Ostomy surgery is lifesaving surgery, the majority of people with an ostomy have had their bowel/bladder ravaged by IBD, cancer, or accidents…

…there is another illness that goes unseen, that can also result in a person becoming an ostomate.

I want to use this blog to give a brief description of the “invisible illness” and how it links in with MY JOURNEY…

I ended up with an ileostomy because I had Slow Colon Transit (SCT).

WHAT IS THAT???

Unlike IBD which is an inflammatory disease of the intestines, STC is a functional abnormality due to disordered nerves and muscles of the colon. Biopsy of the bowel of sufferers of STC has revealed the muscle layer of the bowel wall has abnormalities of the neurotransmitters…

“Abnormalities of the WHAT????

Abnormalities of the neurotransmitters!!

I’ll try to simplify the definition of neurotransmitters the best I can….

Here goes…

….a neurotransmitter is the brain chemical/peptide that communicate information between the brain and the body. They relay signals between the nerve cells. The brain uses the neurotransmitter to tell the colon to propel the food along its length.

I hope that’s easy enough to understand!!!!

A deficiency of  a peptide called “substance P’ has been identified as being involved in activation of the bowel contraction. As a result, movement of pooh along the colon is markedly delayed; transit studies reveal that pooh is usually stored in the right or transverse colon. This was VERY true of me. When results of my Nuclear Transit Study came through, the surgeon explained to me that I had retained over 1/3 of the tracer in my right (ascending) colon, as well none of the tracer was noted in my rectum! This test is performed over five days, so it was this test that I had failed miserably. Contractions don’t adequately push the pooh along the colon to the rectosigmoid section of the bowel. The rectosigmoid is responsible for the propulsion of pooh out of the body. However, the inadequate propulsion leads to a build up of pooh which of course leads to pain and  discomfort equals constipation!

In addition to my bowel having a problem propelling pooh along, I also had a rectal emptying impairment… constipation is a symptom and is reflective  of both of these problems! There are lots of definitions of constipation floating around, the most easiest one to understand is “difficulty in passing stools or incomplete or infrequent passage of hard stools.” To me this definition says it all and I think a lot of people will be able to relate to it! It’s a difficult thing to try and “normalise ” the toileting behaviours of humans! After all, what is normal and healthy for one person is not necessarily so for another. When I first got married, I thought my husband had a problem…he would dash to the loo every morning not long after he had eaten his breakfast!! Me? I would go every however many days my body decided; that could be 3 days, 5 days or even 10 days!! I seriously thought that he had the problem…I even told him that he should see a doctor!

There is a small number of people with slow colon transit that may have a “mega-colon”- a colon that is twice as long and wide as the normal colon. I had been diagnosed with excess bowel following my colonoscopies. Rectal emptying impairment or defecation disorders usually involves some kind of poor muscle function of the recto-sigmoid, rectum or pelvic floor…age, childbirth or anorectal surgery are the most common causes. In my case, childbirth was another  contributing factor to my emptying impairment. I had given birth naturally three times. I endured long and difficult labours. When the surgeon asked me about childbirth, and I explained to him the problems endured…he shook his head in disbelief!! Not only did I have SCT, I also had damage to my pelvic floor!!! It seemed I was ticking ALL the boxes with huge red ticks…

There is a lot of debate surrounding treatment of constipation, and it is dependent upon the cause. If constipation is due to poor diet, lack of fibre or exercise then a change in these areas should help with constipation. If it is because of laxative abuse, stopping laxatives, will help the bowel return to normal. However, when constipation is because of SCT, and the person has been properly evaluated by physiologic testing and proven to have SCT, then surgery is usually beneficial for these people. The procedure of choice is a subtotal colectomy with ileo-rectal anastomosis (IRA). In other words, removal of the large bowel, and rejoining of the ileum to the rectum, unfortunately,  diarrhoea, recurrent or persistent constipation,  and incontinence are complications that may be seen after this type of surgery. This was my downfall following my (IRA)!!

Following my IRA and the complications that followed, it was then decided to form a permanent ileostomy…

…becoming an ostomate is lifesaving, life changing surgery, I was becoming sicker and sicker, suffering bowel obstructions;

SCT was the “invisible illness” that resulted in me becoming an ostomate…

[Source: Bowel Continence Nursing, http://www.chronicillness.org.au]

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