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Dr. Bob
Dr. Bob, Medical Doctor
Category: Medical
Satisfied Customers: 5401
Experience:  20 Years in Internal Medicine, Neurology and Sports Medicine
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I had a major fecal impaction of which I was able to

Customer Question

i had a major fecal impaction of which I was able to manually remove on my own with a rubber glove, lubrication and massage. I ended up getting the "plug out" that was literally the size of a soda can...... I now have to follow up with my gastro. What can i expect to happen at this appointment?
JA: What are all the symptoms you're experiencing (e.g. loss of appetite, fever, rash)?
Customer: i was extremely nauseated, loss of appetite and very uncomfortable.
JA: Anything else in your medical history you think the doctor should know?
Customer: I had surgery on the 1st laproscopically, tubal ligation of left tube, removal of my right overy and tube due to paratubal cysts.
Submitted: 4 months ago.
Category: Medical
Expert:  Dr. Bob replied 4 months ago.

Hi there. Have you had any normal bowel movements since your surgery?

Customer: replied 4 months ago.
No, that was the first as the tylenol 3 caused me severe constipation. I was able to get all of the gas out but it got so bad by sunday that I could barely pass gas. W, T & F I took a Ducolax and all along was taking stool softeners. And I drank a ton of water.
Expert:  Dr. Bob replied 4 months ago.

It is not uncommon for the bowels to "go to sleep" in a sense after major surgery such as you went through. We call this "ileus."It can takes days to weeks for it to wake up and begin to peristalse normally, especially when one is taking narcotic pain killers. Hopefully, this latest movement, as painful as it was, will begin to stimulate more regular contractions of your bowel wall and allow the colon to return to a more normal state. Your GI doctor will ask you about all of this (e.g. bowel history, medications, GI symptoms) and examine your abdomen and rectal area (to make sure there are no obstructions or complications from the surgery). He or she may also order a CT scan or barium enema to look at what is going on inside. They will likely adjust your medications as well and provide more effective agents for promoting evacuation.

Customer: replied 4 months ago.
Since I got the "plug" out (which was a MAJOR relief), what will the rectal exam tell them? Or even a barium enema? I've been constipated before but this was by far the worst I have ever gotten and I am extremely regular.
Expert:  Dr. Bob replied 4 months ago.

First, they will want to rule out something near the opening that may be slowing or resisting the passage of stool, such as a large hemorrhoid or scar tissue or inflammatory mass. They will also want to check the tone in the anal sphincter to make sure it is normal. The CT will show details of the internal organs around the colon and any major issues involving the colon wall or any signs of obstruction from scar tissue, hematoma, etc. The barium enema (much like colonoscopy) show details of what is going on inside the colon (which does not always show up well on CT). There is also a very good chance they will not feel the need to get imaging, especially if all else looks good and they feel the bowels are starting to move more normally.

Expert:  Dr. Bob replied 4 months ago.

Does this make sense?

Expert:  Dr. Bob replied 4 months ago.

Hi Lisa. Does this help going forward toward your follow up appointment?