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Does anyone irrigate with something larger than an empty fleet bottle? I have to do multiple of them a day, and multiple at a time. 

For example, in the morning, I go poop about 9 times over 3 hours. I can't do much else during this time, and have to focus on making the poop happen. I have tried to speed things up with gentle laxatives, coffee, et cetera, and it doesn't help. It is my dinner coming out from the night before. Each poop is in a small amount. Usually near the end of this debacle, I take a few enemas to finish it off so I can move on with my day. 

I have a mutliple-doctor team, including a motility GI. I asked her about that and she said perhaps I could try irrigation but she isn't sure if that would help or even work. I know the small intestine keeps moving, but if I could just flush ALL that contents out of there in much less time, WOW! I would feel amazing!

I called Coloplast and talked about peristeen but not sure it is a good choice. I do not have a j-pouch but am ileorectal anastomosis. But does anyone do this, where they do a large volume (my GI guessed 500 cc vs the 100cc of a fleet bottle, might work, but she was guessing)? I am going to ask my surgeon but I want to be more informed before speaking to him.

ANY insight would be great.

Original Post

@Scott F Thanks for replying. You've been so helpful with many of my questions! 

DO you think it would help consolidate the three hours of pooping? It's all, for example, my last night's dinner coming out in the morning over those three hours. I don't even eat that much, but it sure creates lots of poops. However, those poops over those three hours are generally small. (sometimes 2tbsp to 1/4 cup or so)

I have pelvic floor dysfunction, but if it is coming out in force, I think it could come out. Not a lot of force, but I can expel my current enemas I take (with a bit of strain, but generally it's okay). 

I am at my wit's end. I'm having so many problems and losing weight quickly, and don't know how to handle this much longer. I know it is early, which is fine, but I do need some coping strategies as things adapt, as well as find ways to adapt!

@readann posted:

@Scott F Thanks for replying. You've been so helpful with many of my questions! 

DO you think it would help consolidate the three hours of pooping? It's all, for example, my last night's dinner coming out in the morning over those three hours. I don't even eat that much, but it sure creates lots of poops. However, those poops over those three hours are generally small. (sometimes 2tbsp to 1/4 cup or so)

I have pelvic floor dysfunction, but if it is coming out in force, I think it could come out. Not a lot of force, but I can expel my current enemas I take (with a bit of strain, but generally it's okay). 

I am at my wit's end. I'm having so many problems and losing weight quickly, and don't know how to handle this much longer. I know it is early, which is fine, but I do need some coping strategies as things adapt, as well as find ways to adapt!

Readann, I think you’re going to have to do some gentle trial and error. I’m not sure what’s driving you to the toilet for 2 tbsps of poop - is your rectum full but unable to be emptied, or is it empty but irritable? Is the stool too thick/hard? Is it blocked by a stricture? Would you have an accident (or pain, or ...) if you ignored the sensation?

Thanks. I have tried to ignore it but it just gurgles, causes discomfort, and pain and I get really bloated.

There is definitely more in the rectum, I just can't pass it all at once. This is because of my pelvic floor for sure. If it was more formed, it would be easier. But when I try to form my stool with more thickening foods, it becomes skinny like toothpaste which is also miserable to pass.

I am getting a scope in 13 days but the surgeon is pretty confident there won;t be an issue, and I believe so, as well.

I don't think it's irritable -- It hink it's just my pelvic floor dysfunction, but my poop is only easy to pass if it's thicker in diameter (like a fatter sausage), which I know is hard to achieve but I got once in a while in my first poop of the morning, but nothing else has helped since then.

I've tried so many things with diets and meds. I'm now just not eating much so I can poop less. Not really viable.

We may have discussed this on a different thread, but has your surgeon mentioned a defecogram? If the scope doesn’t answer the question then one possibility could be a prolapse. It would cause similar problems to pelvic floor dysfunction, but has a very different solution...and is best diagnosed with a defecogram.

I haven't had a defecogram lately -- only much before colectomy. It showed nonrelaxing pelvic floor, same as with the anorectal manometry. I can ask him if it is valuable to do another at the time of the scope. I did ask my motility GI today, but she said that generally they do that only with the sigmoid intact, which I didn't believe was true because I know someone with an IRA who recently had it! So I was going to ask him about that, anyway. I think it will be the same results, though, to be honest.

Make Dinner your smallest meal. At least 4 to 5 hours before bedtime. Do the warm water enema before bed. Take psyllium fiber, preferably Konsyl or 365 brand Before bed to second things up through the evening hopefully making more bulk. Then do the warm water enema maybe two of them when you awake. Hopefully the extra bulking of the psyllium fiber drink through the night will help you evacuate better from the night before. Drink plenty of fluids when you do psyllium fiber but not all at once, just make sure you’re drinking electrolyte drink sipping all throughout the day. There is a fine balance between the fiber and a liquid that must be maintained for a proper illumination. I do have to say, I experience the same exact thing and have for years, but a defacography Was ordered about a year after my surgery and that’s when it showed up that I had prolapse as well as rectocele. It has always been hard to have proper elimination But I’ve got it down to where I do the enemas about four times a day if I don’t eat any things that irritate my gut. I try to stick to a bland soft to medium soft diet. I do fruit smoothies eliminating any citrus fruits Because they can be very acidic. I usually use a combination of strawberries with some blueberries and oat nut milk, maybe with a little honey for sweetener to get my nutrition from fruits. Easily digestible and easy to eliminate. You can add some Chia seeds to the smoothie which will help bulk it up even more Truthfully will help things push through if you drink enough liquids in the day. All of this I do with the fiber drink at least 3 to 4 times a day. Get my vegetables without getting too much insoluble fiber, I try to do a green smoothie during the day as well. Smoothies are a great way to get your nutrition and are easily and fast absorbed. Easy to break down and don’t clog up the gut with hard to digest matter and elimination issues. Granted, I do eat a few more carbs than I should with pasta’s, white bread or rice in meals , but we have to do what we have to do to help the quality of our life. Since the prolapse and rectocele happened or was discovered a couple years after my surgery, I strongly suggest you look further into those things with Testing Because this is exactly what happened to me. I’ve still kept my J patch but I have learned to maintain things At an acceptable level And quality of life considering other options.

Anal stenosis can happen too where the opening of rectum gets really small so things done empty all the way. When you use the warm water enema hold it in as long as you can and the try pushing up from lower abdominal area and sides to try and help push up and out what is in there. You can also try pushing in around hip area. I have to do this since things have shifted around and it helps. If you aren’t drinking enough water too that can cause constipation, but not so much that you get watery stool. Uncooked vegetables will clog you up as well as corn mushrooms high fiber foods. I use a blender for smoothies as well as a steamer for steamed softer white fish or potatoes vegetables to soften. I hope all this helps. 

@FRH Thanks. I have a scope in two weeks but don't think that is the issue. I do hold the enema but it doesn't seem to flush everything out. Do you think it is safe to use something with more CCs? Does it happen to you that you have to go many times over a few hours?

I'm definitely not constipated, and try not to overdrink and work on the balance. I don't eat anything that might clog me up -- my diet is very limited and everything is making me sick. If I could make my stool fatter it would help, but nothing is seeming to work for that.

 

If I eat the things that irritate me or burn when coming out then yes I might go more just to try and get rid of it, but no, if I watch diet it’s pretty controlled. In the first 6 months after surgery everything was really watery. However, once I got on the Fiber Konsyl and got the Calmoseptine cream I at least wasn’t in pain most of the day. I was also eating all the wrong things like eating chocolate, eggs, citric acid in soft drinks, coffee, etc etc. They sent me home with hardly any information so I truly was in a lot more pain that I had to bitch because not knowing what I was doing wrong. Later found I had pouch prolapse and rectocele and wasn’t even told that until a year or so after with proper testing. I always wondered if they knew but didn’t want to tell me for fear I might sue. Who knows. It’s 20 years later so water under bridge. I know oatmeal helps in morning, I use nut milks and stay away from dairy which increases output. I use non dairy vegan cheese. Eat steamed fish and softer veges with potato or pasta to help slow things. I love my steamed so I don’t have to cook dinner with oils. It Definitely sounds like they should do extensive rechecking for possibilities causing your issues. 

Word bitch should have been “more pain than I had to be in” and love my cooker steamer I just purchased. Green smoothies (sip on) Fruit smoothies with banana and non citric fruits, nut milk like almond and start with 1/2 smoothie in morning with oatmeal. I take the fiber about 4-5 x day when ai have bad days. 

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