Gastroenterologist Questions Constipation

No peristalsis, floppy colon- what can help?

All my life, I moved my bowels ,2-3 times a day. When I was 27 I had my first bout of constipation and have had issues ever since. I am super healthy, work out everyday, drink tons of water and eat a ton of fiber in the form of fruits and vegetables. Every night I take Metamucil and also a probiotic. I drink coffee, eat prunes, but nothing seems to get me moving consistently. I went for a colonoscopy and the gastroenterologist told me I had a "floppy colon". What does this mean, and why would I move frequent bowels all of my life and then just stop? My stool is not hard, I just don't get the urge/peristalsis to go. Is there anything I can do to help?

12 Answers

It is hard to answer your question without knowing the current pattern (frequency and consistency) of your bowel movements.
This is a difficult situation. I would suggest trying some additional supplementation that may help. A powdered Mg supplement can be very helpful. You can also try a different probiotic than what you have been taking. We have very good success with OrthoBiotic. A powdered product high in L-Glutamine can also be very helpful for those with chronic digestive and absoption problems. Additionally, you may want to look into Ozone Enemas, which have miraculous results in some patients. Here are some links to look at:
People with redundant colon or floppy colon have more colon length for digested food to travel and may be more likely to experience constipation. Consuming a diet high in fiber can reduce constipation. The added fiber will increase the stool’s bulk, stimulating the colon to move the stool more quickly.

Examples of high-fiber foods include:

whole-grain breads
The more processed a food is, the less fiber it likely has. The recommended daily amount of fiber is roughly 20 to 25 grams per day if you eat a 2,500-calorie diet. If you eat much less, slowly increase your intake.

Drinking plenty of water also helps to soften stools, making them easier to pass. If you continue having difficulty with constipation, talk to your doctor. He or she can recommend an additional fiber-containing supplement or determine the need for a laxative.

If these methods don’t work, I recommend seeing a colorectal surgeon. Maybe there is a way to reduce the size of the colon.
Most commonly, this happens with people that take Laxatives frequently in their life (as for 5 to 10 years). It seems you are one of those patients that does not get satisfied unless they have couple of bowel movements.
Per medical standards, most of the females move their bowels every other day and that is normal.
I would talk to the specialist and see if they recommend any medications that can help with the actual movement of the colon, as most of what you are using is "bulking" agents that don't do anything as far as the movement of the intestines.
Good morning, constipation is a health problem present in up to 20% of the general population, there are 2 fundamental types of constipation: primary (due to an intrinsic cause) and secondary (due to an extrinsic cause); inside dl primary constipation there are 3 subtypes, one of which you suffer called colonic inertia or slow transit with normal or abnormal pelvic floor. In constipation due to slow transit or colonic inertia, a decrease in the number of high amplitude propagated colonic contractions and an uncoordinated increase in motor activity of the distal colon has been identified, resulting in a functional barrier or resistance to normal colonic transit. however, causes that associate slow transit with pelvic floor abnormalities may coexist. Initially a therapeutical test with fiber is recommended 25 grams per day for 2 weeks (to assess response to the symptom) without mebargo without no improvement (as in its case) it is necessary to perform complementary studies such as colonic transit with markers and anorectal manometry. If it is only a matter of slow transit or colonic inertia, the pillar of medical treatment is the laxative, first-line bolus formers such as psyllium, if there is minimal response or low tolerance, the second line: hyperosmotic laxatives of which polyethylene glycol has proven to be the safest and most effective prokinetic agents such as cisapride and tegaserod. It should be remembered that defecation is a conditioned reflex learned, so we must re-educate ourselves as patients to establish a regular pattern of bowel movements, mainly morning, perform physical activity, consume appropriately 1500-2000 cc a day and consume a diet rich in fiber (20-30 grams).
I hope to have resolved your doubt, greetings from Mexico.
a thorough evaluation by a board certified gastroenterologist can help determine course of action

A floppy colon is just another term for a redundant colon, which is common in many people. It appears that you may have slow colonic peristalsis, which can sometimes be a part of aging, or it may indicate other medical problems. You have not included your age or other medical issues in your question.
Have the GI has consider this could be IBS or irritable bowel syndrome?? It will be great help for you to discuss this with your PCP too
Your situation is not an uncommon one. Exactly why it happens, no one really knows but it can happen all of a sudden it appears to have happened in you.

Usually a "floppy colon" means one that on colonoscopy appears long and capacious. It's usually a sign of a chronically slow bowel. There are a number of things that can be done. Initially I usually do a colonic transit study to quantify exactly how slow your bowels are. It sounds like you have tried all the dietary options to help your bowels. I would probably also try regular laxatives that promote gut motility. Next I would consider medications that speed up your bowels like Prucalopride. Surgery is usually a last resort. I hope this gives you some options.
Good luck.
You need to get a complete digestive and stool analysis. Its a test conducted by functional laboratories. For example in Australia its Nutripath. It can take 2 to 3 weeks to get reports. The reports should tell us a reason. To me it seems you have Dysbiosis of the gut.
Thank you for asking this question to me - -

Floppy Colon is also called "Redundant Colon."

The average colon is roughly 45 to 60 inches in length.

A Floppy Colon or a Redundant Colon (same) refers to an abnormally long colon. When this condition exists, the extra length is usually in the final section of the colon - referred to as our descending colon. The descending colon is typically less than 24 inches in length, but it can develop additional loops and even twists.The descending colon is where stool is "stored" awaiting final evacuation.

The descending colon is the section of our colon that is most prone to develop diverticulosis - which refers to small pouches in the wall of this part of the colon - and these small pouches can be a place where stool sits for a long time and hardens. The descending colon has the purpose and function to absorb water from our "stool" so that evacuation is a "formed"
stool. Stool moves through the colon as a gravy form in the beginning of the colon and then water is absorbed out of the stool slowly as the stool moves along. The stool stays gravy form until it enters the descending colon - normally - and then firms as it passes through and enters the sigmoid, just prior to evacuation.

Some persons never experience symptoms from a longer floppy descending colon - others do experience constipation, bloating, even crampy discomforts if the stool sits in this colon portion for too long - and then the stool becomes larger, bigger, longer, hard, and dry - and may not pass. Then the colon enlarges even further - and this is when diverticula form - as the colon squeezes to pass - the stool does not move much.

Actual cause of this condition includes poor diet habits, inactivity, low fiber in one's diet, low liquid intake, and the social habit of "holding".