TMI warning, poop problem - evacuation

[Ihearya]

I have numerous GI and bowel issues longterm, such as IBS, reflux, gastritis, functional GI disorder, lazy bowel (slow transit?) I also had traumatic childbirth with extreme tearing and a 'mild' rectocele as a consequence.

Anyway. My bowel urges seem to have disappeared over the years. It's like my bowel has forgotten peristalsis. I do not go to the toilet until my rectum has filled up with hard little bits of stool and I have to manually extract it. There is no bowel urge. Then once empty I will make an effort to have fibre and I will get a few days of nausea and frequent sticky and putty-like stool filling up the rectum. It fills up the rectocele and will not come out of its own accord. Splinting doesn't even help when it's this consistency. Then I will go back to rock hard stools. Occasionally I will get terrible intestinal contraction-like cramps (similar to diarrhoea cramps) but nothing comes out, just the sticky consistency filling up the rectum. My bum has constant external haemorrhoids the whole way around which are purple / blue in colour and small, but are definitely there all the time due to the pressure and the digital extraction I guess. Dietitians / doctors just say more fibre / stool softener / Laxido etc, which all make the soft and sticky problem worse. Can anyone relate?

@VIW

You sound like you have chronic constipation - a constantly full stretched bowel damages the nerve signals to your brain telling you that you need to go - hence no urge. Do a full disimpaction with gradually increasing dose of laxido, increasing sachets by 2 each day until you get to 12 sachets. Keep doing this until you are pooing water/gravy - you may need a stimulant to blow out the remains - then taper down the dose, and find a maintenance dose that enables you to do one soft, formed poo a day. You may need to do this for several months to allow your bowel muscles to shrink back to normal and for the urge sensation to naturally return. Also, drink plenty of water, and go to toilet for a sit after meals, with your knees above your hips.

Thanks for the advice but it's the rectocele that's the main problem. It bulges into my vagina no matter the consistency. I get 'flare ups' where I have many bowel movements per day which are soft/ putty-like and sometimes this flare lasts a week. I get everything out - using a scooping motion but the rectocele soon fills back up. I only need one sachet of Fybogel to rake me from hard stool to this sticky soft consistency.

I also cannot carry out a bowel programme that causes such urgency as I work with vulnerable teens and cannot leave them at a moment's notice.

The sticky stuff sounds like overflow - softer poo from higher up leaking round the hard rocks. Agree with the previous poster about management.

Ask for referral to women's clinic at your gp, u can have physio buy pelvic toners and try everything to improve pelvic floor but if doesn't work they Can repair it without mesh now so don't suffer if it is badly effecting you. Also you need to check diet (sure you know this) bulk up with fibre but also drink more water than you think you need along with stuff that speeds up the poo (bananas maybe) avoid bloaty foods like pasta bread cake biscuits try lighter less stodgy foods not too much red meat more chicken fish vegetables along with maybe porridge or something little n often try and move more and do pelvic floor exercises to strengthen muscles.

I saw a consultant with a view to similar. My bowel was almost exactly as you have described. thought I'd need surgery. His advice was the opposite of what is commonly thought.

He said to cut down on fibre! He said the bowel has become lazy and flaccid and needs to grip the poo to push it out.

In tandem with this I had to use a electronic vaginal exerciser every day for life. I also need to use a bulb enema (water) each day to really clean out the bowel to prevent further distension.

Things really improved. I'm not back to before pregnancy and I never will be because of the nerve damage during labour. But I'm functional. It works. I'm less conscious of my bottom not working perfectly and needing help.

The solution was not one I'd ever considered but my previously very sore bottom and weird bowel habits made me seek nhs advice.

The best bit is I have prevented the need for surgery.

It's not overflow constipation. I really clear out sometimes. It's just the consistency I get when I eat a lot of fibre. I've had a abdo CT, ultrasounds, sigmoidoscopy, bowel transit scan, abdo xrays, gastric emptying scan. All they diagnosed me with is Functional GI Disorder. Sometimes It's like my whole intestines fill up with this soft stool and it sits there not going anywhere. I also had women's physio for a few months - she said my pelvic floor was OK. Gave me exercises to do. I am thinking I need a vaginal exerciser though and the bulb enema thing maybe, as the doctors just ignore how it affects my quality of life. I haven't had an unaided bm in over 7 years.

If you have a rectocele your pelvic floor is not OK, if physio didn't work and stool is getting stuck there refusing to empty you need to get it fixed believe me I am on waiting list to have it fixed and keep putting it off but know its for the best as nothing else is going to work. You need to balance diet with fibre to stop constipation food thst bulks so not so soft and lots of fluid so not too dry, if stool is sitting in the pouch for ages it is going to be dry and small and uncomfortable lighter less stodgy smaller meals moving more and pelvic toners all help but if none of it works and you have tried all other means, pessaries etc go on wl for corrective surgery it's the only thing that is going to solve it.

I know it's sensible to use more fibre rather than having hard stool but, forgive me for tmi... it's easier to pop a hard stool out than to have to go scooping sticky relentless stool out with a gloved finger everyday. I've also been under a dietitian for a couple of years and tried so many different diets... low fodmap, histamine etc and nothing makes a difference to the consistency. Maybe it is time to go back to physio.

Not the physio! You need to see the colorectal nurse. She's specialist in this field.

The pelvic electronic toner is programmed specifically for the rectal damage, by the colorectal nurse.

See your GP and get a referral, it's quite quick.

Thank you. I will do this, it's getting unmanageable.

@toooldtocarewhoknows sorry just jumping on this. I have been told to increase my fibre but i feel its not really bulking up my stool. I feel soft poo is harder to push out probably because the bowels become lazier in doing so. Am i right in thinking that the stool needs to be firmer etc so that the bowels can grip it and help push it out? I hope im making some sense. Thank you