Hospitalized with blockage

An Ileus is a blockage that is caused by cessation of peristalsis for some reason, usually surgery, for a prolonged period of time. What can’t go down must go up. It can’t go down because the muscular contractions that propel food downward- I.e., peristalsis- has stopped. Your stomach continues producing gastric juices- copious quantities of it- and eventually it comes up. 

I had an Ileus that was due to surgery and they inserted an NG tube in me until peristalsis returned. Taking too many pain meds can contribute to getting an Ileus.

How soon are you after surgery?

I’m 3 months out from my takedown. I had a blockage with the ostomy bag and then had gastritis within two weeks of my takedown. It’s been a rough road. 

They were going to put in an NG tube but we wanted to wait until something - I honestly can’t remember since I was on pain medication. Once I started throwing up though, I wanted them to give it to me just so I could feel better.

Do obstructions occur frequently once you get one? I think I read somewhere you’re more apt to get them. I’m just really tired - need to get rid of this headache and shower. 

I had 4 obstructions in the first 3 months after takedown. None in the 26 years since. It takes a while for the swelling from surgery to go down. The first was an Ileus right after takedown,  the other 3 were food obstructions caused by swelling and adhesions. It’s just postsurgical nastiness that dies down.

I would suggest going easy on the pain meds and eating real soft foods for a while. No raw carrots. No overeating even if you feel hungry and great. Lay off anything that will slow the bowels down. Walk a ton (this promotes peristalsis) and drink plenty of liquids. These are all common sense self help steps. Give it another 3 months or so and you should be out of the woods so to speak. For now lots of walking. Get on a treadmill and do at least 30 minutes at a solid pace of like 3.5 mph. Don’t lay around and pop pain pills- do that and you are practically begging for another one.

Regarding the headache- are they withdrawing you off Prednisone? I got weaned off and had a dull headache that was virtually continual for a couple of months. Withdrawal headaches.

I've only had one.

I have some start but I can tell now when the  feeling comes up. That is with my permanent ileo.  I will start feeling a pain on the other side  of my stomach.  Then I know  I have to take action. It very subtle. But i know now.

The first one that  sent me to the hospital was with a temporary ileo.  

14 hours they dug around while i writhed in pain (excruciating I must say) worst pain I have ever felt in my entire life and i hope i never have that again. They had to do my second surgery to find it.  This is a long story. So I'll cut it short.  But it did put me in the hospital bed for 19 days.

Pay attention to the signs and take action if you have an end ileo .  I chew well and I can  still  feel one coming on. 

Just be self aware. Best defense.

Get up and move. Drink water.  Don't eat. 

I have a J Pouch and having experienced 4, I can also sense when one is coming on. Around 6 years ago when my J Pouch inlet appeared to have narrowed on an MRI enterography, I was put on Entocort. At that time I was taking Imodium to which I am sensitive. I went for a big breakfast of banana pancakes and late in the afternoon got that pain on my side. I hadn’t moved bowels all day and I immediately went outside for a long walk. I returned from the walk and was able to move my bowels. I am convinced from this and my other blockage experiences that bowel slowers or pain meds were huge culprits in all of my blockages. After that I started using Imodium more sparingly. I don’t need all that much anyway, as antibiotics thicken the stool and these issues happen when the stool gets too thick and isn’t easily transmitted through the bowels.

My buddy who has a colon and UC had to have cervical fusion surgery, took too many pain pills and ended up in the ER to get an emergency disimpaction. Done manually just as they do with horses. Obviously that’s not doable with an end Ileo or a J Pouch if the blockage is above it. Anyway I gave him the same warning on pain meds and his response was “I have UC, I can’t get constipated.” He found out in a very hard way that was not true. Said it was the worst experience of his life. The NG Tube is no fun either and that is what will happen to you guys if this doesn’t relieve on its own. The NG tube was inserted after my ileus- the damage was done there from taking too much morphine pump after surgery.

Unpacking the blockage by hand? That sounds horrible! Sounds like you got through it okay though?

I only had pain medicine yesterday - normally I never take it- only did for my surgery. My pain was so bad I couldn’t even sit still on the hospital bed! I was just non- stop moving in pain. Literally he worst pain I’ve felt in my life.

I do walk the dog on a daily basis and walk a half mile to work-where I park on campus. I’m hoping to get back to walking tomorrow am. Keep things flowing.

Speaking of keeping things flowing- I’m back to going every hour. It’s like feast or famine! I am also experiencing incontinence - leakage. This has never been an issue for me before. Is that common? My gas pains now that I’m eating- albeit broth and toast, are pretty intense too. Not horrible like yesterday but def more than normal.

Aso, am I supposed to still be sore? I’m still pretty sore, it’s tough to move around. Just crappy and feels like I’m the aftermath of being punched in th stomach. That’ll go away, right? 

Doc has me on a low fat, low residue diet. I’m not even hungry. 

So I'm a few days out and not feeling so hot. Stomach hurts to touch it, but not as bad (or even half as bad) as the other day. I called the nurse at the doc's office and told her. Nurse said to do clears until she could get back to me. That was two hours ago. Wondering what they'll say. 

I haven't increased the lomotil yet bc I didn't want that to cause another blockage. This weekend I laid low, but it has hurt to lay down flat. I've kept a heating pad on my stomach and have been taking it easy with food. This morning all I had was OJ, and a banana mid-morning. Going to have some gatorade now (low sugar). Am I maybe not over the obstruction, or could this be residual pain just from being so bloated and stuff from the other day? It's been 4 days. I figured I'd be better by now.

I think you are doing all the right things. You could have a partial blockage that has lingered, or it could be fallout from the prior blockade episode. If it worsens I would go to the ER, but in the interim I would just rest and drink lots of fluids. Walk, if you feel up to it.

The intestines swell when there is an obstruction, it can take up to a week for things to settle and the pain to resolve. Think of it like a resolving bruise. Even while healing, it remains tender.

Jan

I got my first one nearly 30 yrs after my pouch creation...never had post-op ileus until I did, then again I didn't have any adhesions either.

I started getting blockages regularly after age 50...always in the same spot...Turned out that I had a loop of bowel stuck to the inside of the wall and looped up over itself. Looked like a roller coaster.

Once my surgeon "liberated it " (a French expression) I was free for about 2 yrs then it sort of returned but less violently...for now, I get a mild version of blockages for shorter periods of time...about 12 hrs and I can still drink fluids while I have them.

I know that my guts are not 'normal' since I have had all of the surgeries and that I will pay the price over time but I try to recognize the signs quickly and act accordingly. (clear fluids, hot soups, Gravol or other similar meds, walking, rolling or bouncing on a yoga ball and heating pads).

I would wait until your surgeon takes a peek at your exams to decide on the next step but keeping active and avoiding thickeners like mashed potatoes, chunky foods and excess fibers are good preventative measures.

Sharon

ps. I gave up codine...it stops my guts cold and starts my blockages 

It's been 18 years since I received  my pouch and drinking water  and exercise  like walking  got me through my blocks. Try to eat softer  diet will also work I was  told.

Ugh, I was hoping that I'd be free and clear once I get a year out (or so) from surgery. But based on what you all are saying, is that this might always be a problem? That sucks. I hope I didn't trade one problem for another. In the past year I was hospitalized 7 times (including my two surgeries). I was just hoping I'd be better in general and not have to deal with the extremes of this illness. 

I haven't added in much walking bc the weather here is only 15 degrees- way too cold. Considering buying a treadmill. 

I've heard hot water can be really good for the digestive system. My mother in law works in the medical field and swears by it for helping with digestion, etc. 

Been super tired since getting out of the hospital. I'm hoping that'll be gone within the week too. I'm averaging 9 hours of sleep and could still sleep longer (or go to bed right after dinner). 

I picked up a little trick that I have been using most of my life...a squeezed lemon in hot water in the morning before anything else...it gets the guts cleared out nicely and the pouch flowing (unless you do not want it to in which case, don't!)

I did it for a week straight and in spite of eating like, well, a tourist in a foreign country with an 'all inclusive ' gastronomic restaurant (never, never, never again...up 3lbs in 7 days!!!) I managed to not get a blockage, gain more than my luggage weighed or turn into a beach ball.

My pouch loved the morning routine...I even sucked on fresh oranges every morning without trouble.

Blockages are not a given even if you had one...they can be but not always. Do not panic.

You may just be dealing with swollen guts that are taking their sweet time to settle down.

Sharon 

I actually had lemon in hot water this afternoon and it helped curb my appetite. Why does lemon and orange make you go? The acidity? I love oranges and kind of miss having them! 

Lemon, orange and grapefruit (beware with beta blockers, pain meds, anticonvulsives and a few other categories or meds) are agrumes and contain a certain category of acids that actually turn alkaline in our bloodstream (don't ask, I still haven't figured it out yet!) ...lemons help us not to demineralize our bones, oranges can kickstart our vit C levels (along with other fruits) and grapefruit are just fun to eat...

They have the virtue of cutting our appetite, stimulating our bowels and hydrating us well...

So, I do not know why, but I do love them... 

Sharon

I have liver cysts 

If you ever block up again try using a heating pad and some grape juice I’m a long time blockage sufferer