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6 replies

on going mechanical fault or blockage

S SalmakMember
Hello team

Ive been off the board for awhile. Apart from a few hits of pouchitis I have had my pouch for 14 months. Life is more predictable than when I had my colon.

Unfortunately this week I am having on going blockage / small bowel twists. I was hoping someone may have some words of wisdom for me.

On Tuesday morning (its now saturday afternoon in aus) I had terrible stomach pains at work. They subsided before lunch, which prompted me to eat some lunch. The pains came back strongly in the afternoon, and got worse over night.

I called my surgeon Wednesday morning who asked me to go to cabrini hospital. I arrived after lunch. I was put on a drip and observed.

My symptoms at the time included:

passing stomach cramps / pains. I would get these ever 4 or 5 minutes and would double over from the pain.

I would go to the toilet and nothing would come out even though I felt constipated and felt like I needed to go.

Tailbone pain / discomfort. This was very similar to the urge to go.

I had an xray which did not show an obstruction. This confused me because it certainly felt like one. My surgeon suggested it was a kink / fold in the small bowel.

I started passing small amounts of stool Thursday afternoon after some small liquid meals. I had a solid meal Thursday night, and had bad night with more cramps, pains, and discomfort. I would also get these passing cramps where my jpouch would empty liquid everytime it happened. It was impossible to hold and very unpleasant.

On Friday morning the surgeon recommended I drink 100m of this xray fluid which has a laxative effect. 40 minutes later I felt horrible, I was sitting on the toilet trying to vomit and empty my pouch and couldnt do either. I felt an surge and suddenly what felt like a golf ball (with a lot of stool behind it) fell out of my pouch. This was followed by many watery bms and general relief the stomach.

I had two solid meals that day (lunch and dinner) and felt great. I left shortly after dinner feeling sore but normal. I should note prior to leaving I had an xray which illustrated that the xray fluid I had drunken and reached my pouch.

At 1am that night (this morning - saturday) my cramps came back. I got continued urges to go to the bathroom where I passed small amounts of what I'm fairly certain was water..

Its now 3pm on saturday and I still have cramps and urges to go to the bathroom to pass small amounts of water. I just had a smoothie (the first thing I have eaten since late yesterday).

I spoke to my surgeon this morning to voice my concerns about having a bad night after thinking I was better. He didn't have a lot of suggestions - he still stands by his diagnosis of a fold or bend in the small bowel. He does not know why I am feeling bad again. I suggested coming back to the hospital, but he said they would not do anything proactive, I would just be under observation. I decided against going in, I feel much more happy at home.

So here I am still feeling crampy and sore with no appetite sitting at home. I am going to the batrhoom, I am passing virtually all the water I drink. All the solid food I ate yesterday seemed to eventually make it through me.

Has anyone got any other suggestions other then wait it out? Is that what I need to do? I dont want to miss anymore work or feel ill for longer than I need.

Sorry for the long post.
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Jan DollarJan DollarModerator, RN, retired
Not a whole lot you can do other than wait it out. I try to reduce my solid food intake while it sorts out, but it usually does not alter the resolution of these partial obstructions. The gas cramps are the worst, so I try to reduce gas causes too, like high fiber foods and no fiber supplements.

But, it is individual.

Jan Smiler
S SalmakMember
Thanks for your response Jan.

Whilst I don't post very often, each time I do you are usually one of the first responses. Have you considered any work with one of the bigger GI centres?

Re your response. Seems like we have to do a lot of waiting hey! Waiting between surgeries, waiting for pouchitis to sort itself out, waiting for the pouch to adapt, waiting for blockages to clear. If time = money, we are definitely in huge amounts of debt!

I'm eating soft foods at the moment. Seems to be going through me. Still have the occasional cramp though.
dgtracydgtracyMember
salmak, the issues you described sounds identical to what i went through. it seemed like every other weekend it would do this to me and i wound up in the ER and they always gave me a shot of dilauded to stop any pain which was always absolutely horrible. i would say i visited the ER 8 or 10 times and out of those 8 or 10 times 2 of them after the shot about an hour or 2 in my bowel just fixed itself, the other times my surgeon always did a scope to go in and look and had to navigate around a kink here and there. kinks were my problem, specifically my small intestine fell and wrapped around my j pouch constricting it. i currently have an ostomy and am due back january 26th to get reconnected.
skn69skn69Member
Salmak,
I just had laproscopic surgery 10 days ago for among other things a chronic blockage site.
In my case on the upper left side beside my original colostomy scar.
I started feeling 'backed up' the first few times and eventually felt like things were constantly 'sluggish' in that one spot. I had 3 or 4 major occlusions that resolved within 24hrs but were extremely painful and scary as can be.
I stuck to low residue foods, no sticky carbs at all, no skins (peeled and chewed well all fruits), and avoided all fiberous veggies (chew and spit out technique)...
Since my surgeon had to re-attach my k pouch which was down I mentioned the site and marked it with a pen.
He found a loop of bowel that had been stuck to the wall with adhesions and was wrapped up like a cocoon so that it could neither stretch nor push things through. It looked like a 'V' and I was amazed that things actually got through it at all!
In the early days I would massage the spot because it was close to the surface and try to 'push' things through but after a while a very liquidy soft diet was the only way to go.
It never showed on simple x-rays and honestly no one ever bothered to give me an upper G.I. test so it was ignored. Sometimes the old faithful tests are the best ones.
He considered that I was very lucky to have managed to avoid emergency surgery considering its condition.
My rule of thumb was (and this is personal and neither a rule nor a law) any occlusion that went beyond 24hrs required me to go to ER.
Yes, things hurt for about 3-5 days afterwards...it was all very sore.
If it comes back it should be attended to one way or the other.
Sharon

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