Post-Surgery Bowel Changes After Fibroid Removal

Q: Post-Surgery Bowel Changes After Fibroid Removal

Hello： In response to your question, thin stools accompanied by a feeling of incomplete evacuation are generally symptoms of rectal obstruction. <br>Intestinal obstruction can be categorized into internal and external causes. <br>External obstruction may occur due to pelvic masse

The stool is thin, not abundant, and not well-formed?

Dr.
Ke, you have had uterine fibroids for many years, and due to their location lower in the uterus, they were compressing the intestines, causing your abdomen to appear similar to that of a pregnant woman.
You often experienced thin stools and a feeling of incomplete evacuation.
After undergoing surgery to remove the fibroids in early February of this year, your bowel movements became more regular and abundant, and you felt that you were emptying completely.
However, about a month and a half later, you began to experience thin stools again, with less volume and a feeling of incomplete evacuation, and your abdomen appeared similar to its pre-surgery state.
Could you please advise on what these symptoms might indicate? Is there a connection to the fibroid removal? What examinations should be conducted? Thank you.

A-Hua, 40~49 year old female. Ask Date: 2007/08/14

Dr. Ke Fangxu reply Surgery

Hello: In response to your question, thin stools accompanied by a feeling of incomplete evacuation are generally symptoms of rectal obstruction.
Intestinal obstruction can be categorized into internal and external causes.
External obstruction may occur due to pelvic masses exerting pressure on the rectum, such as uterine fibroids, which can lead to this condition.
Internal obstruction should be considered in the case of severe hemorrhoids or rectal tumors causing pressure.
If you are experiencing abdominal distension similar to pre-surgery, it is advisable to return to your original surgeon for a follow-up to determine if it is related to the surgery.
If it is not related to the previous surgery, it is recommended to consult a colorectal surgeon for a rectal examination to rule out the possibility of malignancy.

Reply Date: 2007/08/14

More Info

After undergoing surgery for fibroid removal, it is not uncommon for patients to experience changes in bowel habits. The symptoms you are describing—thin stools, a feeling of incomplete evacuation, and abdominal distension—can be concerning, especially since they resemble the issues you faced prior to the surgery.
Fibroids, particularly those located near the lower abdomen, can exert pressure on the intestines, leading to altered bowel habits. When these fibroids are removed, many patients report an initial improvement in their bowel function, as you experienced. However, the return of symptoms such as thin stools and a sensation of incomplete evacuation could be attributed to several factors.

1. Scar Tissue Formation: After any abdominal surgery, including fibroid removal, scar tissue (adhesions) can form. These adhesions can cause the intestines to become tethered or restricted, leading to changes in bowel movements. If the intestines are not moving freely, it can result in thinner stools and a feeling of incomplete evacuation.

2. Changes in Gut Motility: Surgery can also affect the motility of the intestines. The manipulation of the intestines during surgery may temporarily disrupt normal peristalsis (the wave-like muscle contractions that move food through the digestive tract). This disruption can lead to changes in stool consistency and frequency.

3. Dietary Factors: Post-surgery, dietary changes may also play a role. If your diet has changed since the surgery, it could affect your bowel movements. A diet low in fiber can lead to harder stools or a feeling of incomplete evacuation.

4. Underlying Conditions: It is also essential to consider whether there are any underlying gastrointestinal conditions that may have been exacerbated by the surgery or were previously masked by the presence of fibroids. Conditions such as irritable bowel syndrome (IBS) or other functional gastrointestinal disorders can lead to similar symptoms.

5. Psychological Factors: Stress and anxiety related to surgery and recovery can also impact bowel habits. The gut-brain connection is significant, and emotional stress can lead to changes in bowel function.

Given these possibilities, it is crucial to consult with your healthcare provider for a thorough evaluation. They may recommend several diagnostic tests, including:
- Abdominal Ultrasound or CT Scan: To check for any structural abnormalities, such as adhesions or other complications.

- Colonoscopy: If there is a concern about other underlying gastrointestinal issues, a colonoscopy may be warranted to visualize the colon and rectum.

- Barium Enema: This imaging test can help assess the shape and function of the colon.

In the meantime, consider maintaining a high-fiber diet, staying hydrated, and engaging in regular physical activity, as these can help promote healthy bowel function. If you experience any alarming symptoms, such as severe pain, significant changes in bowel habits, or blood in your stool, seek medical attention promptly.

In summary, while the return of your previous symptoms after fibroid removal can be frustrating, it is essential to approach this issue with a comprehensive evaluation to determine the underlying cause and appropriate management. Your healthcare provider will be your best resource in navigating these changes and ensuring your gastrointestinal health is addressed effectively.

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