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16 replies

Questions about blockages....

M MonkeymeMember
Hi

I just wondered whether anyone could shed any light on this one...

I had a small bowel obstruction about two weeks ago, went to A&E and was admitted for 3 days, had x ray which showed distended small bowel (although the blockage site couldnt be pinpointed), surgeon I saw wasnt sure if it was a blockage with my pouch (im guessing inlet or outlet to J pouch)or due to an adhesion in small bowel...was discharged once i could tolerate soup, yoghurt etc..

My consultant has since done a rectal exam and said my pouch outlet is fine (no stricture...phew..)and im having a scope of my pouch next week..Im still only able to tolerate liquids and start to feel sick and a bit blocked up if I eat solids but have no pain as I didnt have when originally diagnosed with SBO just some bloating

So my question is...I thought bowel obstructions generally caused pain, is this what others have experienced ? Im confused as to what the heck is going on and why Im still not able to tolerate any solids a few weeks on and does the lack of pain indicate it may well be a pouch problem (inlet maybe)as opposed to an adhesion....

Many thanks for anyones input/ views...!!

MM
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C ChuckusMember
You may have a "twist" in the bowel or a narrowing of the bowel further up the line, causing you to "feel sick" and "blocked up" which may be caused due to any number of reasons. It could be adhesions pushing on the bowel, it could be a stricture (narrowing) of the bowel, it could be anything..

Sometimes it's hard to pinpoint the area of narrowing or stricture, but, if you can't tolerate solids, there is definitely something going on. I'd head to the doctor and tell them, make them figure it out. You shouldn't be that long without eating/tolerating solids. Just my $0.02
Mhg26Mhg26Member
I agree with others. Whenever I've had blockages, they have generally been quite painful and debilitating. Although sometimes I still have minor blockages where its a bit different. I can usually feel food as it moves through my small intestines and while it's often uncomfortable, it now generally passes on its own after anywhere from 15 mins to a few hours. Also, I'm close to 2 years out from my takedown.

You definitely need to stay alert to what your body is telling you. It can be tough sometimes to differentiate between a blockage and other issues, although it sounds like you're still dealing with problems caused by ahesions and probably not physical pouch issues. Pay attention to how hydrated you are and maybe use a food log to write down anything that's giving you trouble for now. It might help in the long term. But definitely keep good contact with your doctor as well.
K KiwiPoucherMember
Hi Monkey Me
Sorry you are having problems. I have on going problems with small bowel obstructions. Every time I am hospitalised as my bowel completely stops and X-Rays show extremely distended small bowel. This is to the extent that the last time the ED Dr came to give me my X-Ray results and said "the bad news is you definitely have an obstruction, but the good news is it is in your Colon rather than your small bowel which is far more dangerous". Her face was a picture when I told her I had no colon!! But it proved how distended it gets. In answer to your question I do not get awful pain with it, more an all over abdomen discomfort, complete nausea and dehydration. It is more of a chronic switching on and off of the intestine. As soon as it starts I know, nausea, difficultly swallowing, no pouch output.

I have previously had adhesions which produced exactly the same symptoms on and off. Surgery rectified it temporarily but it is back. This time I am out of options. Because of the complications I have had more surgery is not an option so I just exist on fluid and electrolytes.

Would be very interested to hear how you get on.
Good luck
M MonkeymeMember
Thanks all for your responses !very informative and interesting that most blockages seem to cause a fair amount of pain (tho kiwi poucher our experiences sound similar in some ways and sorry to hear that u suffer from blockages fairly frequently ).
Thanks for the advice Chuckus and Mhg26 I will keep a beady eye on things and have a chat with my gastroenterologist on Thursday during my scope if things haven't improved.

Kiwi poucher wow a distended small bowel mistaken for a colon ! I was quite surprised when I saw the x ray of mine in A&E and how inflated it looked....

I feel like it's been a bit of a steep learning curve having this blockage out the blue....I was hoping that my chance of getting adhesions (assuming that is what has caused the blockage )would be less having laparoscopic surgery but apparently not in my case !

Kiwi poucher how long does it usually take before u get back onto solids after a blockage or does it vary with blockages ?

For those that have experienced blockages how long do you leave it until you go to A & E ?tho I was advised to go to A & E by gastro on call as I didn't really have any pain and wasn't vomiting (tho felt icky ) in hindsight I probably could have self managed at home...just wondered what others have done ?

Thanks to mysticobra Chuckus catja mhg26 and kiwi poucher for sharing ure experiences much appreciated

Will keep u posted kiwi poucher ref findings of scope

MM
K KiwiPoucherMember
HI MM
I had a single stage laparoscopic procedure which is meant to minimise the chances of adhesions/blockages, but sadly there was a leak which resulted in sepsis, so ended up with an ileostomy after all. Infection increases the chances of adhesions and my previous ones were growing from the ileostomy site on my bowel.

There is a saying "never let the sun set on a small bowel obstruction". I tend to manage mine at home. Mine is not so much related to what I eat and even if my bowel is empty I can feel the second it stops working. I then stop eating completely and drink lots of electrolytes until it passes. I usually end up having to go to hospital when I become dehydrated or if the distension gets too much. I say this though with the benefit (if you can call it a benefit) of having had post operative ileus 3 times in the last couple of years and many obstructions so I know when bad is really bad. I have a great gastroenterologist and together we have worked out a plan of what point I need to stop trying to treat myself and go to ED.

Would say that you should always go to ED if you are blocked until you and your Gastro are happy and confident that you know the point that you need to get help.

A tip you might like to try is to lie on your stomach and put a pillow under your pelvis so your pouch lifts upwards. It is the only way I can get air out of my bowel when it is obstructed. Sounds awful, but I do this and just wait and hope that something comes out. Always wear big knickers and a pad as it is inevitable that once things start to move so do all the fluids. But it is such a relief when it does.

Hope this helps
Caroline
R RLCMember
Monkeyme -
I am just getting over my first obstruction and it was just like you. Originally was told gallstones by my primary doctor. Went to ER three days later as I was projectile vomiting (which was different for me). Once there the surgical resident had said I want to do a couple more tests, CT scan w/barium and that is what showed obstruction. Wasn't in any pain so they gave me an IV for days and then fluids, puree and then solids. Once they gave me puree I had another blockage and was sent for a small bowel scan and they saw lots of distention. I was able to pass gas (at times) but not go completely. I ended up staying in the hospital for 12 days but had lots of gas pain. I walked a great deal in hospital. When I got home I had another vomiting spell and I phoned my surgeon and told him I will stay on liquids for days. That day is when I had extreme pain where it was hard for me to stand. I believe that is when my system finally opened up and started to cooperate.
I hope this helps but I am hoping I will never have to go through this again.
Can't we just catch a break?!
Roberta
clz81clz81Member
Even though pain is usually one of the number one signs, there doesn't have to be pain. The first time I had an obstruction, I was in the hospital for a week. Looking at my x-rays the doctors were amazed I wasn't in any pain. Other than horrible nausea and vomiting and not going to the bathroom for days, that was it for my symptoms. However, my second obstruction was entirely different. This one was very painful, and nothing like the first one. I was only in the hospital for 2 days with this one, and I recovered much quicker.
M MonkeymeMember
RLC Roberta hope you are feeling better after your blockage sounds like you've had a really rough time of it ..poor you 12 days in hospital too !! Hope your small bowel is behaving now (as if our large bowel didn't give us enough grief !!)I agree we should be cut some slack after all we've been through and I feel like this whole blockage episode has knocked my usually very robust and positive spirit a little bit..kind of unnerved me a bit...Really hope you are feeling better Roberta and have managed to advanced onto solids ! Take care...

Clz81
Thanks for your helpful post....I asked my gastro a few days back about how long it can take to recover from a blockage and get back onto solids as I'm 3 weeks on and still can't tolerate solids...he said that wasn't unusual..certainly doesn't sound unusual too from your experience....

Had my pouch scoped . Smiler ..inlet and outlet fine and pouch looks good (phew )hence SBO likely culprit so MRI in a few days...

Thanks all for your input Smiler

Take care

MM
M Maddie07Member

I just had my first SBO a month ago. Since then my gut feels tender. It's like every time I eat I can feel the food moving through my small intestine. I was wondering if obstructions can be caused by food/just diet or are they caused by adhesions? I'm worried about this because I've had my pouch for 7 years without any issues. Does this become a chronic thing? I can't go through losing my quality of life again, I won't survive it. 

AW Angie WilsonMember

I wrote to you on your other post.  Food/diet can certainly cause obstruction - one of mine was because I ate too much coconut - I figured that out afterwards.  Adhesions are definitely not the only thing that causes obstructions - food can do it.  There is no magic diet for the pouch - people will give you all sorts of advice, but I've found over the years that what works for one person does not work for another - it really is trial and error.  I used to eat tons of fruits and veggies as I wanted to be healthy - through the years I have made the choice to still eat them, but in smaller quantities - especially some fruits.  An apple a day was one of my mottos - but then I realized apples are really hard on me - even if I chew them like crazy.  So, I will have a quarter of an apple or something.  Just trial and error. I decided not having all that pain in my GI was worth more than whatever I was losing regarding nutrition.  I think, if I could go back and do it all over, I would have been more proactive in finding a nutritionist who specialized in GI issues and would have tried to figure out a better diet plan.  Back then, it was like, "surgery went great - off you go" and I did.  Well, how ridiculous is that?  I went through a lot of suffering in terms of GI pain and discomfort through the years when perhaps had I slowed down and gotten some help, I could have managed the pouch better.  I was very young and very determined and I just pushed on through and then really broke down at age 45 - looking back, I would have gotten more help.  I would have found a way to get a job that was less stressful, etc. - that's my two cents.  Don't panic about adhesions.  If you ever do have to have them removed, as I did once years later due to another surgery - he just cleaned it all up in there while he was doing something else - that was a great upside of going through those surgeries.  And, I think they have better stuff (I am no a medical person - others will know what it is) now they put in there to help restrict the growth of so many adhesions.  Hang in there!!

Scott FScott FMember

Maddie, I have to respectfully disagree with Angie, but only in a small way. Food alone (eaten within reason) will not obstruct a pristine gut. OTOH, we've all had abdominal surgery, and most of us have some adhesions as a result. Most of those adhesions cause us no problems, some cause occasional problems, and occasional ones cause frequent problems. If you get slightly blocked from an adhesion, the food you eat will tend to pile on, causing pain as the gut tries to push it through. I agree with almost everything Angie wrote about trial and error, though I think we *sometimes* blame a specific food when it just happened to be eaten at a vulnerable time.

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