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   I Survived Sphincteroplasty Surgery Part II (Bowel Disorders board)

12th May 2007
Hi Jou Jou! I forgot to mention that I have suffered since childhood with chronic constipation. But I got Miralax from my PCP and I go everyday when I am on that medicine. The problem is I hold in my farts and some of it seeps out which is where the smell comes from. When I have a bowel movement it takes the farting away for a few hours but I still have gas (not from farts) that seeps out. I have no clue where so much gas could be coming from. And yes, my personal hygiene is just like most people's as far as showering and brushing my teeth everyday. I wear LOTS of body spray and perfume but unfortunately my odor can be smelled over it. As far as doctors, I just had to deal with a gastro doctor who completely dismissed my concerns and said that some people just naturally have more gas. And when I tried to explain that it is 24/7 and I am incontinent he just wrote me off. That is why I am going to a new gastro doctor in a few weeks. Maybe if this doctor doesn't listen to me then I should just go straight to a Colon & Rectal Surgeon. Do you know if digestive diseases alone could cause incontinence as a symptom? Also, my gynecologist did a rectal exam a few months ago and told me I have internal hemmorhoids. And I just read somewhere that hemmorhoids can cause the sphincter muscles to not be able to close completely, thus causing incontinence. So maybe that could be what's wrong. I don't really know. It's very confusing. Thank you for your reply!!
22nd May 2007
I am new to this site and have read most of the posts. I had sphincteroplasty/rectocele/perinium (sp) surgery on April 20th. I am scared to death. I have to be near a bathroom at all times because the urgency is so great and I don't feel I can hold it. I am also having more problems retaining gas than before the surgery. Can anyone tell me if things will get better with healing? The colo-rectal surgeon I used seemed to have great credentials, even authoring portions of medical text books. But when I went for my 2 week post-op exam, he was very please with the sphincteroplasty results, but said I may have to learn to live with the other changes. This makes no sense to me if the surgery was such a success. I go back next week for a 6 week check. I am doing kegel exercises (100 - 3 times a day). I seem to be a little better than at my 2 week post-op check but don't seem to be progressing as quickly as I thought I would. How long does it take to see positive results? I take Miralax and Citrucel every evening so I am having 3 - 4 BMs each day with no difficulty except the retention issue. I've been having terrible anxiety attacks afraid that I will not be able to lead a normal life again. Does anyone have any feedback for me? Thanks
22nd May 2007
szsv,

Welcome to the discussion. I'm happy that you posted. Hang in there. You will get better. I completely understand your anxiety and fear and desperation for a little normalcy. I had a sphincteroplasty, perinealplasty, and levatorplasty (and consequential repair of rectocele) in March. At 4 weeks, there was tremendous pressure before bm's and after being on my feet for awhile. I was also never confident being away from home for fear of having the urge for a bm. Would I be able to hold it? Would I be able to clean afterward? etc. The pressure goes away gradually. Somewhere between 6 & 8 weeks, it was gone except when I was on my feet too much. Take it easy and get as much rest as you can. Reclining always relieved the pressure for me.

Why are you taking Miralax? Are your bm's formed or loose? Having 3-4 bm's daily must be exhausting you. Immediately after my surgery, I had diarrhea for about 10 days. It was difficult (impossible at times) to control. It was very very difficult to deal with. I finally took a dose of Immodium and that's when my stools began to slow down some in frequency and slowly, gradually become more formed, with improving control. Now, at almost 9 weeks, they are consistently soft, formed bm's. Usually once a day.

So, my advice: stop the Miralax, recline with your feet up, and keep your chin up. The things you describe will get better.

As far as the longer term success of the surgery, my story is not so optimistic (yet). After 5-6 weeks of recovery, I began leaking stool. There is leakage consistently after every bm. Sometimes more, sometimes less. I am also incontinent of gas a lot. The fiber content of my diet doesn't seem to make any difference to the bm frequency, consistency, etc. Nevertheless, I make sure that I get at least 23 g/day. Just as before the surgery, I can't cut off the bm and can't fully evacuate everything. So, I can now easily hold it 'til I get to the bathroom, but then I can never finish. Tomorrow, I have an appointment for biofeedback.

There are two other ladies who add to this thread who have happier end results and are further along post-op than you or Mitzee or I. Like you, I am afraid that I will never lead a normal life. I can offer you the assurance that the surgical trauma will heal and the urgency and pressure will diminish. As for good functioning, I am desperate for a solution. I am unwilling to accept that this is what the rest of my life will be, but I could just be in denial. There is no reason for me to believe that things will just magically, suddenly improve, and I have done and am doing everything I possibly can. You don't mention any incontinence of stool, so hopefully, your repair is successful and you can look forward to happy days following a full recovery. Good luck and keep posting. You have my best wishes.

JJ
23rd May 2007
Thank you so much to everyone for their support it is extremely helpful. I was taking the Miralax because my GP told me to take it. Yesterday I had diarrhea and that is when I decided to cut back on the Miralax. The bms have not been well formed, so I think I was overdoing it with the fiber and Miralax. I have very small amounts of seepage occasionally. It's discouraging, but not as frightening as the urgency and inability to hold gas. I think I was expecting miracles. I'm hoping to get down to one bm a day and have some predictability with it. I appreciate the advice on taking it easy. I think I've been trying to do too much too soon. One of my major panics is that my son is getting married in Hawaii on July 21st and I thought I would be completely healed by then. But with what all you are saying, that might not be the case. I can only hope.

Thank goodness for this site.

Szsv
24th May 2007
Hi everyone,

First of all--what an idiot I am--I posted a huge long post to everyone the other day--took about 30 mins to write it all with some great info and forgot to click post before closing out and lost it all!! I was so mad, and I feel bad because everyone seems to be more down than before. Cheer up. I know how hard this is for everyone. I cried almost every day before surgery, and had major ups and downs through the whole process. I wouldn't leak one day, and instead I would convince myself that I was ok and didn't need the surgery. The next day I would leak horrible and just cry and feel sorry for myself. I think that having this surgery was the best thing I could have done for myself. I went into the surgery knowing full well that I might not have a 100% improvement, but finally convinced myself that if I just continued on the way I was, that there would surely not be any improvement. I know this is scary, but we all deserve to live normal lives free from this horrible problem. All I can do is provide a little bit of hope for you all that you can get better. I know that everyone has not had the same success as I have, but you need to be as positive as you can and be prepared for the worst, and hope for the absolute best. This is how I went into surgery. I knew I was trying to fix the problem the best that I could, and I prayed a lot that things would go well. For me, I have a completely normal life now. No leaking or smearing, or incomplete evacuation at all. I am however having major issues with other parts of my health and I feel the same desperation as you all in that area of my life. I was at the hospital yesterday all day having tests done and am now on 5 different medications to help with major pain that I have from an auto-immune connective tissue disease. I too get down all the time about my health on my bad days, and feel great on my good days and try to convince myself that I don't have a chronic disease. It is a very normal coping mechanism. What you need is the support to lift you back up. When I was going through all of this Decav, I also had an 18 month old son who would cry at the bottom of the stairs..."MOMMA" for me when I was on bed-rest. I know how you feel. I couldn't pick him up for 5 weeks, but did a lot of snuggling in bed and reading books with him, and playing dinosaurs. I actually think I spent more time with all my kids because they thought it was fun to have movie night in mommas bed, and breakfast, lunch and dinner in bed with mommy! It is hard, but you will be better soon.

As far as the urgency goes, Yu will have that for a while, but it does get better, and now 4 months post op, I can hold all urges without any difficulty. I too sometimes have some problems even at my stage. I forgot to take my fiber for 3 days because I was out of my routine and I had a 3 hour (no kidding) experience on the toilet with constipation the other day. It was awful. I made myself bleed again, and it is a constant reminder that my life has changed and includes fiber on a daily basis. For those of you who are experiencing some leaking, szsv, I think that eliminating the miralax is a good idea--That is what I wrote in my earlier deleted post. I think you are doing fiber overload and may see some improvement after experimenting with that a little. I know I felt like I had to take what the dr. told me too in the beginning, but I soon learned that my body was mine, and maybe a little tweaking here and there from the dr.s orders would be best for me. I had good success when I did that. I would not recommend taking any laxatives unless you have not had a BM or feel pressure, fullness and bloating. I would stick with regulating your diet and fiber intake as well as lots of water. Also, if you feel like you are getting in trouble with constipation or not going, Milk of magnesium is very gentle and worked for me to get things started without giving me major diarrhea. On the other hand, a 1/2 dose of immodium may be in order if the opposite is occurring.

Everyone, hang in there--Give yourselves time to heal. It is a long process with bumps in the road, little setbacks, and lots of revisions. Play around with your diets and fiber, and most of all, think positive! You had this surgery in hopes of getting better, and if you didn't go ahead with it---your daily problems probably would not have improved. I think of you all often and know how hard it is.

Lisa--:angel: praying for you

Hugs to all,
Kelley
24th May 2007
Kelly,

Thanks for the input on the Miralax. I did stop it 2 days ago and have had much less urgency. I will have to increase my fiber though because I have had harder bms since stopping the Miralax. It really is a balancing act. I'm still pretty discouraged about the gas issue. It seems to be a very common issue. How do you all handle it when you are out in public? Also, several of you have talked about biofeedback. What is the procedure like and how long/many times did you have to do it. Did insurance pay for it?

Thanks to everyone for all their candor. I wish I would have found this site before I had my surgery so I would have known a little more about what to expect. When the doc said I would be recovered in 6 weeks, I thought this was going to be so easy......well, it hasn't been. I have less control over the gas than I did before. I really try hard to make it to the bathroom to expel the gas, so that I can "train" myself for when I'm in public, but I'm not having much success and feel so discouraged when I can't make it. I have really been depressed. I was having such bad panic attacks over this, I asked my psychiatrist (I have major depressive disorder and bi-polar II) for something. She Rx'd some Klonopin for about 5 days. That did help break the cycle somewhat. But after reading most of the posts, I'm finding that this is probably going to be a year long process, not 6 weeks. I too have a wonderful husband who is very encouraging, but my stress level has been difficult for him as well, seeing me so panic stricken. We are empty nesters, so I don't have to take care of little ones while recovering. I don't know how you young moms are doing it all.

Thanks again to everyone for their input.

Suzan
26th May 2007
DeCav12,

I definitely found out that using laxatives caused some seepage. There is a fine line between not being constipated and loose stools due to laxatives. I'm still working on finding the right combination. Sorry you had such a bad day. I was chronically constipated before the surgery, but still leaked. Now with all the fiber I'm taking, not really having that problem. Kelly mentioned I might want to stop taking the Miralax, which I did, but got a little constipated. So I tried 1/2 a dose for 2 days and had some leakage again. So, I'm certain now that it's the Miralax. Hope this helps.

Suzan
30th May 2007
Lisa,

Hope you are doing better this afternoon. I did not have the impaction issue, but just having regular BMs hurt. The pressure from sitting on the toilet hurt so much I could only tolerate it for short periods of time. The surgery was a lot more painful than I thought it would be. The sitz baths are definitely a help. I also did not have the urinary tract problems. My roomate in the hospital who had rectocele and hemroid surgery had a difficult time with urinating. I was only in the hospital 2 nights. I had to take Milk of Magnesia when I got home that first day, per doc directions. I went, but it was painful. I had rectocele & perinium repairs and sphincteroplasty as well. I went for my 6 week check up today and don't have to go back to the doc unless something happens. He said my gas issue should improve with the Kegels. I'm healing really well. I also did not have the opening you all are talking about.

Mary,

The Kegels I have been doing are: holding for a count of 10, then releasing for 5-10 counts and doing 100 of those 3 times a day. I'm so freaked out about not being able to hold gas from expelling that I'm very committed to doing the Kegels. One of the articles I read said to do them the way you are. I started out with holding for a count of 3, then releasing for 3. (After week 2 of the surgery) I do them lying down. The doc said my sphincter muscle is much stronger than before, so hopefully with the combination of surgery and Kegels I'll be able to have better control over the seepage and gas. Since being off the Miralax, I haven't had any seepage. So I'm keeping my fingers crossed.

Lisa, give yourself lots of time to heal. So glad you have help. I'm an empty nester with a great hubby who took good care of me, so I'm lucky not to have little ones to have to run after.

Something I did from the beginning was drink a lot of fruit juices. Grape, Cranberry and Orange. I was also taking Citrucel, ground up flax seed and Miralax the two latter in V-8 juice. That may be why I didn't become impacted. But I was having 3-4 BMs a day, usually in the morning. I also have IBS, Chronic Fatigue Syndrome and Fibromyalgia. The CFS did flare up during my recovery and is only now getting a little better. I still have to rest a lot more than I thought I would after 6 weeks. It's just a long slow recovery.

Take Care Everyone,
Suzan
30th May 2007
Mitzie,

The opening is where (in my case) almost the entire incision opened up. Basically the stitches ripped open leaving a huge gaping wound that had to heal from the inside out. It is actually pretty common in this type of surgery because the area is so very fragile, and the skin thin. I was still on bed rest when mine occurred. You are very lucky to not have to deal with it. It took mine 4 1/2 months to completely heal shut. In the meantime, I had it cauterized every 2 weeks to help with the healing. It was very sore and a huge pain to deal with. It added tremendously to my recovery period. The ridge that you are talking about is the area that you need to be careful of. You are not out of the woods for it opening up. Mine occured at about 2 weeks post op. The stitches will dissolve (I had a few stragglers removed) and that ridge will soften out and appear more normal looking after it is completely healed. Mine was the same. Be careful with lifting, and bending and straining too much.

Suzan,

I am so glad your seeing improvement after quiting the miralax. It should only get better from here on out. I agree that this surgery really wipes you out. I also have other issues similar to yours and I had a terrible flare and am still recovering now after the surgery. It has taken me a long time to feel like myself again. Now that I am on medication and feeling better, I have an improved outlook on life :) I am sorry you have fibrom. and cfs--I know how you feel (for me doctors are still in limbo as to whether I have RA or lupus (for now, connective tissue disorder) I hope you are feeling better soon.

Robinlake,

Welcome, sorry you too suffer from this horrible stuff. Can you tell us a little more about your first experience?? I am sure we would all like to hear. I also was going to have my ob/gyn do the surgery but decided to have a second opinion and went with the colo-rectal surgeon instead. I am glad I did. How bad is your gas that you are considering surgery again?? Does the colorectal surgeon say he can fix that problem? I ask because I had a sphincteroplasty, levatorplasty, and perinealplasty in January and I still suffer from gas leakage also but was told there is nothing that can realistically help that.. From the begining my surgeon was not optimistic for correcting the gas situation. I have no problems with leaking stool any more, and have just been dealing with the gas because I wasn't sure it could be fixed. This must be a very difficult decision for you. Especially because you know what the surgery entails already. Let us know if there is anything else we can help you with.
Kelley
3rd June 2007
Hi Linds77,

You will get a lot of help from this board. I did not find it until after my surgery. I am 6 weeks post-op. I had a rectocele fixed, plus perinium repair and sphinctoplasty. I am an empty nester, so I didn't have the baby issues you are talking about, but several people on the board have small children. I agree with Mitzee that 4 weeks is probably too short for recovery, especially if there are any problems, such as the wound opening, as it has for some of the members here.

I had leakage problems and difficulty controlling gas before the surgery. The doc said I had one of the worst rectoceles he had seen, so surgery was recommended. I did very little research before the surgery, blindly trusting the doc (recommended by my primary care doc).

I have been having problems with urgency and worse problems retaining gas since the surgery. (BTW read as many of the old postings as possible. You will get tons of info.) I was using Miralax, Citrucel and ground up flax seed to keep my BMs soft, but that overloaded my system and I was having difficulty making it to the bathroom. I cut back to just the Citrucel, but was having intermittant diarrhea, so day before yesterday I cut out the Citrucel and today the urgency was not as bad as it has been. The gas is a big issue for me. I cannot hold it. I'm doing Kegels 3 times a day in hopes of gaining control. I am slightly better than right after the surgery, but still not anywhere NEAR what I think is acceptable.

I was told the recovery would be 6 weeks, initially. Then after the surgery the doc said it would take about 3 mos. to fully heal. I was driving after 2 weeks, just a little, and more as time went on. You'll be pretty sore, so sitting directly down on your bottom can be a challenge. The surgery was more painful than I thought it would be, but I was completely off pain meds by about 10 days. So, the pain comes mainly right after the surgery. Sitz baths really help.

I can't help you on complications. But several of the other members can and you will find them on the old postings.

Are you confident in your surgeon? How many has he/she done? Can you talk to some of their other patients? My doc has done over 1000 of these surgeries, so I was pretty confident in his ability. I just can't get this darned gas issue resolved yet. I'm told by other members that things will probably get better with time.

Hope some of this has helped. This is a very open and caring board, so ask anything you wish to know. Someone will mostly likely have an answer for you.

Suzan
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