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Hi everyone,

I come here today because I'm having a lot of trouble. Leading up to an obstruction I had last week that put me in the hospital for a few days, I was feeling a bit blocked up. Now that I'm out, I feel like I did leading up to my obstruction. Although I was emptying my j-pouch well in the hospital I was going too many times and it was very loose. I felt fine when I left, not blocked up at all. Now that I'm out, I'm not going as much, but I feel very blocked up when I do go and when I'm done, it still feels like I have to go. I've been having accidents in my sleep as well. I'm just restless from it all.
I can't pass gas without going as well.
I do take benefiber, could that be what's making me feel blocked? Should I stop? Anyone think Psyllium Husks may help? I've never tried that. It's been a long while since I've been dilated too, over three years now, but I just don't know. I was fine until a few days before my obstruction. Any suggestions?

I'm 20 years old.
Ulcerative Colitis Diagnosed: December 2008
J-Pouch: October 2010

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One of the symptoms of a partial obstruction is very watery stool (some stool is able to pass around the obstruction, but the bulk does not move.). If you're feeling blocked, I would NOT recommend taking lomotil, imodium, pepto bismol or any other bowel slower, as these could all exacerbate the problem. It would be advisable to avoid the benefibre for the time being.

I would suggest going on a low residue diet for at least 3 or 4 days and see if this improves the situation. Make sure you also drink plenty of fluids. You do mention that you were dilated a few years ago, which suggests you may have had a stricture. Strictures can certainly cause obstructions. They can form gradually over time, so perhaps yours has recurred to a point that it is now causing you problems.

There are a few other things to consider as well. Partial obstructions can be tricky, because symptoms can be the same as other issues, such as a gastrointestinal virus (I am guilty of going to the ER once with what I thought was a partial obstruction, but what turned out to be acute gastroenteritis - in my defense, however, I'd had 2 obstructions in the few months prior to that episode, which is the reason I decided to go to the ER. The cramping at the time was horrific.). Also, pouchitis should be ruled out, as it can cause similar symptoms.

Hope you get this sorted out!
Spooky
In addition to the suggestions already made by Spooky, I have been able to relieve partial obstructions by doing a lot of walking around. Inactivity is not your friend when your gut is blocked up. The act of vomiting has itself relieved one of my obstructions, just before NG tube was about to be inserted in the ER.

Also, as suggested by Spooky, pouchitis that is poorly controlled or out of control can cause strictures. This happened to me in 2012 when an MRI Enterography revealed my J Pouch inlet was narrowed due to inflammation, which in turn was causing pooling of the feces ("fecal stasis") above the J Pouch. This situation led to a blockage like sensation for several days in August 2012, after which Entocort I was taking began to kick in. I later made drastic changes in my diet and the situation improved and have not felt like that since 2012. I am very conscious now about staying on top of my treatment and my diet.
CTBarrister

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