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What causes incomplete fecal evacuation, bladder spasms and thin bowels?

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Posted on Mon, 28 Jul 2014
Question: 4/11 this year I had a sigmocele (for severe constipation and medically induced slow gut) removed that had adhesives to my bladder and fallopian tube A total of about 18 inches were removed. I developed an infection and was re-hospitalized for infection and then again for a blockage. I am 5ft 1in and 115lb. I can still palpate some internal stiches and have BMs just about every trip to the toilet. After urination, I have bladder spasms and feel like I have to BM all the time. My whole bottom pelvic floor still has pain at about at a level 4/10. My last CT scan revealed ascending and descending colon was inflamed ( about a month ago). The vast majority of the time my BMs are pencil thin. I have reported all to my colo-recto surgeon who states I am doing well and to just give it time to normalize. Just want to know if I am being impatient. Again original surgery was 4/11.

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Answered by Dr. T Chandrakant (8 hours later)
Brief Answer:
Per-rectal examination for the ? Anal stenosis

Detailed Answer:
Hi.
Thanks for your query.
Read and re-read your history.

What I could catch up the most was'' BMs are pencil thin''.

This is a problem since long or was it after the surgery?

This looks to be a case of stricture of the anal canal. This can cause all the symptoms you have at the moment, the problem is added with the effects of surgery, complications which developed thereon, adhesion inside, inflamed colon.

This may be the reason for incomplete evacuation and the after effects like frequency for BM, spasms inside abdomen, pelvic floor spasm and all.

I would advise:
Consult your Surgeon ASAP, discuss about this. You need per-rectal examination to determine the degree of the anal stenosis and its treatment. Once this is treated many of your problems will be reduced and the recovery would be faster and better.

Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. T Chandrakant (9 hours later)
I have had numerous rectal exams post-op due to the complications in the surgery. My physician thinks that the inflammation is due to the drain that was placed around the abscess that developed around the resection and posterior vaginal wall adhesion. I was re-hospitalized for the infection. The drain was removed about 8 weeks ago. I only had it for about 5 days. At that time, I had an enema CT with contrast that revealed inflammation in the ascending and descending colon. I was wondering if I could still be inflamed this long and could that inflammation cause a narrowing to the lumen of the colon at the resection site. My physician said I need to be patient that there was much trauma to that area. I was wondering if I am being inpatient and need to just give it more time. I appreciate your patience with my questions.
doctor
Answered by Dr. T Chandrakant (4 hours later)
Brief Answer:
Colonoscopy

Detailed Answer:
Thanks for your appreciation.

There is nothing wrong to be impatient as it is more than 2 months post-operation.
This is also true that after such a major problem the things - I mean healing , recovering from the ill-effects of surgery , its complications and general health would definitely take time.

But it is just possible to get a colonoscopy done to see exactly what is the position at the moment..It may also be possible to do dilatation of any stricture and helping the bowel movements, to take biopsy of the suspicious areas and so on.

You may please request for this. This is the most practical solution.
Please also see that your hemoglobin, serum proteins are within normal limits as this has the direct bearing on the healing process and outcome of the disease.
I hope you are taking Vitamin and protein supplements in therapeutic dosages.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 13467 Questions

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What causes incomplete fecal evacuation, bladder spasms and thin bowels?

Brief Answer: Per-rectal examination for the ? Anal stenosis Detailed Answer: Hi. Thanks for your query. Read and re-read your history. What I could catch up the most was'' BMs are pencil thin''. This is a problem since long or was it after the surgery? This looks to be a case of stricture of the anal canal. This can cause all the symptoms you have at the moment, the problem is added with the effects of surgery, complications which developed thereon, adhesion inside, inflamed colon. This may be the reason for incomplete evacuation and the after effects like frequency for BM, spasms inside abdomen, pelvic floor spasm and all. I would advise: Consult your Surgeon ASAP, discuss about this. You need per-rectal examination to determine the degree of the anal stenosis and its treatment. Once this is treated many of your problems will be reduced and the recovery would be faster and better.