Rectal Urgency After Colostomy: Causes and Solutions

Q: Rectal Urgency After Colostomy: Causes and Solutions

Hello： It is recommended to return for a follow-up with the surgeon to clearly understand the length of the preserved bowel at the anal end, as this can help determine the cause of the urgency and tenesmus. <br>If the length of the preserved bowel at the anal end is longer, it ma

Does having a stoma cause the urge to defecate from the anus?

Hello Doctor: My mother has had a colostomy for about a year.
Previously, she did not have any particular sensations in her rectum, but four days ago, she started feeling a constant urge to have a bowel movement, which feels very unusual and uncomfortable for her.
She has never experienced this before, but she is unable to pass anything because her stool is being expelled through the colostomy.
Eating or drinking seems to increase the urge to defecate, making it so uncomfortable that she is afraid to eat or drink anything.
Thank you, Doctor.

Miss Chen, 20~29 year old female. Ask Date: 2016/01/26

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: It is recommended to return for a follow-up with the surgeon to clearly understand the length of the preserved bowel at the anal end, as this can help determine the cause of the urgency and tenesmus.
If the length of the preserved bowel at the anal end is longer, it may lead to the accumulation of intestinal fluid over time, which, if not expelled in a timely manner, could result in discomfort.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2016/01/26

More Info

Understanding rectal urgency after a colostomy can be quite complex, as it involves various physiological and psychological factors. Your mother's experience of persistent rectal urgency after having a colostomy for about a year is indeed concerning, especially since she did not have such sensations previously. Let's explore the potential causes and solutions for this condition.

Causes of Rectal Urgency After Colostomy
1. Phantom Rectal Sensation: After a colostomy, some patients experience what is known as phantom rectal sensations. This phenomenon occurs when the nerves that were previously connected to the rectum are still sending signals to the brain, even though the rectum is no longer functioning in its traditional capacity. This can lead to a sensation of urgency despite the absence of stool in the rectum.

2. Residual Rectal Function: In some cases, patients may retain some degree of rectal function after a colostomy. This can lead to sensations of urgency as the rectum may still respond to stimuli, even if it is not actively involved in the elimination process.

3. Bowel Habits and Diet: Changes in diet or bowel habits can also contribute to feelings of urgency. If your mother has recently altered her diet or fluid intake, this could lead to increased bowel activity or sensations of fullness in the rectal area.

4. Psychological Factors: Anxiety and stress can exacerbate feelings of urgency. The psychological impact of living with a colostomy can lead to heightened awareness of bodily sensations, which may manifest as urgency.

5. Infection or Inflammation: Infections or inflammatory conditions in the remaining rectal tissue can also cause discomfort and urgency. It is essential to rule out any underlying medical issues that may be contributing to her symptoms.

Solutions and Recommendations
1. Consultation with a Specialist: It is crucial for your mother to consult with her healthcare provider or a gastroenterologist. They can perform a thorough evaluation, including a physical examination and possibly imaging studies, to rule out any complications or underlying conditions.

2. Dietary Adjustments: Keeping a food diary may help identify any dietary triggers that could be contributing to her symptoms. A dietitian can provide guidance on managing her diet to minimize discomfort and urgency.

3. Pelvic Floor Therapy: Engaging in pelvic floor therapy with a trained physiotherapist can help manage rectal sensations and improve overall bowel function. This type of therapy focuses on strengthening the pelvic floor muscles and can help alleviate some of the urgency.

4. Medication: Depending on the underlying cause, medications may be prescribed to help manage symptoms. Antispasmodics or medications that modify bowel activity could be beneficial.

5. Psychological Support: If anxiety or stress is a contributing factor, psychological support or counseling may be helpful. Cognitive-behavioral therapy (CBT) can assist in addressing the emotional aspects of living with a colostomy.

6. Regular Follow-ups: Regular follow-ups with her healthcare team are essential to monitor her condition and adjust treatment as necessary. Keeping an open line of communication with her doctors will ensure that any changes in her symptoms are addressed promptly.

In conclusion, while rectal urgency after a colostomy can be distressing, understanding the potential causes and exploring various solutions can help your mother manage her symptoms effectively. It is essential to work closely with her healthcare team to ensure she receives the appropriate care and support.

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