Colchicine for persistent constipation after total abdominal colectomy with ileorectostomy for colonic inertia.
Severe constipation caused by colonic inertia may be associated with a generalized gastrointestinal dysmotility syndrome. Patients with severe constipation pose a significant challenge in terms of management. Failure of medical therapy usually leads to surgery in the form of a subtotal colectomy. Most patients develop diarrhea after the surgery, but a subgroup of patients continue to experience constipation. We report the case of such a patient who underwent a total abdominal colectomy and ileorectostomy for intractable constipation. He continued to have constipation after the surgery that was responsive only to a gallon of bowel-cleansing solution. A treatment trial of colchicine was partially unsuccessful when used on its own, but a combination of colchicine and a lesser dose of Colyte was found to be effective in maintaining regular bowel movements.
Rajapakse
R
R
Division of Gastroenterology, Department of Medicine, Lenox Hill Hospital, 100 East 77th Street, New York, NY 10021, U.S.A.
Warman
J
J
Korelitz
B I
BI
D000328:Adult; D000714:Anastomosis, Surgical; D003078:Colchicine / Q000627:therapeutic use*; D003082:Colectomy; D003108:Colonic Diseases / Q000188:drug therapy / Q000601:surgery*; D003248:Constipation / Q000188:drug therapy / Q000601:surgery*; D004359:Drug Therapy, Combination; D004573:Electrolytes / Q000008:administration & dosage; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011183:Postoperative Complications / Q000188:drug therapy*; D012007:Rectum / Q000601:surgery; D012008:Recurrence
D004573:Electrolytes; C033608:Golytely; D011092:Polyethylene Glycols; D003078:Colchicine