TONI...Did you read Dr. Gerhart's message about Constipation alternating with diarrhea...??

Sun Mar 4 12:03:57 2001

Dear Toni,

Did you read Dr. Gerhart's message? Does his explanation sound like what you are experiencing? I don't want to wish this onto to you -- I am just trying to understand what and how you are feeling.

~ ~ ~ ~

At Sat, 3 Mar 2001, Helen Dynda wrote:

Dr. Clark Gerhart posted the following message:

The constipation alternating with diarrhea is a little concerning. There are a number of things that can cause this ( such as irritable bowel syndrome ), but it can also be a sign of partial bowel obstruction from adhesions.

What happens is this: there is a narrowed area in the intestines that is not completely blocked, but which blocks larger food pieces as they are being digested. When a blockage occurs, you experience constipation until enough force builds up behind the food to force it through the narrowed area, and diarrhea results. Then food gets stuck at the narrowing again, and stays until pressure builds up, and the whole thing starts over.

This is probably why your doctor was concerned and recommended you see a surgeon, to prevent complete obstruction from occurring. Unfortunately, as others on the message board have mentioned, many surgeons do not recommend surgery until complete obstruction results, and it is too late. Fixing the problem before it becomes severe is generally better. The reason surgeons have waited to operate is because they know that surgery causes adhesions, so operating hasn't made sense -- until the advent of laparoscopy, which creates few new adhesions.

Although many surgeons who perform basic laparoscopy consider adhesions a contraindication to laparoscopic surgery, there is a growing number of advanced laparoscopic surgeons who will deal with this. It may take some hunting, but you will probably be able to find an advanced laparoscopic surgeon willing to take your case near where you live by asking your doctor and friends and making some calls.

One thing I will recommend to patients in the mean time is to eat foods LOW in fiber, and drink a lot of fluids. This reduces the amount of undigestible particles in the food passing through your intestines, and will generally make your stool smaller and easier to pass through narrow areas. Foods rich in carbohydrates ( sugars, rice, potatos, pasta ) are digested high in the intestinal tract, and become liquid quickly.

Unfortunately, high fiber diets are healthier for your intestines long term, and low fiber diets can lead to constipation ( even without narrowed areas ) so this is not a long term solution.

[] Dr. Clark Gerhart

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