Obstruction leading to surgery?

[missy12886]

Hey all!

I just recently had a horrible trip to the ER, with what they told me was just a crohn's flare. I talked to my GI and he told me that i had some kind of blockage. I am not sure what kind (i can't remember). But i had every sypmtom of a blockage, but eventually went away. My GI told me that if i continue to have these symptoms, then i will have to have surgery.

I guess my questions are, how often do these have to occur before they do surgery? I thought that any kind of blockage would result in at least a hospital stay.

Does anyone konw what kind of blockage fixes itself like that?

I"m really concerned because my husband is deployed and we have 3 kids. I have an appt. to get another CT soon and then a follow up with my GI. Should i be worried? I've never had a blockage before. I just need to know, that if after having one, how often will it come back?

Thanks!

Melissa

 

[Jennifer]

If things died down then you may be dealing with a partial blockage for now but could at anytime turn into a full blockage. A full blockage would require surgery as they can be deadly.

If the blockage/stricture/narrowing is caused by inflammation then certain meds may help reduce the inflammation so things can pass. If its scar tissue though then no meds will help and you only have a few options.

One is stretching (but that depends on the severity, size and location and isn't permanent so not one of the best choices in my opinion), the other is a strictureplasty (the area is cut, pushed together and stitched up, again depends on the size and severity) and the last option is surgery/resection (where they remove the entire section and any other non salvageable sections and sew it back together).

Every case is different. Some people live with their partial blockages until surgery is required to save their life and some get scheduled for surgery because they know its not healing and will only get worse (that's why I had my resection). Keep in mind that resection does not mean you will have a bag for the rest of your life (depends on how much is removed, they took out 8 inches of my small and large intestine so I didn't need a bag).

How often it will occur is unknown. Eating anything that moves stool faster (like fiber for instance or anything you know gives you diarrhea) will make the area bottle neck and you'll have pain, nausea and vomiting and hopefully not a full blockage that winds up rupturing the lining of your intestines (that and cutting off blood flow can be deadly).

If you have surgery you should have someone available to watch your kids because you will be in the hospital for roughly 4-7 days (and that's just post op).

Good luck and keep us posted.

 

[missy12886]

Thanks a bunch for the info! So do partial blockages go away and just come back? or are there and you're just waiting for it to turn into a full? I'm on Humera every 15 days, which seemed to help with my symptoms until now of course. i'm eating everything i should/shouldn't be, so i really don't understand what went wrong. It's not preventable is it? I"m just sitting on pins and needles, becuase i can feel the pain almost like it's trying to come on full blown again, but doesn't. i'm just worried that it's going to happen again. The ER really didnt' do anything for me. I guess i'll put my family "on call" incase they have to come out here (i'm in WA and they're in VA). If the pain comes back, when does it ususally? sorry for all the questions, i'm just really paranoid about surgery.

 

[Jennifer]

Everyone is different so I can't give a definite answer about when it will come back. My guess is that it hasn't gone away. A partial blockage allows some things to pass. You may go through periods of inflammation rising and reducing making the opening smaller or larger. Either way its not fully open. So if the inflammation continues, then it may become far too small for anything to pass.

Keep in mind that repeated inflammation causes scar tissue so you're likely dealing with both inflammation and scar tissue. Eventually though if treatment doesn't work then all the bowel in that area will scar up and there wont be anymore good tissue which the meds would be able to help.

If you have horrible unbearable pain, are vomiting and/or have a high fever and basically feel like you have the worst stomach flu ever, then chances are its a full blockage and you'll need to go to the ER right away and may require emergency surgery.

For me, I didn't wait until I needed emergency surgery. If your GI is suggesting surgery then that may help you get back to a better quality of life. Its not a cure of course but for me it was better than all the pain and high doses of meds that weren't working to get it under control.

Keep your GI updated on all of your symptoms.

 

[missy12886]

Well, I had all those symptoms of the worst flu, minus the vomitting. I was extrememly nauscous (sp?) though. I had a small amount of diarrhea (sorry) and then from 4am sunday to about the end of the day tuesday, i didn't have a bm at all. My stomach was distended which my GI told me was probably a blockage. Well the er told me that because i had that TINY bit of diarrhea i did not have a blockage. My GI told me today over the phone, based on my symptoms, that i did infact have probably a partial because i am able to have bms now. I"m just so confused, i don't have an actual appointment with him until august 8, but he wants to do another CT to compare from the last one i did. When i was diagnosed he told me i was really severe. I had a colonoscopy done and even with the pediatric scope he couldn't get through the affected part of my intestines. He put me on humera and i had no symptoms until this past weekend. Thanks for the help. I just hope i can hold off the surger until at least January. But i guess we will see.

 

[Jennifer]

January? What? Why so late?

Yes with a partial blockage you can pass small amounts of stool. When's your next CT scan? Surely he'll do it before your appointment so you can go over the results.

Based on the results of the scan your appointment with him may be bumped up sooner.

 

[missy12886]

January because my huband will definitely be home then. I know i shouldn't wait, i guess i'll contact my family and see if someone could come out just in case. I Still have to schedule my CT scan. Hopefully they'll schedule it soon!

 

[missy12886]

Also, do blockages go away? Or am i just basically waiting for it to turn into a full blockage?

 

[Jennifer]

If its just caused by inflammation then yes it can from steroids or other meds that help reduce inflammation. If its scar tissue, then sorry no. If its a combination of both then its kind of a matter of "when" because the scar tissue wont go away and may still cause problems down the road even if the inflammation on top of it is treated. In that case its just more of an unknown.

 

[missy12886]

darn, i wanna say that my GI doc said i had some scar tissue building up from my original CT. My intestines were so inflammed that he couldn't even get past it with a pediatric scope during my colonoscopy. Thank you for your help!

 

[LivinglifewithCrohn's]

I have had Crohn's for over 20 years and had my first blockage this past memorial day weekend. I had a 3 day hospital stay. They were hoping it would resolve itself or else they would have had to have done surgery. From the CT they could see the blockage. They could also see the extreme narrowing in my small intestine. When I was in the hospital for the blockage my GI doc and also the colorectal surgeon paid me a visit and recommended surgery. My GI doc could not get through all the way the last time he did a scope, 8 months ago, but I was not in any pain or having symptoms of a flare up so no action was taken at that time. I had my surgery 6.26, 14 inches removed. The surgeon said it was a mess and it was a very good thing I proceeded with the surgery. Only so much can be seen via a CT or small bowel series (had that too when I was in the hospital for the blockage). When they actually go in they never know for sure what they are going to get. Best of luck to you. Regarding your husband, he should be able to take emergency leave if you have surgery. I was a dependent many years ago so maybe things have changed but I recall a friend having surgery stateside and her husband being able to return for that. If you have surgery there is no way you can manage 3 kids when you get home. You will be on pain meds and lifting restrictions. You will need help.