Partial Bowel Obstruction

[AMLove]

I am newly diagnosed with Crohn's disease, but I've had it since I was a child. Recently, I was prescribed Prednisone for a month. During that time, my abdomen began to swell, and I was having more frequent episodes of cramping/diarrhea after a period of constipation. I mentioned it to the doctor several times over the course of a month. They asked if I could be pregnant and gave me a brochure on Thursday. The following Sunday I became violently ill. This time was different because I couldn't go to the bathroom with the waves of cramps (about 20min of severe pain with no poop). Finally, I vomited several times and then I was able to go to the bathroom. I couldn't get away from the bathroom to go to the hospital. I lost 5lbs that night.
I'm fairly certain it was a partial bowel obstruction. I don't think it's completely cleared. The area around my belly button is tender and my abdomen is still distended. My doc took 2 days to respond and then had me come in for a small bowel follow through this morning. Those results could take another 48hrs to receive. I'm exhausted, my WBC count is elevated, and I'm scared to eat. Would it be inappropriate for me to go to the ER before the severe pain started again? Once it starts, I can't really get there. Should I just wait on my GI? I'm a little irritated at him because I feel like he could have done something at the appt to prevent me from getting so sick. I kind of just want them to admit me to the hospital and fix it because I'm terrified of another bad episode, but I really don't know what to do with myself.

 

[ronroush7]

Do you have anyone who could drive you if you have another episode? I am sorry for what you have been through.

 

[Guerrero]

I'd stay in a liquit or semi liquid diet in the meantime. You can find liquid nutrition like ensure or modulen, you should be fine taking only liquids. When you got the results tell your doctors whats the plan (another course of prednisone or start a biologic etc...)
Wbc count could be elevated because of prednisone. Are you still taking it and which dose?

 

[shamrock15]

If you are partially obstructed there isn't a lot your GI can do at the moment. Options, based on my experiences, are bowel rest for about a week in hospital with anti inflammatories or surgery.

Heading to an ER without serious symptoms is just a waste of your money and their time. They will need to see something active and serious enough to act on, and that would like mean immediate admittance for surgery or the bowel rest. If you aren't actually obstructed I think they will just take your cash and show you the door.

Hope it resolves quickly for you.

 

[AMLove]

Thanks for the advice and encouragement, guys!
I've been so sleepy since Sunday.
My husband can take me to the ER if I get sick again, but I feel like I can't get away from the bathroom long enough even for the short drive. Even if I'm not actively going to the bathroom, it feels like I'm going to.
I got the results back today, and the radiologist said it was normal. I think he was really focused on the Crohn's in the terminal ileum and less on looking for a stricture or obstruction. He seemed hurried so I'm not super confident in his results.
They prescribed a new medication, but I haven't picked it up and can't recall the name. I'm scared to eat solid foods still.
I suppose I'll just anxiously wait until it happens again and try to make it to the ER. I have mild episodes like this all the time (probably weekly) so maybe I can make it to the hospital during a milder episode and get a more accurate diagnosis.

 

[ronroush7]

Best to you.

 

[Jabee]

Good grief. With symptoms like that he orders a small bowel follow through? Those things leave me constipated for weeks. The last time I had one the radiologist rushed right through. Like you, everything came back fine, but he was taking images so fast it made my head spin. I was in severe pain, too, and his only advice was to call my GI--which I'd already done. I hope you don't have any more "episodes" like this, but I'd really like to see your GI order an MRE or CT scan.

 

[AMLove]

I thought it was odd that he ordered a barium test since I was so distended. When I told him my stomach was really swollen this past Thursday, he asked if I tried Immodium, which made 0 sense to me.

 

[Guerrero]

Thanks for the advice and encouragement, guys!
I've been so sleepy since Sunday.
My husband can take me to the ER if I get sick again, but I feel like I can't get away from the bathroom long enough even for the short drive. Even if I'm not actively going to the bathroom, it feels like I'm going to.
I got the results back today, and the radiologist said it was normal. I think he was really focused on the Crohn's in the terminal ileum and less on looking for a stricture or obstruction. He seemed hurried so I'm not super confident in his results.
They prescribed a new medication, but I haven't picked it up and can't recall the name. I'm scared to eat solid foods still.
I suppose I'll just anxiously wait until it happens again and try to make it to the ER. I have mild episodes like this all the time (probably weekly) so maybe I can make it to the hospital during a milder episode and get a more accurate diagnosis.

mmm how could they not look for strictures??? was it an MRI? they must see a stricture with an MRI that's almost for sure.

If you dont have stricture, could you vomiting and nausea came from your stomach?
I had stomach issues after a prednisone therapy, have you been taking Proton Pump Inhibitors like omeprazole during this month you been on prednisone? it could easily have bothered your stomach and gave you nausea as it probably did to me...

 

[AMLove]

I am taking Omeprazole. The small bowel follow through is a barium xray series. I looked at some of the images, and I thought I saw a stricture (of course I'm not a trained radiologist). But I feel like the radiologist was rushed and the tech told him I had Crohn's so he was really focusing his attention on the terminal ileum.