHO I should see to determine if it is pushing on my bowl. I DO NOT KNOW WHAT TO DO. CONSTIPATION is stilla problem.
doctor
Answered by Dr. Dr. Ivan Romich (45 minutes later)
Brief Answer:
MRI required

Detailed Answer:

Hi,

Considering inconclusive CT scan findings, I'd suggest doing an abdominal MRI scan in the first place.

If there is a lipoma intra-abdominally, then it should be managed by the abdominal surgeon. If the lipoma is placed in the abdominal wall, outside the cavity, then it should be managed by the plastic surgeon.

Also, it would be better to do contrast-induced bowel tests where you swallow contrast for evaluating bowel passage. It would be useful to do tumor markers and tests on food allergy for further evaluation along with this.

Feel free to ask further questions.

Regards
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Ivan Romich (18 hours later)
Thanks. what are tumor makers.
doctor
Answered by Dr. Dr. Ivan Romich (5 hours later)
Brief Answer:
Follow up

Detailed Answer:

Hi,

Tumor markers are blood tests which may show presence of gastrointestinal tumors. These include CEA, CA 19-9, CA 125 and AFP. These tests can be done at your GP.

Regards
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Dr. Ivan Romich

General Surgeon

Practicing since :2008

Answered : 13886 Questions

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How Should Chronic Constipation Be Managed?

Brief Answer: MRI required Detailed Answer: Hi, Considering inconclusive CT scan findings, I'd suggest doing an abdominal MRI scan in the first place. If there is a lipoma intra-abdominally, then it should be managed by the abdominal surgeon. If the lipoma is placed in the abdominal wall, outside the cavity, then it should be managed by the plastic surgeon. Also, it would be better to do contrast-induced bowel tests where you swallow contrast for evaluating bowel passage. It would be useful to do tumor markers and tests on food allergy for further evaluation along with this. Feel free to ask further questions. Regards