Partial Obstructions-How To Know When Not To Wait It Out

[LodgeLady]

Although my GI is having a hard time finding any strictures or intestinal narrowing, I am repeatedly having episodes of what I fear are partial blockage attacks. Out of nowhere I get extremely nauseous with sweating and the urgent need to vomit. I am overcome with abdominal pain. Sometimes I know exactly where the pain is located but sometimes not. These episodes are debilitating and I have to take Zofran and narcotics to get through them. I I abstain from food for 2 days ( liquid diet) then slowly increase with soft foods. It takes about 5 days to get back to normal. My question is how will I know when it's time to go to the ER instead of waiting it out? This last episode I almost made the decision but didn't go. I'm afraid I'm not going to be so lucky in the future. These episodes happen about 3 times/ year. Otherwise I'm treating Crohns symptoms with LDN which is working quite well.

 

[UnXmas]

If your episodes are happening only three times a year, why not go to the ER every time? If it meant you'd be turninng up every week you'd need to work out how to judge when it wasn't an emergency, but three times a year I think you should just go. Even if it doesn't need medical treatment, they can probably give you better painkillers, keep you hydrated, aspirate your stomach if necessary (that relieved my pain more than any painkiller when I'd had ileus and when I had my blockage) and hopefully keep you a lot more comfortable and shorten the duration of the episodes - and give you more peace of mind during the episodes as well. I know hospitals are awful places and even when you're sick you'd rather be sick at home, but with the symptoms you're getting I think hospital would be safer.

 

[LodgeLady]

I guess I'd rather try to get through it at home but am not sure at what point it might be life threatening? I really hate our local ER. At my next GI appt I'm going to ask if they can direct admit if needed because I would rather see them instead of the ER. But I'm thinking they are going to say go directly to the ER.

 

[The Real MC]

I have had regular abdominal cramps the last 18 months. I didn't go to ER every time because sometimes the cramps were from blockages, while most of the time they were from indigestion.

I learned to tell the difference, and my GI told me when to go to ER. If you're having a blockage, your abdomen will be inflamed and firm and there may be little flatulence. If indigestion, the abs will be soft and you will feel gas breaking.

The important thing is to stay hydrated. Those cramps drain you bad.

Sometimes I vomit and that is the end of it, sometimes not. Vomiting really dehydrates you, if you can't quench the dryness after vomiting then it is time to go.

In any event, my GI say to go to the ER if you have fever, chills, dizziness, nausea, pain does not let up after vomiting, dehydration, loss of appetite.

Half the time I went to ER, the IV fluids alone cleared the problem. No need for CT scan. On one occasion I developed a full blockage while at work and I had to leave on a gurney, the pain came on hard and fast. That landed me in the hospital for six days, five weeks recovering on disability.

I eventually learned what foods were triggering the indigestion and have cut them out of my diet. My cramps have been fewer and farther between, until I discover another food that triggers it.

 

[LodgeLady]

That is the hardest part. Trying to figure out what triggers it. I'm also paranoid when traveling since it is something I can't control or foresee. Last thing I want to be is in a hospital in the Virgin Islands ( yes I have a cruise booked for my 35 th anniversary)

 

[UnXmas]

I see the dilemma with traveling. In general, I think people should weigh up the positives and negatives: if you know your worries or your physical symptoms will mean the stress of travelling is not worth the pleasure you'll get from it, don't force yourself to go. But as these bad episodes are not common, you may find you put you fears aside once you're there. Just make sure you get good travel insurance (I'm not sure how that works for you in the US, here it can be hard to get cover for an existing condition).

But congratulations on your anniversary. A marriage that long I am sure you will find a way to celebrate, one way or the other.

Sometimes there are no specific triggers, but a soft, low fibre, low residue diet is probably the safest. Or even a liquid diet, though you must be careful you are getting the calories and nutrients you need if you decide to try that.

When I had ileus and when I had a small bowel blockage, I did get indicators that something was very wrong. With my post-surgery ileus (paralysis of the digestive tract, like a blockage but with no physical obstruction), I was already in hospital. My surgeon had got sick the day after he operated on me, so the doctors I had didn't know me, and I didn't vomit, which is a key sign of ileus, so they missed the diagnosis at first. I knew something was wrong because I was getting worse, not better in the days following surgery and having had many surgeries before, I knew this surgery was too minor to be causing me so much pain. With my small bowel blockage, my stoma stopped working, but I developed stomach pain which was different to the pain I'd experienced with partial stoma blockages before. I did all the things that helped when I'd had stoma blockages - had a hot drink, changed my body position, massaged my stoma - but nothing was helping, and I just knew I needed to get to hospital.

When you have pain, the symptoms which accompany it can indicate whether it's serious: fever is a bad sign; as is a hard, bloated stomach; severe vomiting; the inability to have a bowel movement; or severe, watery diarrhoea. Pain that is constant is more likely to be serious than crampy pain. Also check for dehydration, which causes thirst, lightheadedness and dark urine or a low volume of urine.

So if you have new symptoms that you've not had before, or have symptoms which deteriorate no matter what you do to try and treat them, it could be serious. You should sense when something is very wrong.

 

[LodgeLady]

Ok sounds like I will know if it changes from these other painful sudden episodes. Here in the U.S. We can get preexisting travel insurance. I also am sure to get medical travel insurance to include medical air transportation. That is where the costs can really hit you. Thanks!

 

[DougUte]

I would go to the ER every time it happens. If you don't like your local ER, then go to next closest (Unless of course it is a unreasonable distance away.) 3 times a year is not unreasonable. When I have had obstructions the ER was my best friend, mainly because I was able to get an IV saline and get rehydrated while there.

 

[Gutsii]

I've had similar episodes in the past.

I have always been extremely exhausted when they have happened. Monitor the episodes and write down what you did the day after they happened.

This will be the best way to find out what triggers your body to react that way.