I apologize in advance for the length of this post. The first part is background. The concern is toward the end – severe dehydration.
I am not BarbC, I am her other half.
Barb has encountered what we thought was a blockage. She has very little output, but a continual pressure and the urge to evacuate. Not much comes out but small particles. Per the doctor’s suggestion to stay off Imodium and harsh laxatives, she uses prune juice in an attempt to get some movement, but the liquid seems to seep around the 'blockage' or whatever it is that is preventing the output. All of this with a considerable amount of straining.
Over the past several months, she has had a pouch exam (using a sigmoidoscope). The surgeon said that the J-pouch looks perfect, but empty. He suspected that she was impacted, so he ordered a CT scan. His review of the scan confirmed that Barb’s intestines were full (even the J-pouch at the time of the scan). He scheduled an appointment with his associate to perform a J-pouch exam, going further than he could without anesthesia. It seems that the prep procedure cleaned her out. The J-pouch is in good shape, there were a couple of very small ulcers near the J-pouch exit, which the doctor sent for biopsy – they came back negative for Crohn's or cancer. He suggested a GI Series (small bowel -- barium enema) to see if there was a twist or other obstruction. That came out completely negative -- no strictures, no obstructions, no fecal impaction, nothing to indicate a problem. As soon as she started eating, again, her output slowed to almost a stop.
The doctor determined that she needed to learn how to poop, again. He referred Barb to a physical therapist for physical therapy with bio-feedback. Now, months of doing all these extra exercises, she remains in the same condition.
She has had another small bowel series and everything points to no physical blockage. The surgeon now feels that the UC diagnosis may be wrong and referred Barb back to the GI to eliminate the possibility of Crohn’s Disease. A blood test, Prometheus IBD sgi diagnostic, was ordered. Blood was drawn this past week. We should know the results this coming week.
In the meantime, the GI doctor ordered a Capsule Endoscopy in two weeks. His assumption is that the previous tests having showed no mechanical blockage would minimize the risks – we sure hope so, since it requires an operation if the capsule gets stuck.
Now for the real reason of this post, since last December, Barb had been in the hospital three times for severe dehydration. This past Saturday, she started vomiting for no reason (no illness). We got home from an evening out just in time for her to start having diarrhea. The vomiting stopped, but she remained nauseated and the diarrhea continued until after the paramedics had her in the ER.
Barb’s BP upon arrival in the ER was 42/36. The ER staff struggled to get an IV started because Barb’s veins were collapsed from lack of fluid. Once they got her stabilized, she continued to have labile BP. After five liters of fluid, two doses of Cipro and Flagyl, and a few hours of observation in a step-down unit, they deemed her fit to be discharged.
Does anyone else have these rapid dehydration issues? Barb’s start as though her intestines are full and when the stomach tries to empty it is into a system that is already too full and there is no place for the stomach contents to go but back from the direction it entered, through vomiting. Once the vomiting starts, the extra pressure on the gut from the retching causes the clearing out the intestines.
Is there any way to head off severe dehydration when the only indication is vomiting without being ill? Obviously drinking is out of the question since that comes right back out. Each time this happens, her BP drops to the point of her passing out and I call 911.
I appreciate any thoughts.
Stan
I am not BarbC, I am her other half.
Barb has encountered what we thought was a blockage. She has very little output, but a continual pressure and the urge to evacuate. Not much comes out but small particles. Per the doctor’s suggestion to stay off Imodium and harsh laxatives, she uses prune juice in an attempt to get some movement, but the liquid seems to seep around the 'blockage' or whatever it is that is preventing the output. All of this with a considerable amount of straining.
Over the past several months, she has had a pouch exam (using a sigmoidoscope). The surgeon said that the J-pouch looks perfect, but empty. He suspected that she was impacted, so he ordered a CT scan. His review of the scan confirmed that Barb’s intestines were full (even the J-pouch at the time of the scan). He scheduled an appointment with his associate to perform a J-pouch exam, going further than he could without anesthesia. It seems that the prep procedure cleaned her out. The J-pouch is in good shape, there were a couple of very small ulcers near the J-pouch exit, which the doctor sent for biopsy – they came back negative for Crohn's or cancer. He suggested a GI Series (small bowel -- barium enema) to see if there was a twist or other obstruction. That came out completely negative -- no strictures, no obstructions, no fecal impaction, nothing to indicate a problem. As soon as she started eating, again, her output slowed to almost a stop.
The doctor determined that she needed to learn how to poop, again. He referred Barb to a physical therapist for physical therapy with bio-feedback. Now, months of doing all these extra exercises, she remains in the same condition.
She has had another small bowel series and everything points to no physical blockage. The surgeon now feels that the UC diagnosis may be wrong and referred Barb back to the GI to eliminate the possibility of Crohn’s Disease. A blood test, Prometheus IBD sgi diagnostic, was ordered. Blood was drawn this past week. We should know the results this coming week.
In the meantime, the GI doctor ordered a Capsule Endoscopy in two weeks. His assumption is that the previous tests having showed no mechanical blockage would minimize the risks – we sure hope so, since it requires an operation if the capsule gets stuck.
Now for the real reason of this post, since last December, Barb had been in the hospital three times for severe dehydration. This past Saturday, she started vomiting for no reason (no illness). We got home from an evening out just in time for her to start having diarrhea. The vomiting stopped, but she remained nauseated and the diarrhea continued until after the paramedics had her in the ER.
Barb’s BP upon arrival in the ER was 42/36. The ER staff struggled to get an IV started because Barb’s veins were collapsed from lack of fluid. Once they got her stabilized, she continued to have labile BP. After five liters of fluid, two doses of Cipro and Flagyl, and a few hours of observation in a step-down unit, they deemed her fit to be discharged.
Does anyone else have these rapid dehydration issues? Barb’s start as though her intestines are full and when the stomach tries to empty it is into a system that is already too full and there is no place for the stomach contents to go but back from the direction it entered, through vomiting. Once the vomiting starts, the extra pressure on the gut from the retching causes the clearing out the intestines.
Is there any way to head off severe dehydration when the only indication is vomiting without being ill? Obviously drinking is out of the question since that comes right back out. Each time this happens, her BP drops to the point of her passing out and I call 911.
I appreciate any thoughts.
Stan
