Sitz Marker Advice

Hi all, I have been battling abdominal distension/bloating/constipation for so long. I am 24 years old and have tried everything imaginable. Medications, diets, laxatives etc. And everything fails. I will be going to a new gastro doctor on Tuesday and I'm planning on asking for some diagnostic tests to see if my colon has stopped working altogether. I know the sitz marker test is one of the main tests they use to diagnose colonic inertia, and although I shiver at the thought of not being able to take any laxatives for the duration of the test, I am prepared to do so if it will help figure out my problem.

I was wondering if anyone has experienced this test and could provide a little advice on what they did during the test. What did you eat, how much, and how often did you eat? I can only eat once a day right now because my distension and discomfort is so awful, and I feel I would want to eat even less if I know I will not be able to take my usual measures to go to the bathroom for up to a week. Will this affect the transit time of the markers? Are there certain foods that I should avoid during the test? I am just worried that after all of this suffering, with my luck, I'll eat something bad or I'll eat too little and the markers will move through my system faster than usual. I just want to make sure the test is as accurate as possible.

Also, do they do a blood draw before or during or after the test? I would be going to the appointments by myself but would prefer to have someone with me if they will be doing a lot of bloodwork.

Hi Alibee, I've had the test done and there's really nothing to it.  I took the capsule with the markers in it on a saturday and had my first abdominal x-ray on monday. The next x-ray was on wednesday, and the final one on friday. The only thing I couldn't do was take any laxatives. I ate as little as possible that week to prevent getting sick. If I don't go for a while I run the risk of severe pain, sweating, nausea, vomiting, and faintness. No fun at all :-( 

To make a long story short, I failed the test. After the sitz-mark study I had pelvic floor and defecography tests done and they were ok. I'm a soon to be 41 year old male and have had this condition for 18 years. Enough is enough!!!! I am due to have a sub-total cloectomy on the 20th of this month. The surgeon said he will remove all of my colon except the sigmoid portion and rectum, and reconnect.  I'm pretty nervous with surgery coming up so quikly. This is a big operation, and I hope it's well worth it. The doc said I should be in the hospital 5 to 7 days. He said as soon as my bowels wake up (meaning I can eat and move my bowels) I can go home. He said for the first few months I will have the opposite problem, going to the bathroom 5 to 6 times (sometimes more) a day, but that over time it should slow down to about 3-4 times a day. He said it takes the small bowel time to readjust itself to absorb more water. That is the main function of the large bowel, to absorb water from the food. He said I will never go completely solid again, but that it should slow down to a reasonable level over about a year's time. He said that since my rectum and sigmoid colon will be intact, I should do fine "holding it" until I reach a bathroom. He said I will feel more urgency the first couple of months until things readjust.

I wish you well with your test and hope you can find a resolution to your problem. Believe me, I know how miserable it is when your bowels don't function properly.

God bless you.

                                      Tom

 

Post Edited (G20man) : 10/16/2010 2:23:24 PM (GMT-6)

I'm glad I can be of some help to you, Alibee. My real bowel troubles started when I was 22, although I can remember having some trouble going all my life. But I was about 22 when I started to use laxatives on a regular basis. When I was about 25 I started to have episodes of severe pain, nausea, vomiting, sweating, faintness, etc. I never knew when it would happen, but it was mostly when I didn't move my bowels for like a week or more. If I wasn't vigilant to keep my bowels moving I'd get one of those attacks. I'd have to plan my outings based on if moved my bowels a day or two before. What a way to live!!!! I can remember one time while walking my dog I started to get the pains. I hurried up home and just made it. I broke out in a sweat and heat was coming off my body unreal as I was unlocking the door to my house. I went to the bathroom, and after trying to go, the nausea and faintness started. After I passed the harder stool, the rest came out loose. I would sometimes be on the toilet and vomiting in the trash can at the same time. Sorry to be so graphic.

I went to the same GI doctor for a number of years. All he would do is perform colonoscopies and send me home telling me to take more fiber. Fiber and Miralax never worked for me. The more I took, the more I would blow up.

 

I finally changed doctors. I told my new GI doc everything. He sent me for the Sitz-Mark test and informed me that my bowel wasn't working. He said that after a week all markers were still in my bowels. He said the episodes of nausea, vomiting, sweating, and faintness were due to vaso-vagal stimulation brought on by the pain of stool blockage. It's the same nerve that can make people pass out from from a fright, such as the sight of blood.

 

After the Sitz-Mark test my doctor told me I could try more aggresive use of various laxatives, or if I felt bad enough, a sub-total colectomy. I opted for surgery, so he sent me to a GI surgeon. The surgeon sent me for anal manometry and defecograhpy studies to make sure everything there was working ok. He said if the nerves that control evacuating and retention are screwed up, I may still have problems going after the surgery. But, thankfully, everything was ok. I knew it was ok before the test, because when I use enough laxatives I would go. My problem is that the waste never makes it to that point to go.  

 

When you go to your new doctor, Alibee, make sure to tell him/her everything. Mention all of the tests that I've mentioned here. Tell them how miserable your life is, and that you want a resolution to the problem. Maybe you have some of the pelvic floor problems I've mentioned. Or maybe, like me, the waste never makes it to that point to go to the bathroom. Let them know that. Being you're a young lady of 24, I hate to think of you suffering for years on end like I have. Even if it means surgery, I've read of younger people having a colectomies (usually for ulcerative colitis) and they do just fine. Just make sure they check everything before you commit to surgery. If they perform all tests and come to the conclusion that surgery would help you, it would be better for you to do it while you're young, not only to avoid years of suffering, but because surgery becomes more risky the older you get. I'm not quite an old goat yet, so I think I'll do ok too .

 

God bless you. I pray that everything works out for you.

 

                                      Tom

Post Edited (G20man) : 10/17/2010 10:28:12 PM (GMT-6)

I did the sitz marker test this summer.  I swallowed the capsule on a Wednesday, was told not to use ANY type of laxatives, and then went in the next Monday for an x-ray.  I asked to look at the x-ray and the markers were scattered all through the large instestine.  I knew none had come out because I had not had a BM!!  It was an easy test compared to all the others I had had all summer to diagnose colonic inertia.

Good luck!!!

Anne

Hi all,
Well I had my appointment today and I have mixed feelings. I typed up my entire history and also the ways in which this has ruined my quality of life and gave them to the nurse when she brought be into the room and took my blood pressure and stuff. Then the doctor came in and said she read through my history and my information and said said "I basically don't think there is anything I can do to help you" She said based on what I told her and all of the things I've already tried she wants to refer me to UNC's gastro people because she thinks it could be one of two things: hirschsprung's disease or the fact that my colon just stopped working. I don't think it's hirschprung's because although I had constipation issues when I was little, they were intermittent and if there is something there that needs to come out, I can push it out. I think she was a little confused. My issue is that nothing ever seems to get to that point, it just stays stuck way up in my intestines and doesn't move. She said if I go there they'll run tests and if I feel like they aren't helping me or listening/paying attention (which can be a risk when you go to such a large hospital like that) then I can come back to her and we can "start over" and try a few other things and if nothing ends up working again, she can refer me to a surgeon herself. She also sent me to have an xray of my abdomen today and the office just called me back and said there wasn't any blockage or anything - just that my colon is filled with stool (duh, I haven't gone in days).

I am uneasy about going somewhere like UNC because I feel like to them I will just be a number. She said she is referring me today but that it could take 2 or 3 weeks for them to call me back, and that I should answer right away because if they call and I'm not there, they might not call back. She also said I need to get a colonoscopy, which I knew but I've been putting off because I'm afraid the prep won't work. I am going to school several hours from home, and I don't have anyone who can give me a ride to and from the appointment or look after me for a little bit when it's over. I also live in a dorm and it's bad enough being in the bathroom as often as I am, just trying to go, I can't imagine how embarrassing it would be to do the prep in my dorm room as well. I asked if I could do it somewhere closer to home so I could just go home for the procedure but she said she would rather I try to keep everything in the same location because it is easier (I don't really understand that part)

She said they would probably do a manometry (sp?) test on me, which I think sees if your rectum is working properly...but again, I really don't think that is the problem. If it's there, it will come out. If nothing ever reaches that point - it won't, no matter how well my rectum works. I couldn't gauge how serious she was about surgery but she did say she's seen a lot of success with it and I should rule everything else out before surgery. She also wrote a prescription for a very large amount of miralax and told me to try taking 2 caps of it twice a day for the next 2 weeks until my next appointment with her. I HATE MIRALAX, I have tried it so many times and it makes me feel terrible. She said she isn't expecting miracles with it but wants me to try it anyway. I hate the fact that it hasn't actually been studied for long-term use and that all it is is polyethlyene glycole, which is powdered plastic.

Anyway, after the appointment I was so uncomfortable that I went out and bought a fleet saline enema and used it. Unfortunately all that came out was what looked/felt like a handful of small rocks and that's it. I guess I will just have to wait until my next appointment and see what she says?
Does anyone have any advice or experience with larger hospitals or clinics, like UNC? I am worried I will go there and they will just tell me I'm constipated and to just deal with it.
Also, any advice with the miralax? I don't want to ignore her advice but at the same time I've gone the miralax route before and the bloating never went away in all the time I used it and I still needed dulcolax to get everything out.

I wish I were closer to home because this is all very hard to deal with when I am all by myself. Being lonely is bad enough but being lonely and feeling awful is just the pits. Not to mention I have a class from 3:30-6:30pm, and a lecture I have to go to from 7-9, I don't know how I am going to get through that. I just want to take dulcolax and go to bed, I don't care how sick it makes me I just need to get this stuff out of me.

i would insist to the doctor that you go and have it done at home where you are comfortable. since you've had it a long time it should not be a big deal. medicine is a business and they want the money to go to their hospital and not elsewhere.

isn't there a hospital near home, can't you do it on the upcoming break when you have a week or a few days off? you are paying for your education, don't miss classes because some doctor thinks it's a good idea.

tell her you can bring the results back to her. just my thoughts on the matter. speak to your folks. and take good care of yourself.

Alibee

The UNC is one of the best centers in the world.

Good luck and let us know how it all turns out.

Do you know the name of your doctor at the UNC?

 

Alibee

I will find out for you. They train GI doctors to listen to their patients and help them out as well as being state of the art.

I know quite a few people there and they are all excellent professionals.

Did you read this by any chance, just something to think about and a good read.

https://www.healingwell.com/library/health/article.asp?author=salvucci&id=5

I'll get back to you.

Hi there, I'm new and have a question about Amitiza. My husband's colon has quit working, just recently diagnosed after monthes of tests, Drs. etc..

He took Amitiza and it worked beautifully for 5 days then quit working. Does anyone know why it wouldn't work or has anyone had this experience. This condition has not been easy for my husband and information is key. 

Sheresh, I also tried Amitiza and it did not work for me. I have colonic inertia and will be having surgery in a week to remove my colon, so my constipation is a little extreme. But I know for many people Amitiza either didn't work, or didn't work well. Maybe your husband and his doctor need to change up the dosage a little bit to see if a different dosage would work for your husband?

Ashlyns, I too have been in your position, taking medications that weren't even for any condition I had...just to MAYBE get the side effect of having a BM. Didn't work for me. Keep seeing doctors until someone takes you seriously, all it takes is to fine that ONE doctor who will finally listen to you and offer some solutions. Good luck with your sitzmarker test...I know it is hard, but you can do anything for 5 days! That's what I kept telling myself. I totally understand about it effecting your mood/sleep/job/etc. I usually post about this in the ostomies board, but I'll check back on this one every so often, so be sure to update on how your test goes!

Good luck :)