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Lead Pipe Colon

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Posted 5/18/2010 3:10 AM (GMT 0)
This was a new one to me! 

At my recent appt with my GI, I mentioned that even though I have no blood or urgency, my poo is still abnormally loose. She said having the disease for so long would have caused my colon to lose its musculature (sp?) that normal colons have to mold poo into harder lumps. Add that to the scar tissue, and I probably have "lead pipe colon" which means my colon is more like a chute than a poo packer. Sorry for the visuals, but that's the best way to describe it.

Nothing wrong with a lead pipe colon, it just doesn't get as much water out of the poo or pack it up.

 

Posted 5/18/2010 4:46 AM (GMT 0)
The colon absorbs the remaining water and produces the feces. The process takes about 12 hours. Liquid chyle enters the colon through the ileocecal sphincter, whose pursed lips protrude into the cecum to help prevent backflow of chyme under pressure. This valve relaxes only when peristalsis arrives from the ileum. Muscle movements in the colon consist of: 1) minor peristaltic waves, 2) haustral churning, and 3) mass peristalsis.
Haustral churning is produced by segmentation contractions which serve to mix the contents to enhance absorption. Mass peristalsis consists of large movements which occur at intervals, usually associated with meals. These movements are often initiated by the gastrocolic reflex (or gastroileal or duodenocolic reflexes) which stimulates the colon in response to food entering the stomach. This reflex is especially active after fasting and when the food is hot or cold. It causes mass peristalsis in about 15 minutes which continues for about 30 minutes. These movements cause the chyme to move in several large steps through the colon, stopping at each step to be further concentrated and converted into feces. The chyme turns from a liquid into a slush and then into firm feces. In the process some vitamins such as vitamin K and certain B vitamins are produced and absorbed, along with water and electrolytes.
The defecation reflex:
As a result of the mass movements described above, pressure is exerted on the rectum and on the internal anal sphincter, which is smooth muscle, resulting in its involuntary relaxation. Afferent impulses are sent to the brain indicating the need to defecate. The external sphincter is voluntary muscle and is controlled by the voluntary nervous system. This sphincter is relaxed along with contraction of the rectal and abdominal muscles in the defecation reflex.

http://webanatomy.net/anatomy/digestion_notes.htm
q
Posted 5/18/2010 3:30 PM (GMT 0)
THis made me giggle! I hope that doesn't offend you, Peety! I mean, it's not funny that your poor colon is like that, but the description just kills me.
Posted 5/18/2010 5:45 PM (GMT 0)
I used to have an iron stomach to go with my lead pipe colon, but unfortunately I think my iron stomach started to rust....

I've asked my GI about this because even though when I was in remission, I was still having issues. He asked me if it interferring with my life - I said not really (mornings were a bit rough and that was it). He then said that this is the nature of the beast and that I might have some IBS going on too. He never described it like your doc did, but it seems to be spot on since I have this issue as well. I was thinking that my poor colon was just plain wore out after all these years!

Quincy - I've tried to read what you posted but it's like trying to read another language. Do you have a simplified version?! lol
Posted 5/18/2010 6:00 PM (GMT 0)
Sherry....part of it is what we describe to others after eating and they have the urge....mass peristalsis and movement.

Regarding the haustral movement, think of a caterpillar moving forward and being kneeded at the same time. The colon's () sections are called haustral. They're like different areas or segments or "rooms" which the "stuff" in the colon is moved into and stays there for a while for the water to be absorbed. Without the different sections for it to be moved into and stay a while, it's just forced down a longer area without a rest, therefore the water isn't absorbed,

Now.....that's after long-standing inflammation.

Inflammation will cause the same thing, forcing it out quickly so that it cannot stand around, as a protection factor.

With IBS, which is mechanical, it's like a spoiled brat not wanting to deal with anything....hurries things out of its area quickly. The colon eventually becomes lazy in movement (kneeding and holding) and it like a spasming fool to work overtime continually...hence the suggestion of fibre and eating enough food so that it forces the colon to work harder at the rhythm rather than the prospect of hurrying things out quickly and not wanting to deal with the process. Kind of like the game hot potato..lol. Antispasmodics help this as well....I believe this helps maintain the haustral sections....

At least that's how I see it.

q
Posted 5/19/2010 12:33 AM (GMT 0)

fruitgirl said...
THis made me giggle! I hope that doesn't offend you, Peety! I mean, it's not funny that your poor colon is like that, but the description just kills me.

No offense taken! It's good to learn the science, but "poo packer" was the best description I could think of.

My GI is great, we're the same age and always laugh a lot. This time we compared feet, fretted over bunions and getting older...
Posted 5/19/2010 1:56 AM (GMT 0)
"Lead pipe" colon was a concept much discussed in gastro articles available back in 1980, when I was diagnosed with UC. The doctors would write descriptions of the colon stiffening due to thinning of its mucosal layer + scarring over time from repeat or prolonged inflammation. They generally added that whatever anti-inflammatory meds the IBD patient could take at that time would hopefully mitigate permanent damage to the colon so that it would not stiffen! So-- gastros have long been aware of how the colon can change structurally due to UC, but they don't always tell us flat-out what has happened to ours in particular. I just happened to notice that my last c-scope report listed my ileo-cecal valve at 83 cm., which seemed kind of short-- so I asked my gastro about the measurement. My gastro replied that the colon not only narrows over time as a result of longterm UC, but it also shrinks lengthwise. I then remembered how long my 1st gastro had said my colon was the year after diagnosis, did the math, and figured out that it shrank over a foot in length over ca. 25 yrs! Anyway, those process descriptions Quincy just found are very helpful. / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)
Posted 5/19/2010 2:12 AM (GMT 0)
I laughed too lol
Posted 5/19/2010 12:17 PM (GMT 0)
If I'm not mistaken, it's also covered in The Angry Gut, which is an excellent comprehensive text on managing (and living with) UC and Crohn's.
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