Abdominal pain and presssure after colostomy reversal

Resolved question:
Five years ago I had a left colon resection due to paralytic ileus and the resulting rupture of my colon. About 20 inches were removed and a colostomy was performed. After three months I had successful reversal surgery. However, I have had abdominal pain and pressure and difficult bowel movements since then with the situation getting progressively worse. About a year ago I had a colonoscopy and endoscopy. The surgeon could not complete the colonoscopy because part of my colon was pulled into a loop, apparently from adhesions. He suggested that I have more surgery to remove that section of the colon and "make it a straight run." I did not have the surgery at that time as my husband was in the last stages of cancer My discomfort has increased and a recent CT scan revealed a stricture at the anastamosis site. My PCP is urging that I have surgery to correct the problems but I'm concerned that more surgery will just lead to more adhesions and scar tissue. My question is: Are there other effective ways to deal with this problem?

Submitted: 4 Days
Category: Gastroenterologist, Medical

Expert:  Dr. Ratnakar Kini replied 4 Days.

Hi,
Thanks for posting your query at DoctorSpring.com. I am Dr. Kini and I am pleased to assist you. I am very sorry to hear about your bowel issues.

You have two issues to be addressed - the stricture at the anastamotic site which is causing difficult bowel movements and the adhesions which is causing is causing abdominal pain probably due to intermittent bowel obstruction.

There are no medications to cure these two conditions. Stricture can be dilated endoscopically or even a stent can be placed across the narrowed segment.

And yes, surgery can also be done to remove the narrowed segment and the normal segments anastomosed again.

But as far as adhesions are concerned it has to "lysed" which can be done laparascopically. But of course as you said it may recur.

I hope that answers your question. Please let me know if I can assist you further.

Regards,
Dr.R.K.

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