Small bowel fecalization - anybody know about this?

[Marquis Mark]

Back pain. Went to urgent care and they did a CT scan. Couldn't figure out my back issue (so they're giving me an MRI in a couple of weeks), but my CT scan did show some interesting results.

They said I have fecal material in my small bowel. I'm pooping fine, but am wondering if this is normal for us? If so, is it backed up into our alimentary channel, the digestive juices channel and/or the common channel? This may explain why even after over prepping for my recent colonoscopy, the doctor still only rated it s "fair." I do recall that as I prepped, I ran clear, but then an hour later it would be cloudy again, then I'd drink more prep and it was clear again, etc.

Here is the report. Anyone have any insight about this?

Limited noncontrast exam. No urinary tract stones or hydronephrosis. Nonspecific mildly enlarged mesenteric, retroperitoneal, intrapelvic and inguinal lymph nodes. Status post gastric sleeve surgery and cholecystectomy. No evidence of bowel obstruction. Small bowel fecalization may be secondary to dysmotility or enteritis. 2.1 cm lucent lesion in the left iliac wing with thin sclerotic rim suggestive of a nonaggressive process but new when compared to 2/2/2015. No other specific imaging features are seen, consider outpatient follow-up MRI with IV contrast for further characterization.

Narrative​

CLINICAL HISTORY: Reason: 60 yo male with Right flank pain x 2 weeks, pain persistent, not improving with pain medication, need CT for evaluation. TECHNIQUE: Study performed per protocol. CT Dose: As required by California law, the CTDIvol and DLP radiation doses associated with this CT study are listed below. This represents the estimated dose to a standard lucite phantom resulting from the technique used for this study, but is not the dose to this specific patient. Type / CTDIvol / DLP / Phantom Abdomen / 11.64 / 608.81 / B Total Exam DLP: 608.81 CTDIvol = mGy DLP = mGy-cm Phantom: B=Body32, H=Head16 Comparison: Abdominal ultrasound 6/23/2017, CT abdomen/pelvis 2/2/2015 FINDINGS: The visualized lung bases are unremarkable. Limited evaluation of the solid organs and vasculature due to the lack of intravenous contrast. There is no hydronephrosis. No renal, ureteral, or urinary bladder stone detected. There are low-density cyst in the left kidney, with interval decrease in size of the previously demonstrated large 14 cm exophytic cyst. Gastric sleeve postoperative changes are noted ( I have th DS, they just dodn't know any better). There is no evidence of bowel obstruction but there is fecalization of the small bowel which may be secondary to dysmotility or enteritis. There is no evidence of acute colitis or diverticulitis. There is no evidence of acute appendicitis (good, because my appendix was removed in 1969!). An enlarged portacaval lymph node measures 1.8 cm in short axis. Additional multiple mildly enlarged mesenteric and retroperitoneal lymph nodes are also seen in the abdomen. There is no intraperitoneal free air or significant intraperitoneal free fluid. No loculated fluid collections are seen. Gallbladder is surgically absent. No significant biliary ductal dilatation is seen. The unenhanced images of the liver, spleen, pancreas and bilateral adrenal glands are unremarkable. The abdominal aorta is normal in caliber. Prostate gland is not enlarged. There are bilateral mildly enlarged intrapelvic and inguinal lymph nodes. Bilateral fat-containing inguinal hernias also noted. There is a 2.1 cm lucent lesion in the lateral left iliac wing demonstrating thin sclerotic border suggestive of a nonaggressive process however is new when compared to CT 2/2/2015.

 

[southernlady]

Is it possible you just didn’t poop enough that day?

 

[Marquis Mark]

Is it possible you just didn’t poop enough that day?

I don't think so. And even if that was the case, poop should be in the colon not the small intestines, no? Also, the two weeks before, when I had the Colonsocopy, it may have been backed into the small bowel and I definitely popped my brains out for 24 hours before that test.

 

[Larra]

It can be a sign of small bowel obstruction (though it doesn't sound like you have an obstruction) or it could be a sign that bacteria normally found in the colon have worked their way up into the small intestine, aka SIBO, aka small intestinal bacterial overgrowth. Assuming you are not ill, I have no idea whether or not this requires any treatment.
Here is a link to an article about it:

SIBO: Small Intestinal Bacterial Overgrowth

SIBO is an imbalance of the microorganisms in your gut that maintain healthy digestion. Learn about the symptoms, causes and treatment.

my.clevelandclinic.org

 

[Marquis Mark]

It can be a sign of small bowel obstruction (though it doesn't sound like you have an obstruction) or it could be a sign that bacteria normally found in the colon have worked their way up into the small intestine, aka SIBO, aka small intestinal bacterial overgrowth. Assuming you are not ill, I have no idea whether or not this requires any treatment.
Here is a link to an article about it:

SIBO: Small Intestinal Bacterial Overgrowth

SIBO is an imbalance of the microorganisms in your gut that maintain healthy digestion. Learn about the symptoms, causes and treatment.

my.clevelandclinic.org

Thanks for that, Larra. Use of your phrase "worked it's way up the colon" is interesting. I can understand how that might happen with bacteria, but it's pretty scary to think that actually poop is going backward. The CT scan makes me think it's poop more than bacteria. I don't have any of the symptoms for SIBO (other than the usual DS by-products). Is this fecalaziton more common for us? Your article mentioned it may be caused by abdominal adhesions and low stomach acid. Since we've been tampered with, I'm wondering if that may be part of the story and, if so, maybe this is more common in us?

 

[Marquis Mark]

Thanks for that, Larra. I don't have any of the symptoms for SIBO (other than the usual DS by-products). Is this fecalaziton more common for us? Your article mentioned it may be caused by abdominal adhesions and low stomach acid. Since we've been tampered with, I'm wondering if that may be part of the story and, if so, maybe this is more common in us?

Thanks for that, Larra. I don't have any of the symptoms for SIBO (other than the usual DS by-products). Is this fecalaziton more common for us? Your article mentioned it may be caused by abdominal adhesions and low stomach acid. Since we've been tampered with, I'm wondering if that may be part of the story and, if so, maybe this is more common in us?

 

[Larra]

I don't think actual feces is what goes upstream to the small intestine, rather, it is bacteria that go on to create feces, just as they do in the colon. Good questions about how our altered anatomy may have a role in this, and I don't have any good answers for you. I do think that, for us, it could be more difficult to sort out whether GI symptoms could be SIBO or just our expected DS side effects.

 

[Marquis Mark]

I don't think actual feces is what goes upstream to the small intestine, rather, it is bacteria that go on to create feces, just as they do in the colon. Good questions about how our altered anatomy may have a role in this, and I don't have any good answers for you. I do think that, for us, it could be more difficult to sort out whether GI symptoms could be SIBO or just our expected DS side effects.

Well, I guess I'll add this to the list of things I should try not to worry about unless I start having those nasty SIBO symptoms. I really just don't like the THOUGHT of this one. And now I have an idea of why the colonoscopies can be hard for us. The prep is made to flush the colon, but it can't flush out the small intestines as well and maybe that's what kept turning my clear back to cloudy. Thank you again, Larra. So glad to have you on this board!