Re: IBS/adhesions/surgical outcomes-Chris

From: Tina Shelby (
Sat Oct 16 21:26:24 1999

Chris -

Thanks - I'm glad I can help in some small way - by being able to share what I have learned - I feel like I am turning a negative experience into a something that can benifit others.

When your GI specialist said you were letting him know it he was hurting you and gave you more meds - it is very possible that he was trying to get the colonscope to go around a curve/turn in your colon and was encountering a great deal of resistance. If adhesions had your bowel fixed then he had to push fairly hard to get around the corner - and will cause a fair amount of pain because the colon is not as flexable as it should be. His "fairly normal" comment may be eluding to the fact that procedure-wise it was a difficult case - more than likely from your colon being fixed and attached to other structures within the cavity. It might be worth-while for you to request a copy of his procedure report to see if he noted that it was a difficult procedure. The report will also document that the procedure was "essentially normal" but also address any out of the ordinary findings that would not necessarily be diagnostic. Most of the time you can get these records without the doc knowing about it because it is usually handled through the administrative staff. Also, many GI specialists will schedule extra time for the procedure if they know ahead of time that it is going to be difficult for them.

It is very possible that the gi doc did not pick up on the abnormal location of your colon just using the scope. However, a barium enema would have picked up on it immediately. Basically - the scope really just picks up on abnormalities involving the inside of the colon wall that is visualized. Because the GI doc may not see 100% of the inner colon surface - abnormalities can be missed. And if something is causing problems on the outer colon wall - like adhesions - the scope will definitely not see them - and will be overlooked as a possible source of the pain. What we must keep in mind is that those of us who have pain assoicated with adhesions are in the minority. The gi doc may encounter a large number of patients who have fixed colons from adhesions but are not experiencing pain from them - so when they do encounter the rare instance when the adhesions are causing pain, they usually don't see the connection.

As far as there being anything you can do ahead of time to find out if the colon is out of place - it would have to be a test that radiographically shows where the colon is in relationship to other organs in the abdominal cavity. This would include tests like a barium enema (yuk) or a CT scan. There is a fair amount of skill required by the doc to manuver around the colon when resistance is met but if the patient is properly sedated - they would not be aware of this.

My experience with this comes from working for a GI specialist for > 2 years. (Not to mention having had no less than 5 colonoscopys myself). I have not seen a case of Crohns disease without the presense of bloody diarrhea and colon wall abnormalities but have heard that it is possible. Cases like this are usually diagnosed because the colon biopsy showed the colon changes at the microscopic level - but are not yet visible to the human eye.

Let me know if decide to get the procedure note - I would be interested in seeing what he documented vs what he told your husband.


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