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What Does My Colonoscopy Report Indicate?
Question: I am having a problem with bm. for the last several years I have had to strain to evacuate. The past few years even when I have a succesful bm, I still have the pressure of a bm at the muscle of my anus, that felling is presestent and urgent as well as painful and very unconfortable I am only able to strain succesfully about 2 times when it feels like my anus just locks up. For the lat 3 days I have not been able to strain and get anything out. I take movantik daily and 2 doses of maralax, along with fleet enemas as well as warm water enemas and sometimes I will retain a 4oz bottle of water of
a few hours. this morning I have done all of that with very little results. I have had a colonoscopy, 2 ct scans and they say all is well but what could be causing the muscle of the anus to always feel as if I have a stool right there that will not come out.
I am a diabetic, hbp and chronic backpain. The only pain meds I currently take is oxycodone15mg 3x's daily.
I have asked this question on webmd.com about 2 years ago and was told more fiber, more water and squats. I havedone all or those suggestions and they have faild to help.
a few hours. this morning I have done all of that with very little results. I have had a colonoscopy, 2 ct scans and they say all is well but what could be causing the muscle of the anus to always feel as if I have a stool right there that will not come out.
I am a diabetic, hbp and chronic backpain. The only pain meds I currently take is oxycodone15mg 3x's daily.
I have asked this question on webmd.com about 2 years ago and was told more fiber, more water and squats. I havedone all or those suggestions and they have faild to help.
Brief Answer:
Impacted stool you have to go for digital finger extraction.
Detailed Answer:
Hello,
Thanks for choosing HealthcareMagic for your query.
Have gone through your details and i appreciate your concerns.
As per your query most likely your symptoms are due to fecal impaction.A fecal impaction is a solid, immobile bulk of human feces that can develop in the rectum as a result of chronic constipation.No amount of laxative would help.
You have go for Digital evacuation.It involves the use of fingers to aid in the removal of stool from the rectum.Stool is emptied by gently inserting a finger into the rectum and removing it.
Thanks!
Impacted stool you have to go for digital finger extraction.
Detailed Answer:
Hello,
Thanks for choosing HealthcareMagic for your query.
Have gone through your details and i appreciate your concerns.
As per your query most likely your symptoms are due to fecal impaction.A fecal impaction is a solid, immobile bulk of human feces that can develop in the rectum as a result of chronic constipation.No amount of laxative would help.
You have go for Digital evacuation.It involves the use of fingers to aid in the removal of stool from the rectum.Stool is emptied by gently inserting a finger into the rectum and removing it.
Thanks!
Above answer was peer-reviewed by :
Dr. Prasad
Thank you for your answer, however it does not address the fact that I have to strain to get out any thing at all and to feel that I've had an incomplete evacuation. I understand that I may have a fecal impacation now, but I was cleaned out enough to have a colonoscopy a few months ago, yet I still had to strain before and after the cleanning process.
Several years ago I was taking 240mg of oxycontin and of maralax in the morning and at night. It worked great for several months and then my stool became very watery. The same dr then switched me to linzess 145mg,I began to have to strain more during my bms. My family dr incress the linzess to 290mg and later to monvantik 25. Lately I have been taking a double dose of maralax at bedtime, movantik and a double dose in the morning, as well as fleet enemas.
What I really want to know is why I have to strain to evacuate with every bm and why do the strains suddenly quit working, sometimes with a stool feeling like it is part way out? And why did the strains suddenly stop working 3 days ago when the stool felt like it was soft. 2 hours later I could feel it harden and I haven't go much out in the lat 3 days.
Several years ago I was taking 240mg of oxycontin and of maralax in the morning and at night. It worked great for several months and then my stool became very watery. The same dr then switched me to linzess 145mg,I began to have to strain more during my bms. My family dr incress the linzess to 290mg and later to monvantik 25. Lately I have been taking a double dose of maralax at bedtime, movantik and a double dose in the morning, as well as fleet enemas.
What I really want to know is why I have to strain to evacuate with every bm and why do the strains suddenly quit working, sometimes with a stool feeling like it is part way out? And why did the strains suddenly stop working 3 days ago when the stool felt like it was soft. 2 hours later I could feel it harden and I haven't go much out in the lat 3 days.
Brief Answer:
follow up.
Detailed Answer:
Hi again,
Ok so lets first understand the physiology of normal defection.
Muscular contractions in the walls of the colon move fecal material through the digestive tract to the rectum. The rectum is a muscular tube that acts as a temporary reservoir for the waste material stretch receptors from the nervous system, located in the rectal walls, stimulate the desire to defecate.
Now please go through the last line it clearly says that there are small receptors on surface of rectum which when stimulated carry signals to the brain which further directs the muscles to contract and pass feces and you need not to strain .This was a normal persons physiology.
In a person with constipation(severe) any thing from receptors to brain signals to muscles may not be working properly therefore either you have to strain a lot and that too in vain or you have to take laxatives(which mimics brain signals and stimulate the intestines to contract).
As per your history you were earlier relieved by a laxative but now thats not helping.
See my dear patient our body is a complex machinery with extreme power of adaptation.A particular type of laxative acts on particular receptors hence by continuous use they lose their sensitivity to salt in that laxative and hence medicine don't help.
A better way is to alter between 2-3 types of laxatives every month or two.This will give time for receptors to be sensitized again.
For e.g Use Miralax for 1 month there after you can take lactulose.
Try to increase and decrease the doses.This will help these salts to remain effective over years.
Now lets move to your question-
What I really want to know .............................. 3 days.
Answer-1)Initially go for rectal examination of canal,Patency of sphincter would be checked by your surgeon.lubricated finger would be inserted into your rectum to evaluate the strength of your sphincter muscles and to check for any abnormalities in the rectal area.
Balloon expulsion test. A small balloon is inserted into the rectum and filled with water. You are then asked to go to the toilet and expel the balloon. The length of time it takes to expel the balloon is recorded. A time of one minute or longer is usually considered a sign of a defecation disorder.
Anal manometry. -Anorectal manometry is a test performed to evaluate patients with constipation or fecal incontinence. This test measures the pressures of the anal sphincter muscles, the sensation in the rectum, and the neural reflexes that are needed for normal bowel movements.
A professional advice regarding the cause of your problem and its sudden advent can be given only after proper investigation.In these tests all sensations,patency etc of muscles would be checked,Therefore after these test we could conclude the cause of problem.
Hope i was helpful.
If you have any questions or confusions please feel free to follow up.
Wish you a good luck.
Thanks
follow up.
Detailed Answer:
Hi again,
Ok so lets first understand the physiology of normal defection.
Muscular contractions in the walls of the colon move fecal material through the digestive tract to the rectum. The rectum is a muscular tube that acts as a temporary reservoir for the waste material stretch receptors from the nervous system, located in the rectal walls, stimulate the desire to defecate.
Now please go through the last line it clearly says that there are small receptors on surface of rectum which when stimulated carry signals to the brain which further directs the muscles to contract and pass feces and you need not to strain .This was a normal persons physiology.
In a person with constipation(severe) any thing from receptors to brain signals to muscles may not be working properly therefore either you have to strain a lot and that too in vain or you have to take laxatives(which mimics brain signals and stimulate the intestines to contract).
As per your history you were earlier relieved by a laxative but now thats not helping.
See my dear patient our body is a complex machinery with extreme power of adaptation.A particular type of laxative acts on particular receptors hence by continuous use they lose their sensitivity to salt in that laxative and hence medicine don't help.
A better way is to alter between 2-3 types of laxatives every month or two.This will give time for receptors to be sensitized again.
For e.g Use Miralax for 1 month there after you can take lactulose.
Try to increase and decrease the doses.This will help these salts to remain effective over years.
Now lets move to your question-
What I really want to know .............................. 3 days.
Answer-1)Initially go for rectal examination of canal,Patency of sphincter would be checked by your surgeon.lubricated finger would be inserted into your rectum to evaluate the strength of your sphincter muscles and to check for any abnormalities in the rectal area.
Balloon expulsion test. A small balloon is inserted into the rectum and filled with water. You are then asked to go to the toilet and expel the balloon. The length of time it takes to expel the balloon is recorded. A time of one minute or longer is usually considered a sign of a defecation disorder.
Anal manometry. -Anorectal manometry is a test performed to evaluate patients with constipation or fecal incontinence. This test measures the pressures of the anal sphincter muscles, the sensation in the rectum, and the neural reflexes that are needed for normal bowel movements.
A professional advice regarding the cause of your problem and its sudden advent can be given only after proper investigation.In these tests all sensations,patency etc of muscles would be checked,Therefore after these test we could conclude the cause of problem.
Hope i was helpful.
If you have any questions or confusions please feel free to follow up.
Wish you a good luck.
Thanks
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Above answer was peer-reviewed by :
Dr. Vishesh Rohatgi
Answered by
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