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IBS after hyst? IBS after hyst?

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Unread 11-11-2005, 11:39 PM
IBS after hyst?

Ok, I talked to my pharmacist. Here's what I learned:
Paxil is a Selective Seratonin Reuptake Inhibitor. What that means is Paxil allows the seratonin to remain in an active form rather than being bound up and not used by the brain. Think of that TV commercial that shows all the little black dots being spit out but then most of them get sucked right back in where they came from in the first place. Since I have a chemical imbalance that prevents me from using the seratonin I produce, Paxil works wonderfully to allow me access to the seratonin I need in order to function before it's taken up again (hence, the Reuptake part of the name).
Zelnorm is a Selective Seratonin Receptor Agonist. What that means is that it works to keep the bowel function going rather than let the bowels slow down to an almost nonexistent movement by blocking the seratonin from attaching to it's receptors in my bowels. Receptors are only supposed to be used to take back extra seratonin that can't be used. It's almost the same as when the seratonin in my brain is taken back up before it's been used. Keep in mind that there's a reason for the Selective part of the names.
The difference between the two is that Paxil allows my brain access to the seratonin being manufactured for my brain before it's bound up. Zelnorm, on the other hand, works to use the available seratonin manufactured for my bowels. There's more than one type of hormone function going on here. Think of it like this. My brain controls my body, however, there's also a "brain" specifically for my bowels. In actuality, it's a nerve bundle that functions almost like a brain just for my bowels. It's controlled by my brain but it uses it's own hormones, chemicals, and yes, even seratonin. The seratonin in my bowels serves to maintain the normal contractions of the small and large intestines, but also to keep inflamation down and to dull the nerve endings so it's not so painful to pass waste materials. When the seratonin for my bowels is attaching to it's receptors, the intestines won't contract regularly like in normal situations because there's just not enough free seratonin to use. Also, the nerve endings become irritated and so causes much pain. Because the waste material sits in the intestines so long, it helps to build up gas and to make constipation worse. Therefore, the longer I have to wait to defecate, the more constipated I become, the more gas I develop and the more painful my nerves in my bowels become. By taking the Zelnorm, the seratonin is made to act on the bowels like it's supposed to. My intestines contract somewhat normally, my nerve endings are dulled so that I'm not in as much pain and I don't develop as much gas because the waste materials aren't sitting in my intestines for so long.
Sorry this is so long, but when talking to my pharmacist, I wanted to be sure that I understood everything before I got back to you on this. She did tell me that Zelnorm is contraindicated for anyone that has IBS with diahrrea and that if I DO develop it, to let my doc know so I can stop taking it or lower the dose. Also, IBS symptoms that involve the gallbladder shouldn't be treated with Zelnorm because the problem is entirely different and blocking the seratonin will worsen the symptoms, not make them better. I wish I would have talked to her about this a month ago. I would have started taking the Zelnorm right away! lol I hope I made sense when I was explaining all this. If not, let me know. I can always get more specific! lol
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Unread 11-12-2005, 01:21 AM
IBS after hyst?

Hi, I too had bad pain in my left side before TAH with BSO. My bowel was stuck to my left ovary apparently. Now and then I still get like a tugging pain on that side. My doctor reckons there is nothing there to cause that sort of pain and my bowel is now moving freely. Anyway, keep researching and always trust your first instinct.
Unread 11-12-2005, 05:30 PM
IBS after hyst?

Thank you aheimerl - that was brilliant!
You must sure need to learn a lot to become a doctor eh! I do believe that knowledge is power though, thanks for sharing the info and please keep us posted with updates! It sounds almost too good to be true - the zelnorm that is, and it's obvious that you are the exact kind of IBS patient it was created for. I'm not even sure if that's what it's called here in the UK either.
((((((((Peggy)))))) thank you too for your infor. I hope you are doing well in your recovery and not in too much pain
Gabi How does your doctor know that your bowel is moving freely? The only way they can do this is by laparoscopy, adhesions do not show up on scans or x-rays. As you say, trust your own instincts. Take care.

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Unread 11-13-2005, 12:13 AM
IBS after hyst?

Hi Aunty Sue,
I had an internal scan, ultrasound & xrays. Doctor reckons she couldn't see anything, but then she didn't say that the tests could not pick these things up. I thought the test would be conclusive & thought that surely the surgeon wouldv'e had a good look around during my TAH. There was however a lot of women on the list to get through that day. Oh well, I'll keep researching and insist on more tests if the pain keeps up. Thanks for the advice.
Unread 11-13-2005, 06:53 AM
IBS after hyst?

Hi Gabi
Even if your doctor had seen that your bowel was moving freely when you had the op, it's after they close you up when adhesions form! That is why surgery is not the answer to adhesions, because surgery, along with endo is the main cause of adhesions! I was told that where the bowel is concerned adhesions can be a risk because they could interfere with the functioning of the bowel.
I hope you get some answers, as you and I both say - trust your instincts!
Take care
Unread 11-13-2005, 07:04 AM
IBS after hyst?

Gabi, you can develop adhesions AFTER a TAH. Any surgery, no matter how "minor" can cause scarring. And since we have had abdominal surgery, it's more than likely that there are some adhesions from that, especially if your surgeon didn't use the little strips to prevent them. Believe it or not, most don't. And some don't even believe that adhesions cause pain even after all the actedotal evidence to the contrary. You may want to talk to your doctor about actually looking for them. If the doctor is sure that there's no other reason for the pain, then ruling out adhesions is a good way to go. X-rays and ultrasounds will only show that there are no obstructions or areas of constriction. They do not, however, show whether there are external adhesions that pull or otherwise "glue" your bowels to another organ or muscle. Honestly, we're not even sure I don't have adhesions. I was just leary of having another surgery right now so we decided to try the Zelnorm anyway and monitor the pain. If the pain increases I develop other problems, I'm to stop taking it right away and get into the doctor. I was willing to take that chance before we used surgery as an option.
Just make sure you listen to your body. Pain is not normal and tells us that there's a problem. Sometimes, doctors will minimize the importance of pain because they don't have time or don't know what else to do for us. That doesn't mean we have to give up. It just means we're going to have to take that detour on our road to recovery instead.
Unread 11-15-2005, 11:49 AM
IBS after hyst?

Originally Posted by aheimerl
The only test we have done is a barium enima. That test came back as nothing being wrong. This all started because I'd have a great deal of pain when "stuff" would hit a certain spot in my bowels. It almost felt like things would get "stuck" for a while. As soon as it passed, I felt fine. I don't alternate between constipation and diarhea or have either very often. I do get plenty of gas though. The gas is the most painful. I feel bloated, but I'm not physically bloated. It causes so much pain in my lower left abdomen that I can barely stand.
Truely, it might be something like an overgrowth of yeast that causes the gas. It's the pain I'm worried about though. It never goes away anymore. I used to be able to have a bm and the pain would ease up. Now, I'm lucky if I don't just hurt worse. I've gone home early a few times from work because I could barely walk from the pain. I'm back on pain meds just so I can get through work. I don't think that's normal for IBS.
Holy cow, you could be me, only that I had those symptoms to some degree for about a year before the surgery, only to have them return about 3-4 months afterwards and escalate ever since. I also had a "normal" abdominal CT (had to drink the barium) and contrast pelvic CT. Next step is colonoscopy and seeing my GYN today.

I'd suggest extra care with narcotic pain meds, though. I'd taken them for years for residual nerve damage after neck surgery as well as my abdominal pain, so I had no real side effects other than relief of pain. However, I had two episodes of near black-out in September - my PCP says that if medication gets "stuck" the ingredients can "dump" (or disperse too quickly as opposed to over a few hours as it normally passes through your digestive system).
Unread 11-15-2005, 12:53 PM
IBS after hyst?

It seems there is a recurring theme of left side pain after hyst. I never had the pain before my surgery, but started having the pain several months afterwords. Mine is up high though. I have had scans, ultrasounds, etc. My gyno said he could do exploratory lap, but i declined. Then the gastrologist suggested a colonoscopy, but i have'nt talked myself into that either. I sometimes go several day, weeks without symptoms, then get hit hard. I am beginning to wonder about hormonal peaks and valleys since i still have my ovaries. Does anyone else notice this?
Unread 11-16-2005, 05:47 AM
IBS after hyst?

Pain high up on the left side should definitely be checked out. And for a colonoscopy, you're put under anethesia so you don't have to be awake for the whole thing. You'd still have to empty your bowels though.
I absolutely refuse to take any more narcotic pain relievers at all if I can get away with something else. I hate feeling "stoned" all the time. And all I ever did was sleep. Besides, they make constipation that much worse. The neurontin seems to work ok (it's in a capsule form) but we had to raise the dosage. This one will be out of the question soon too.
I've just had two and a half days off of work in a row and normally I'd be feeling great. Now, I just hurt all the time. I'm calling my doc today to reschedule my appointment. But I may be looking for a new doc anyway since this one seems to be having a hard time helping me control the pain and getting this under control. But we may be discussing disability on my next visit. I'm leaving work early so often now that my bosses are starting to get more than a little concerned about my attendence. They were hoping I could make it through Christmas, but I can barely walk now. I'm not doing them or myself any good this way.
It's frustrating to say the least. But I will get this under control. I won't live like this any longer than I absolutely have to.
Unread 11-17-2005, 09:42 PM
IBS after hyst?

Hi ladies,

I have a question for you about IBS. I've had alternating constipation/diarrhea for five months now which is not associated with any particular foods that I eat. Two months ago, I started having moderate to severe pain on my lower right side and was diagnosed with a complex ovarian cyst a few weeks ago. For the past two weeks, I've had almost constant nausea and vomiting, along with bloating and feeling full after eating just a few bites of food (and almost everything I do eat comes back up ) I've also been having problems with frequent urination and extreme fatigue for a few weeks.

I had an appointment with a gyn/oncologist yesterday and and besides doing a CA 125 blood test for ovarian cancer and scheduling a follow-up ultrasound for the ovarian cyst, she mentioned that my symptoms might be caused by IBS.

Would IBS cause all these symptoms, especially the ? I've just been so sick lately, and I need to know what on earth is wrong1

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