Suggest Treatment For Pain While Coughing An Sneezing Post Sub Total Colectomy

Posted on Sat, 26 Jul 2014

Question: 18 months ago, I had a sub total colectomy with an ileo rectal anasthamosis. This followed 2 other colon resections and major pelvic floor reconstruction one year prior. When the urogyn did the pelvic floor surgery, he commented that I had a huge number of adhesions and the process of lysis added hours onto the surgery.
So now, if I sneeze,cough stretch, bend, I can feel painful tugging in several places..and it often sets up an extremely painful cramping that feels like my guts are being twisted. I've lost 25 lbs in the past six weeks...eating is a miserable activity..the cramping is very painful. My gastro says that I have IBS and adhesions and that surgeons don't like to perform more surgery when likely more adhesions will form. Thoughts on what to do? I actually feel as if I am slowly loosing life from the inside out.

Answered by Dr. T Shobha Deepak (1 hour later)

Brief Answer:
Symptoms unlikelt to be due to adhesions

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day

Every Surgery done creates further adhesions. Adhesions usually become symptomatic due to kinking and angulation of intesttine causing obstructive symptoms. It usually presents with distension of abdomen, vomiting / nausea and constipation.
Your symptoms do not suggest the possibility of symptomatic adhesions. Dense adhesion in pelvis with entrapment of nerves may be one of contributing factor in causing your symptoms. The symptoms profile fit more in the bracket of IBS.

Further investigation like Barium meal and follow through along with Ultrasound?MRI abdomen need to be planned in consultation with your Physician.

Take Care

Best Regards
Dr T Shobha Deepak
MBBS,MD

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Shobha Deepak (9 minutes later)

I had an MRI and the report read, "Many Surgical Changes." Of course.
What you're describing sounds like a bowel obstruction...
The discomfort I'm experiencing with the cramping, twisting is similar to diverticulitis pain, only worse. It is a transient pain that builds up to a crescendo and at that point I cannot speak or even breathe...it resolves, rebuilds and eventually disappears. Is this really IBS?

Answered by Dr. T Shobha Deepak (2 hours later)

Brief Answer:
Contrast study will be required

Detailed Answer:
Hi

Greetings

IBS is diagnosis of exclusion, if detailed investigation have failed to reveal any organic cause that can explain the symptoms experienced, it is labelled as IBS.

I would suggest you to get Tripple Contrast CT scan of abdomen in consultation with your physician for further evaluation. Contrast study of Gasro-intestinal tract will be required to rule out any kinking of intestine seconadry to adhesion.

Take Care

Best Regards
Dr T Shobha Deepak

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar