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Thread: SCI & Colostomy

  1. #1
    Junior Member
    Join Date
    Feb 2018
    Location
    Tillsonburg, Ontario, Canada
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    SCI & Colostomy

    SCI Aug 2011, Colostomy, Sept 6/2017. When I got out of the hospital, I was very active. Physio 2x/wk, Riding indoor recumbent trainer for 20 min/day, walking short distances with walking sticks & riding a recumbent trike outside (max dist 10k). Not much muscle tone, no pain above a 2,3 anywhere. Left knee was biggest problem as they tore ligaments when put me on stretcher. Knee replacement May 2, 2012. Starting in 2014 my rectum started hurting. Had two hemorrhoids remove, one cut and the other tied. Pan continued to get worse until I could no longer ride. Had 6.7 pain after BM. Wasn't voiding all the stool and it remained in Sigmoid caused pain when sitting. Pain stopped cycling and it caused so much muscle tone it's difficult to walk, but I do, about 20 ft, 2 to 4x/day. Talked to surgeon and after many discussions with surgeon & physiatrist, got the colostomy. Thinking was if stool didn't get into Sigmoid pain would decrease. It's not the case. I have more pain.6-8 all the time now. Get pain, 5,6 from muscle tone in abdomen, legs, arms & back. It's hard moving around, dong exercises and riding in power chair and especially painful riding in the chair in the van. I'm so stiff, just bounce around in the chair. Pain levels go up a number. Thought colostomy would solve the problem but they didn't say how much mucus would be produced. a Bisacotyl suppository is required before a BM. Now it's required every 2 or 3 days for the mucus. I get more pain now in my sigmoid and rectum than I ever did before the colostomy. Don't know if t s reversible as t is near the top of the descending colon. With the pan n my rectum/sigmoid it causes the abdomen muslsee to really tighten up and the ileocecal valve to tighten. This caused bloating. I've had a bloated abdomen for about 3 months+. My family doc has no answers and the hospital is no better. I call the surgeon and she tells me to go to emerg. Last time there, they said I had an obstruction, took xrays and said there wasn't one. They don't understand a neurogenic bowel and the complications with an SCI. Wondering if anyone else as with a SCI and a colostomy is having problems and what they have done about them. Sorry about the length. Here's a good resource for Neurogenic bowels in SCI patients: Neurogenic Bowel Dysfunction After Spinal Cord Injury: Clinical Evaluation and Rehabilitative Management http://www.archives-pmr.org/article/...97)90416-0/pdf

  2. #2
    Welcome to CareCure. It would be helpful to add your level of SCI to your profile. Also, paragraphs are your friend when writing long posts!

    It sounds like you have neuropathic pain that involves your perineum and peri-anal area. Are you getting treatment for this type of pain with meds such as gababentin, pregabalin, or carbamazepine, or TENS?

    Most colostomies can be reversed if they were done with a surgical method that permits this. I assume you did not have any removal of your lower colon?

    When you talk about mucous, are you talking about it coming out of your colostomy, or through your anus? It is very rare to have huge amounts of mucous coming from the rectum after a colostomy. Most often it is sufficient to do a small Fleets enema once or twice monthly through the anus to remove mucous like this. Have you always had this mucous problem? Have you had a sigmoidoscopy or colonoscopy to see if you have a mucolith, which is like a mucous stone, which can stimulate a lot of mucous formation in the residual bowel, and may even trigger some of your neuropathic pain.

    Have you sought advice from a gastroenterologist as well as your GI surgeon on this?

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #3
    You may have a fairly rare condition called diversion colitis:

    https://www.sciencedirect.com/scienc...12097113701389

    http://cursoenarm.net/UPTODATE/conte...source=HISTORY

    A good gastroenterologist should be able to diagnose this and discuss options for treatment with you.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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