Motility Dysfunction From Chronic Colitis

Has anyone experienced colonic motility issues from long-standing chronic colitis? This might take the form of constipation, impacted stool on imaging, or general chronic feeling of fullness and abdominal distention (even without active disease or inflammation).

I've had chronic proctosigmoiditis for many years, but am now dealing with chronic abdominal distention from impacted stool throughout the colon. My scans and biopsies have shown no active disease, but have revealed the stool impaction. I'm beginning to wonder if my sigmoid and rectum have lost their propulsive abilities and the rest of the colon has slowed as a result.

It'd be great to hear from someone going through something similar or for anyone who may have insights into motility disorders from long-standing chronic colitis. There is some evidence that chronic inflammation can damage the smooth muscle in the colon that aids motility, even in the absence of active disease. I'd be curious to know if anyone was helped by anti-inflammatory (or any other) treatment over time (outside of laxatives, etc. which don't really treat the underlying cause). Diet (fiber), exercise, water, have had no effect.

Any thoughts or suggestions would be appreciated. Thanks! :)

The great thing about fibre (soluble and insoluble) is it's purpose is to bulk things up and keep them moving which is why it generally aids with D and/or C. Drinking plenty of water daily is also beneficial in keeping things moving and flushing out toxins (pun intended). Regular daily exercise is also known to help the bowels function properly as well.

What does your GI have to say about your motility dysfunction?

Thanks, imagardener. Yes, I agree most of us deal with some type of motility issue. Unfortunately, this appears to be more of a colon muscle issue rather than related to active inflammation (resulting in diarrhea, etc.). I don't have any other disease symptoms otherwise, but do have chronic disease.

My biopsies have shown inactive disease. So, I'm not taking any medications (but was). I really stopped the drugs more to see if they were responsible for the slow down. The drugs had no effect either way. In fact, I think I may have been overtreating my rectum and sigmoid with enemas without much active disease and that may have caused the communication problem with the rest of the colon. But, it's been a while since then with little change. My diet is quite healthy and has kept my disease quiet for many years. I also do just about everything else to keep the bowel moving properly.

I genuinely believe this is a muscle or neuro damage issue to the intestine (or lack of cooperation with rectal/sigmoid communication to the rest of the bowel, perhaps med-related). I'd love to know if someone's ever been to a motility expert that provided a useful treatment, aside from offering laxatives, etc. Also, it'd be great to know if this type of problem ever gets better on its own over time (or with the help of regular anti-inflammatory medication). I think this is an issue that may affect many of us UCers (at least down the line) and it'd be nice to gain some collective knowledge on possible help.

Pb4- I'm with you on fiber and have always had a lot of it naturally in my diet. In fact, I pretty much have never been constipated my whole life. I'm an active athlete who eats an organic whole foods diet (with lots of water in between). I've worked hard for my health for many years and it did help with active UC. In many ways, I'm more depressed by what's going on now, in that no GI or anyone else has any viable solutions or treatments for those with this type of condition. A cruel disease indeed! :)

Or does chronic disease cause irreversible fibrosis to the muscle layer which can never be rescued?

I for one will never believe that because my colon has gotten so much better after being very very close to either Remicade, Humira or surgery. I'm a believer in our bodies ability to heal itself.

I think the C is caused by inflammation which causes the motility issues. Just because the inflammation can't be measured or seen doesn't mean it's not there. My last c-scope didn't show as much inflammation as my symptoms would imply (i.e. BAD symptoms). And then there are IBS people who have bad symptoms but no visible cause in their colon.

I'm going to continue with my anti-inflammatory diet (like you I am athletic and was a healthy vegetarian pre-UC) because it's given me positive results so far and because there isn't anything else to do.

Please consider adding teaspoon(s) of good oils to your diet. Can't hurt and may help the C. In the old days it was castor oil

I do know someone who had both colonic inertia and UC. I don't think in her case one caused the other. She ended up having surgery, jpouch, and got rid of both conditions.

Sue

Silversky, I have come to the same point as you. I don't think I have any inflammation (or at least, nothing significant), but I do have significant motility issues. I started taking a small dose of sennacot a few weeks ago and it has really helped to keep me regular. I didn't want to resort to a laxative either, but I was having chronic upper right quadrant pain that I think was due to just a colon full of stool. The main urge to defecate that I have been getting for years has been at that upper right corner of the colon, which is bizarre. Now that I'm taking senna I no longer have much of the URQ pain and I'm moving my bowels almost every day.

My GI recommended miralax, but a physiatrist I know recommended senna. It's what she uses for her spinal cord patients, so I figured that fit with my sense that the motility issue is a nerve problem. If senna can work for someone who has little to no sensation in their gut, I was going to find it good, too.