Need advice about partial obstruction

[Muppetgirl]

I hope it's okay for me to post here. I found you guys through searching for info on post bowel surgery complications and obstructions. I have advanced endometriosis which is widespread including invading my rectum and sigmoid colon. I've had multiple laparotomies and laparoscopies with repeated bowel surgery including a low anterior resection.

Recently I found myself experiencing intense and severe pain, which was totally out of this world (I found myself wondering how I was still conscious), accompanied by just as intense nausea and the inability to pass anything. After an hour or two it would resolve into D and ordinary cramp pains. This has now happened several times and the gaps in between are decreasing. In between I have loose stools or D, I get full after a few mouthfuls of food, sometimes pain with eating, and heartburn all the time. My surgeon and doctors think I have a blockage and it is probably caused by adhesions. However, they think its not complete as most of the time stuff can get through.

I was wondering if anyone has had a similar experience and what happened? Do partial obstructions often turn into complete ones or is that quite rare? This is something I am quite concerned about as I do not want emergency surgery. Do people recommend surgery for adhesion based obstructions? If it was managed conservatively was this enough or did you have problems later? Sorry for all the questions! I know you can't give definitive answers but I would just love to hear people advice / experiences as this is a new thing for me.

 

[DJW]

Hi and welcome.

Partial obstructions can become full obstructions very quickly. Personally I've gone from partial to perforated in under 48 hours. Unfortunately meds don't get rid of scare tissue.

You could go on a no fiber diet and get more nutrition from boost or ensure but I don't think its a long term solution.

 

[Crohns11]

Hello and welcome
I had a partial blockage ( localised illeus) which was very painfull I ended up in hospital. I spoke to my professor and he says they can clear them selves . I had a laperscopy in March to see if it was scar tissue causing the obstruction, which that was not the case, I have a narrowing of the bowel. I can go up to two weeks without a bowel movement, which causes me a lot of pain, I'm now waiting to see my professor to see what Is going to happen, as I really can't take much more of the pain.

 

[Muppetgirl]

Thank you both. It helps a lot to hear from those who have been there.

Dave - Do you mind me asking what happened in those 48hrs? Was it change in pain or other stuff too? I am not very good at going to hospital when I should. What surgery did they perform for your perforation?

I have been on a low fibre diet for the last few months. My colo-rectal surgeon wants me to stay on it while we work out what to do, but I am totally fed up of it.

Crohns11- Ouch! I'm sorry you're in so much pain. Is your blockage inside the bowel lumen then? Did he say how they clear themselves?

Sorry again for so many questions. I have always dealt with my ill health by arming myself with info, especially where surgery is involved.

 

[DJW]

Keep asking questions.

I had been admitted with a partial obstruction and given iv fluids. We were all hoping it would clear on its own. I woke up in the morning feeling awful. Running a fever. I was in the operating room later that day. Surgeon discovered my bowel perforated. While I was recovering I got a blood infection and ended up in the ICU. In total I was in 4-5 weeks. Recovery was agonizingly slow.

 

[DJW]

I'll add that during surgery the surgeon discovered my 20 year remission had come to an end. A total shocker.

 

[Kaevata]

It’s happened to me and sometime like you it would clear.
It is surprising how much pain some people tollerate and in May I thought my bowel sounds had stopped and then I got sick, sorry to say, you can sick up poo. :stinks:
I took myself to hospital sharpish.

They will not normally do surgery unless they have to, so don't wait for it go silent, the sooner you get to hospital the better.
I was blocked up and the first thing do is put you on a drip for hydration and give meds to relax the bowel and morphine for the pain and Nil by mouth except fluids.
I did lots of clock wise belly rubbing and patting, twisting, bending, walking and riding the lifts up and down the hospital drip in tow and bingo.

However this was sign my stricture had closed up again and so a month later I had a colonoscopy and balloon dilatation to open up the bowel stricture. I have had this done on the same stricture 5 times now and have saved the last 100cm of my bowel that I have left for the last 10 years! So I am still dodging the knife for now.

Put yourself on a very low residual diet right now, no red meats, cereals, nuts, fruit with skins pips and fibrous bits ie. Oranges or veg except for that which grows below ground, excluding onions. Eat sloppy foods and chew well, even get some Build Up drinks and go on a liquid diet if you already do the above.

Second speak to your consultant, I don't know why they would wait around for a full blockage to occur, ask about dilatation, are the adhesions within the bowel or external? I have always regarded them as external and strictures are simlar but internal.

Go to AE if it happens again at least you get all the tests done in one go.

Hope this helps. Good Luck

 

[Muppetgirl]

Dave - oh my, what a nightmare to go through. How are you now?

Kaevata - That must have been awful. Coming back up the wrong way is one of my fears

I really appreciate you guys sharing experiences and advice. How long does someone need to be on low firbre/residue before they need nutrition drinks? It's been a few months for me but I've not been told to supplement. I don't think I'm getting what I need, though I try to eat the allowed things like tinned peaches. It is also because I cannot tolerate eating much and have been losing weight.

I have been assuming that the adhesions would be on the outside of the bowel but I don't know for sure. I've certainly had adhesions there before. Would they be able to avoid another resection if this was the case? If it is this they could be anywhere along bowel as my last pelvic surgery left raw surfaces front to back and left to right.

I had been assuming the reason they were not too concerned was because it's partial, but it sounds like this is not generally this case. They tried to look with a colonoscopy using a paedeatric scope but it failed completely. I was in severe pain maybe 9.5/10 and in tears. And I am used to pain so I don't cry out over nothing. So they didn't get beyond sigmoid. It was pretty awful and left me feeling rubbish. I'm not sure it was the most sensible thing. :ybatty:

 

[DJW]

Still flaring. I start remicade soon. This flares been going on over 2.5 years. Ready for it to be done.

 

[Muppetgirl]

Sorry to hear that, that sucks. You've obviously had a lifetime of it and it is so hard when it has such a substaintial impact on your life. I don't know much about the medical treatment but I hope it helps.

I am feeling rubbish today. Difficult to get anything down and a lot of pain and D. I just feel really run down too, so I will definately try and find out about nutrition drinks. Thanks for the support.

 

[Kaevata]

Muppetgirl
My colonoscopy after my blockage was done under sedation as usual but it was stopped because I could not stand the pain. I am a complicated case and the Dr stopped it. He said I should have it done under GA and that was happy news to me, so that was done a month ago. Bit sore from manual manipulation as I was out of it and a dead weight and could not turn over etc but no more probs.

There is no length of time of being on a low residual diet; many of us maintain it most of the time. To help supplement your diet try some build up drinks, they are full of all you need and come in soups and milk shakes and you can nibble on what you fancy. It helps to give the bowel a rest but keeps you fed well. Sound like they could be very helpfull to you.

As for reverse poo, it really is not as bad as you would imagine, its sick with a faint odd odor but you really could not give a damn at the time as it makes you feel better.
Can’t help you on adhesions, I don’t know enough about them, sorry.

Hang in there, try the drinks, it might give you the break you need.

X

 

[Muppetgirl]

Thank you. I am new to obstructions so I appreciate the advice. I'm so glad they were sensible and went for GA for you. There is no way they will get me back in without, its GA or the highway!

I will try the drinks. Not sure whether to ask docs or just buy some, but I will get there.

 

[Kaevata]

You can buy comercial ones over the counter but the doctor might perscribe better ones. In the UK we have one called Build UP made by Nestle and it is used in hopitals here. About £3 for 4 sachets milk shakes and soups. Each a meal replacement. Just having a Vanilla one myself as I skipped dinner.