Constipation Conundrum

In the more than 20 years since I have been diagnosed with IBS – though I have had experiences on both sides of the dilemma – I've always fallen way more heavily on the IBS-D side of the spectrum.

When IBS started

In fact, when I was first diagnosed, I was going to the bathroom sometimes between 10 and 20 times a day and lost well over 20 pounds in a single semester of college. I wound up taking the next semester off to recover and get a battery of tests to determine what was wrong with me. My GI doc at the time was convinced I had Crohn's disease or another form of IBD due to the nature and severity of my symptoms (namely, the relentless, near-daily bouts of diarrhea and massive weight loss). But the tests didn't turn up anything to support his suspicion and my default diagnosis became IBS.

Understanding my IBS

From there on out, I was more or less on my own and spent the next miserable few years trying to adjust my diet and lifestyle to tame my IBS. I did on occasion suffer from constipation, but it was intermittent. I had one specific summer where I wavered drastically between constipation and diarrhea and nothing in between – not being able to go at all for 2 or 3 days and then getting an "episode" where I had to run to the bathroom over and over again for several hours till what was in me was cleaned out and then the cycle would repeat. Finally, I broke those cycles with acupuncture and herbs and semi-stabilized for awhile.

IBS symptoms after surgery

It wasn't until I had my lap surgery to confirm and remove endometriosis (including a lot of it that was on my intestines) that both diarrhea and constipation issues decreased substantially. However, I continued on and off to have diarrhea problems from time to time over the years. For the most part, I stopped having problems with constipation though.

That is, until this year. I can count on less than one hand how many times I have had a bout of diarrhea since 2020 began. I thought if the time ever came again when I could claim that I would be ecstatic. But the problem is, I've now swerved far into the opposite direction. I have had growing problems with constipation and it's been difficult to pinpoint why it's happening.

There could be many reasons. At the end of last year, I had another lap and radical endo excision, along with a hysterectomy and removal of my fallopian tubes (since I also had adenomyosis in the uterus).

While it's wonderful no longer having a period, I do have to wonder if the constipation is a possible complication of the surgery. The constipation problems started about 3 to 4 months after the operation, right around the time I was supposed to start pelvic floor therapy as per my surgeon's suggestion (he recommends it for all his post-op patients who have hysterectomies). But that timing coincided with COVID occurring and instigating the shut-downs for all non-emergency medical treatments.

So, I have to wonder if I am having some kind of pelvic floor problem as a fallout of my surgery, or if something inside me has shifted since the surgery and is causing the issue because it's putting pressure on my colon or GI tract (sometimes organs re-orient positions when a womb is removed or an ovary shifts out of place and can become buried somewhere without the tubes to anchor them).

Other conditions plus IBS

I also have disc issues in my back (degenerative disc disease and spinal stenosis) and cysts in my spine, and I am concerned about it messing with my bowel function, which isn't unheard of at all.

And then there is also the fact that I do have IBS and perhaps as I get older (I am in my 40s now), and my hormones dip, my IBS is swinging in the opposite direction than it was in my younger years. I also have a genetic predisposition toward colon cancer. I was actually also supposed to have a colonoscopy due to this genetic risk also around March/April, but it's also been postponed due to COVID concerns.

However, now that the surge is over and numbers are much lower where I live, and I am having these issues, I have now scheduled my colonoscopy for next month (hoping there's not a second surge, so I can keep my appt and get some answers). I also have an ultrasound scheduled for next week to see if they can find anything changing inside me that could be one of the culprits causing my constipation.

I'll keep you all apprised as updates arise. But if you've experienced a sudden onset of constipation with IBS after years of the opposite, please know you're not alone.