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Hi all,

I was diagnosed with Crohn's in March last year which led to an ileostomy for 6 months (due to being on steroids, malnourished, having an abscess, and my bowel had decided it was on its way out anyway!).

Since the reversal surgery I have, on a few occasions experienced the most extreme pain I have ever felt in my life (worse than before the initial surgery). The pain seems to come on with no warning and at this point the only pattern I can find is that it always happens in the middle of the night, sometimes I vomit and sometimes I don't. On one occasion I called a doctor who sent me to A & E with ? Appendicitis (even though I told him before hand that I didn't have an appendix!) the hospital (after preparing me for surgery) filled me with painkillers and discharged me the next day.

On the last occasion I took 100mg of tramadol and had vomited about 20 times!
I have called my consultant who says he needs to see me when this happens but he only works mon-fri 9-5 kind of hours.
I have had an MRI and the only thing they said was possible stricture or possible adhesions and they won't do anything unless my bowel completely obstructs. Needless to say I am getting pretty fed up with it and wondered if anyone else had experienced anything similar and had any ideas of a cause or remedy??

Thanks
 
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Hi.

I've had a lot of obstruction issues. They are terrible. I've had a few surgeries because of obstructions. All Ican suggest is going on a zero fiber, low residue diet. Keep a food and symptom journal. If you do get blocked (distended hard abdomen, unable to keep anything down, lack of bowel sounds) go to the A & E. You can get dehydrated very easily.

Obstructions are an emergency and need to be taken very seriously.
 
Hi Pinky, sorry you are going through this. The extreme degree of pain and sickness you describe is something I have had with the blockage(s) I am currently dealing with. Are you able to pass anything when you feel like this?

They really shouldn't leave you in this state. Your consultant can still meet with you to discuss management options, even if you are not experiencing it at that minute.

I have been put on a low fibre diet which does help, but it doesn't remove the problem, so I will still have treatment. I hope you get the care you are entitled to.
 
Thanks muppetgirl,

Usually no but it's only temporary, the doctor doesn't seem to think that this is a problem as it's only for a short period.

The only thing the doctor has suggested is don't eat any juicy fruit with a skin eg. Oranges, have you got any better ideas?
 
Yes, low residue/fibre diet. I think the reason they are reluctant to do anything is that in the case of strictures they have a tendency to come back, the buggers. They get worse quite slowly so can be managed by diet until they need removing. The worse thing you can do for obstructive pain is take any sort of constipating pain meds. Have you queried about the possibility of dilation?
 
Hi Daisy,

I've asked for everything I can think of so far but will ask again and my next appointment.

Any suggestions on the best things to eat and not eat?
 
Basically a low residue is everything that is bad for you. I stick to chicken, rice, eggs, cheese, butter and soup. I was told about a double balloon Enteroscopy where they put you under GA, I think they can do it with sedation but would be too painful for me because of where the strictures are located. But my GI doesn't want to put me forward yet, I think,he needs visible proof of how much they are affecting me. But of course on low residue I maintain weight as it is so fatty and high calorie. It took four weeks for my last obstructive episode to clear. But I know when it is happening and stop all meds, go on fluids and try to walk as much as possible. I feel for you, I am distraught that I am stuck on strong pain meds, bland food and in constant pain. I think you need to ask for a CT scan, that is when my problems showed up. Xxx
 
My complete blockages and inability to pass anything have been temporary too, but I still have loads of problems in between and a worsening trend overall. If you define it as a problem then your doctor should hear that and be willing to think about options. The extremity of the pain of complete obstruction alone is not reasonable to expect human beings to go through repeatedly. They maybe something relatively conservative they can do, but they don't know unless they look into it. Personally my worry is having emergency surgery which would be a disaster for me.

I'm sorry, I can't believe they only told you to avoid juicy fruit with skins! Google low fibre diet sheet and there are loads which list things that are ok and things to avoid. As daisy says it's not the best nutritionally, so you should be on it only with medical supervision. The only fruit on mine is tinned peaches, melon & ripe banana. Bland I know. A lot of veggies are out too. And generally white over brown when it comes to carbs like bread & rice etc.

If you feel able, I would push for another appointment to discuss this. They can at least do a full workup & discuss conservative options in detail. How long ago was your reversal?
 
Hi Pinky,

My name is Sharon and in 2009 I WAS EXACTLY WHERE YOU ARE NOW! I was minimized and dismissed by countless doctors. I was told that I had a possible stricture and in time it would pass. I was told there wasn't anything wrong with me. I was given test after test and nobody could find anything significant. I could tell that doctors were starting to think that I was coming to the hospital because I liked the attention. That year I was admitted to the hospital 14 times. I learned so much about hospital culture. With my HMO plan, which was Kaiser, if you didn't have a regular appointment to see a doctor then you had to come to urgent care or the emergency room. I found out that many doctors at the ER are residents. Their expertise and skills are far more limited than you would expect to find in the ER. I also learned that when tests are performed on you, the results of those tests are subjective. What a doctor can figure out from varies greatly. Once, when I was in the hospital for a week, a doctor came in and gleefully said, "You're going home! How do you feel about that?" "Not good", I replied. "You haven't figured out what's wrong with me." "That's because there's nothing wrong with you." I said, "I can't eat! I'm going to starve to death!" I told him that I could feel that once the food left my stomach it just stopped. It felt as if it wasn't able to travel through my intestines. The doctor looked at my 204 pound body and giggled (YES, HE GIGGLED!) and said, "Believe me, you are not going to starve to death." And then he discharged me. Within 6 months I had lost 100 pounds, my hair was falling out, my teeth were moving in my mouth and the biggest part of my legs was my knees. I looked like a concentration camp victim. (I later found out that he was a resident. His job was to come in and assess me, report his findings to his attending doctor, then they were both supposed to come back in and examine me and when they left the attending would discuss me with the resident. This resident downplayed my condition so much that the attending doctor never even came in to see me! Since this was my first stay at the hospital I didn't know how things worked yet. I figured this all out over the following year.) Finally, I found a doctor who looked at all of my tests and saw something different than everyone else. He decided to operate on me. When he opened my up he said my insides looked like a frozen block of cement. There were so many adhesions literally strangling my intestines.

Pinky, I also had profuse and frequent vomiting. Even though I wasn't eating I was vomiting so much and so often that I had to walk around with a plastic trash can just in I wasn't able to make it to the toilet. This vomiting was the result of the build up of the pressure in my gut. I guess my body finally couldn't take it any longer and just tried to find some sort of release.

Pinky, I know everyone is suggesting to you to make another appointment with your doctor. What I'm telling you is GET ON THE PHONE AND INSIST ON SEEING A SPECIALIST IMMEDIATELY!!! KEEP GOING UNTIL YOU GET WHAT YOU WANT!!! KICK, SCREAM, CRY, DO WHATEVER IS NECESSARY TO GET SOMEONE WHO KNOWS WHAT THEY'RE DOING AND WHO'S BEEN DOING IT FOR A LONG TIME!!! INSIST ON SEEING AN EXPERT ON ADHESIONS AND STRICTURES!!! DO NOT TAKE NO FOR AN ANSWER!! By the time I found someone like that I was literally on death's door. Unless someone has experienced the agony of a blockage they have no idea the intense agony that comes with it. Mine got to where they would last for OVER 3 DAYS. I'M TALKING ABOUT 3 DAYS OF RELENTLESS AGONY THAT DIDN'T EVEN LET GO FOR 5 MINUTES. Then what followed would be 3 days of profuse vomiting even though there was nothing in my stomach. Then the final phase was 3 days of profuse diarrhea. Then the cycle would begin again. And there was no predicting what would cause it. Once I ate a big meal on Thanksgiving with no problem. About 4 days later I ate an orange which resulted in a 72 hour blockage. Once, and this really terrified me, I had such a severe blockage that water wouldn't go through.

Don't let them tell you that they won't do anything about it until you have a complete blockage. THAT'S ********! WHY SHOULD YOU HAVE TO BE IN SO MUCH PAIN BECAUSE THE DOCTORS' INEXPERIENCE AND LACK OF SKILL ONLY ALLOWS THEM TO SEE A POSSIBLE STRICTURE? **** THAT! And if you cannot get someone to listen to you see if you can find the office of the PATIENT ADVOCATE. I was helped so much when I felt like someone was on my side.

The other problem with having to wait is that, at least for me, a whole host of other problems began to show up as a result of not being treated for the adhesions. For one year of my life I was a walking nightmare! I won't go into the details but if you read it in a book you'd think it was too farfetched to be true. BE STRONG, PINKY! FIGHT FOR YOURSELF AND, IF YOU ARE TOO PHYSICALLY WEAK OR EMOTIONALLY WEAK TO DO IT YOURSELF, GET SOMEONE YOU LOVE AND TRUST TO DO IT FOR YOU! DON'T WAIT ANOTHER SECOND. YOU SHOULD NEVER HAVE TO SUFFER BECAUSE A DOCTOR IS TOO INEXPERIENCED OR THEIR EGO IS GETTING IN THE WAY. IF YOU'RE SHY AND THIS IS NOT IN YOUR NATURE THEN FIND YOUR LOUDEST, MOST OBNOXIOUS FRIEND OR FAMILY MEMBER TO DO IT FOR YOU. PLEASE PINKY, DO IT NOW!!! Sharon J.
 

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