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Rectal Prolapse After Surgery?

Aphrael fIntro:

I was first diagnoses with Ulcerative Colitis in 2009 and eventually had to have the total colectomy and ileoanal pouch surgery. The final surgery was completed in February 2014 and all was well until recently. I saw my GI this afternoon and am scheduled for a colonoscopy in 2 weeks time.

Some more background:

I am from South Africa and previously enjoyed horse-riding but currently my life is so hectically busy that I have not had the time to re-start this since my surgeries

Symptoms:

Though I no longer have the typical UC symptoms since my surgery, I am currently experiencing a potential rectal prolapse. SInce the surgery, my quality of life has greatly improved but I do still experience the obvious consequences of no longer having a colon e.g. +- 10 bowel movements a day; high risk of dehydration especially when experiencing a stomach bug

Rectal Prolapse After Surgery?

My question is for anyone who may have experienced a rectal prolapse since their surgery. I will describe my situation below and hopefully somebody has had a similar experience or has heard of such so I can have some guidance of what to expect.

Late December I was feeling more constipated than normal – by constipated I mean that instead of 10 very loose explosive bowel movements, I was having to strain a bit to get any stool out. That evening when I went to the toilet, it felt as if a hard stool was stuck in my rectum so I pushed.

There was a burning sensation and when I tried to “rub off” the stuck stool with toilet paper, I could feel something was not right and there was a lot of blood on the toilet paper. I then realized that there was a mass the size of a golf ball sticking out of me. It was very dark red and when I stood up, I could feel this mass pulsing as if I could feel my heart beat.

Every time I would stand up, some stool would slip out past the mass so I would have to sit back down again. This continued for quite sometime until the mass eventually retracted back inside by itself.

Since then, every time I go to the toilet, it feels as if the mass is trying to come out again when ever I need to push. With a bit of maneuvering and creativity I managed to use a mirror and I can see that whenever I push, a pink mass starts coming out of my rectum. I obviously do not let it come out as I am afraid of it not retracting this time.

I contacted my surgeon as soon as his practice opened after the festive season and he unfortunately was too busy to be able to see me and recommended that I rather follow up with my GI who could assist me sooner.

I met with my GI this afternoon and he says that he suspects that it is a rectal prolapse but that he has never heard of this happening to someone who has had the surgery. He has scheduled a colonoscopy for two weeks time to try and investigate.

Has anyone had a similar experience? What where you diagnosed with and if it is rectal prolapse, what is the treatment?

I am really scared that this means my pouch is failing and that I would end up with a full time ileostomy.

For now, my GI has started me on Probiotics as well as Agiobulk to help with the stool consistency and frequency. My surgeon had me using Imodium on a as-needed basis but my GI seemed quite surprised by this as he says Imodium works on the colon and that since I no longer have one, it is not effective.

I am trying to be positive and not freak myself out by imagining the worse but I would love anybody’s experiences as the waiting for the colonoscopy is going to be stressful

Current Medications:

Currently been treating loose stools with Imodium with minimal effectiveness. I have started with Agiobulk and Probiotics from today so am hopeful that this might help with the frequency and consistency of my stools

written by Aphrael

submitted in the colitis venting area




prolapse, rectal

7 Responses to Rectal Prolapse After Surgery?

  1. Paul Willoughby February 10, 2015 at 1:18 pm #

    Wow, that sounds scary. I just had my reversal surgery on January 9th and I go as frequently as you do. Good luck with your test and I hope it all works out.

    • Aphrael
      Aphrael February 12, 2015 at 11:56 pm #

      Thank you Paul, all the best with your recovery!

  2. george noseda April 9, 2015 at 3:54 pm #

    Dear Aphrael :I’m not going to tell you ow much I’m sorry for you because that is not going to help you any! Instead I have couple of thing to recommend you in your behalf. Consult with your doctor about: “LOMOTIL” and “APRISO” for medication. I have a total colectomy about 4 years ago, and subsequent a “J” PUCH and suffering all the things that everybody have after such surgery. Frequent bowel movements, day and night, sometimes it is very active overnight and those nights are very extenuating the exercise to get to the toilet and come back to bed sleeping during the all process, and so for. Hard to gain weight, leg and hands cramps, be careful with the diet. Fruits, dairy products, provoke more bowel movements, has to be carefully with that. Other than that life is much better than living with “CRONIC ULCERATIVE COLITIS” I wish you get well and happy as much as you possible can! Love you….
    G.H.Noseda Sr. (75 years yang)

  3. Aphrael
    Aphrael May 4, 2015 at 7:56 am #

    Hi All, thought to give an update in case anybody else experiences similar symptoms as what I reported. I went for the colonoscopy which did not show up anything (fortunately, with some body contortion, I had managed to take a short video of the ‘prolapse’ so I was able to show my GI what I was referring to). His conclusion was that he felt it was my small intestine that was prolapsing through my J-pouch and he referred me back to my surgeon for further management. Once I met with the surgeon, his opinion was that is was in fact the pouch itself that was prolapsing and not my small intestine. He referred me for a Proctogram (also known as defecogram) x-ray in an attempt to determine which part of the pouch was prolapsing so that he knew which part to surgically tighten. I have just returned from this x-ray. Below follows a summary of how this x-ray works:

    My appointment was for 11:30am and I was required to stop eating from 22:00pm the previous evening. Fortunately no other prep was required. Once I got to the radiologists, I was given two full glasses of Barium to drink (oral contrast). Barium is a white, chalky thick liquid (with the consistency of thick paint) which you have to drink two hours prior to the x-ray. Two hours later you return to the radiologists for the x-ray.

    For ladies, be aware that this x-ray may involve the radiologist inserting a tampon in order to indicate where your vaginal wall is during the x-ray. The radiologist then injects two full syringes of a pumpkin and berry mixture (which you do not see) directly into your rectum in order to fill your J-Pouch. They will first x-ray your stomach while you lie flat on your back, then again while you are standing upright.

    The toilet is then introduced. This basically involves a wooden structure with a toilet seat on top and a bucket underneath. You will then be required to sit and follow the radiologists instructions of when to push.

    Following the X-ray, my Radiologist was really great in that he called me to the back and showed me on his screen exactly what he had found. He was able to confirm that my GI was in fact correct and that it was my small intestine which is prolapsing through my pouch. He was surprised to see this in someone as young as myself, apparently this is more common in older ladies who have had children. His theory is that due to the inflammation experienced due to my UC prior the operation, as well as the intervention of the operation may have weakened my lining which has resulted in the small intestine hernia.

    Unfortunately he was unable to give me any indication regarding the treatment of this so I will have to wait for my follow up appointment with my surgeon on 29 May

    I hope if anyone else is referred to go for this x-ray, this post will help dispel some of the fear which a person can experience if you read some of the internet descriptions of what it all entails.

    I will provide a further update once I have my answers from my surgeon!

    • VN April 30, 2017 at 9:24 pm #

      Did you end up requiring surgery? My teenage child is experiencing the same thing and I haven’t been able to get in touch with the doctor yet. Thank you.

  4. Aphrael May 8, 2017 at 4:35 am #

    Hi, I did not end up getting surgery. Though he had said that surgery would fix it, he didnt want to put my body under further strain since we were considering falling pregnant shortly thereafter and he said the surgery would further influence my fertility. I had to go for physio to work on my core structure, mostly using kegal exercises etc and this helped significantly.

    I hope that your childs doctor is also able to find a less intrusive solution than surgery. I have not had a protrusion in many many months now.

  5. VN May 8, 2017 at 12:15 pm #

    Thank you for responding! I know this was an old thread. The GI doctor recommended 1 Tbsp Metamucil 2xday, using a squatty potty, avoiding straining and they are going to contact the surgeon to get his opinion. I don’t think she strains because she rarely has fully formed bm’s. Thanks again for taking the time to reply and for sharing your story. I couldn’t find a lot of webpages regarding this issue. :)

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