Brief Answer: Evaluation for excluding possible causes required Detailed Answer: Hi Lady, Thanks for your query. A 'tipped' colon means that there is compression over it, most likely due to adhesion of bowel loops or, by adhesive bands, which are common complications of abdominal surgery. As such, you have already undergone appendisectomy and hysterectomy in the past. In this event, a re- surgery to separate the bowel loops or, excision of the adhesive bands will relieve the compression. The other causes can be polyp(s)/growth within the first part of colon causing obstruction to the passage of food. Since the colonoscope tube is not long enough to reach the proximal part of colon, these growths are likely to be missed. A Barium enema combined with MRI of the colon should be carried out to conclusively rule out these possibilities. I would therefore recommend use of a purgative, such as Lactulose 30ml daily at bedtime for 2-3 days, until the bowels are completely clear. Once the bowels move freely, daily intake of stool-bulking agent, such as, Psyllium powder / granules would ensure normal bowel movements. Further, high fiber diet, lot of green leafy vegetables and lots of water daily are some of the other precautions to ensure smooth bowel movements. Lastly, I am still not convinced about thyroid report being normal. Gross weight gain along with chronic constipation are definite indications of under-active thyroid. If the thyroid test was done more than 6 months ago, a repeat test would be invaluable. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Dr. Rakesh Karanwal

---

Brief Answer: Get investigated for Menopausal syndrome Detailed Answer: We have excluded all of the commonest causes of constipation with weight gain. This narrows down the possibilities to Menopausal/Peri-menopausal Syndrome : considering your age, partial hysterectomy and, presence of a single ovary. There is a drastic fall in production of female hormones (estrogen and progesterone) by the ovaries during menopausal phase. Low estrogen leads to significant weight gain. So, consult your Gynecologist or your Family doctor, and apprise him of my opinion. He- or your family doctor- will get hormones' levels estimation done. Once the diagnosis of female-hormones' deficiency is confirmed, he will put you Hormone replacement therapy (HRT), which will take care of all your problems (weight and constipation). Fond regards

---