Med treatment or diet for partial obstruction?

[awmom]

My son was recently in Israel and called saying he had tremendous pain around his bellybutton area, had urgency to go to the bathroom but could only do so very, very little, and it was a clear yellow liquid (sorry for detailed description) This was happening at 30 minute intervals. So he stuck to liquids the following day (felt better)and then ate 1/2 cup oatmeal and the same symptoms started, plus he felt bloated. No nausea. We brought him back home last nite and all he has had has been peptamen. He is now having NO pain. Still has some urgency and can go just a little. I have put a call in to his doctor. His meds are currently remicade every 10 weeks.

My question is, can anything be done for this or should he just stick to a liquid diet for a week and then proceed slowly? Does it mean his treatment isn't working? what tests could I ask for (inflammatory markers, CT, MRI?). Will this resolve just on its own? or does it mean the disease is active and we need to review his medications? Could this have been just a flare even though he felt he was having an obstruction. He had a resection in 2012. I am worried because since diagnosed 4 years ago he has been unable to be at a healthy weight (age 19, 100 pounds) and is now probably way below that.

Thank you in advance for any help.

 

[Clash]

I would say yes to all the testing. It will give you a better indication of what may be occurring. Also a liquid diet may not be a bad idea until he can't get into his GI.

It may be that his remicade infusions are spaced to far apart or that the dose isn't enough or even that he may need to switch altogether. Those are things testing could tell you, including a trough level test.

My son is 18 and stays around 110 lbs so I understand the weight issue. There is nothing going on, that we can tell with his active CD but is is something that concerns me and something I push for testing with.

 

[awmom]

Hi Clash! Thanks for your response. He has an appointment with the GI tomorrow and had some blood work done today. Hopefully it will tell part of the story. In the meantime he is still on a liquid diet, though he barely got 4 cans in today and then slept the rest of the time. I dread seeing his weight tomorrow. and I dread the doc saying he has to go on steroids!

I know that you are also concerned about C's weight and it has been an uphill battle for you both. It seems to me that there must be something that someone is missing that keeps them from gaining or, in N's case, eating enough. Does Clash feel strong even though he is so slim? Does he have energy? Is he able to eat most foods and in teenage quantities? Is his doc concerned and are they working on his weight issue? Do you think the surgery helped him? I'm sorry I haven't kept up with the board, and you may have all of this posted already....please let me know and I will look!!!

 

[Clash]

I'm not sure where your son's disease is located but Dusty commented one time that those with small bowel disease can tend toward being underweight.

C waxes and wanes on having the normal teen boy appetitie. The only thing I can say he actively avoids is spicy foods but he always has since he was little. Otherwise, he eats any and all types of food. He doesn't have energy but he also has JSpA and due to his issues with that I feel he became deconditioned before treatment started working. We are still working to find out what his low weight is due to. His vitamin levels are all really good and he has had vertical growth. Part of the reason for surgery was hopes that he would start gainingafter but he hasn't.

 

[DustyKat]

Small bowel/Ileal disease does have the potential to have its own set of problems for some when disease is active, there is scarring or bowel has been resected. This then makes the weight loss, or failure to gain, issue quite complex as it has the ability to affect the absorption of carbohydrates and lipids, so the most efficient way for the body to gain weight is hindered. Sometimes it can be this alone that is the pathway to difficulty in gaining weight but it can also be compounded as the malabsorption of fats leads to irritation and diarrhoea.

Also bear in mind that once a carbohydrate and lipid malabsorption is present it will in turn affect the absorption of the fat soluble vitamins A,D,E and K.

I can say at our end that both of my kids weights are stable but neither really has an ounce to spare. They can eat copious amounts of food and have little to show for it.

The GI has never expressed a concern about their weight and neither have they. They both have no issues with energy and although they can sleep quite a bit I don’t feel it is out of the realm of the majority of teenagers/young adults.

In our case surgery has helped my children. Their disease was severity at the outset and surgery came hard and fast but they have both been in remission since, 8.5 and 4 years respectively. Surgery isn’t without it legacies as you would know but it has been the best of a bad bunch at our end.

Thinking of you awmom and hoping your lad is feeling better now that he is home, bless him. :heart:

Dusty. xxx