Hey everyone, I welcome all advice on this....

 

Today, I was in hospital all day with a small bowel obstruction. Luckily I was released today without having to get a NG tube.  I kept having small BMs in the ER and I kept walking around the ER to get my bowels moving, which I guess worked.

 

April 2014 I had adhesion removal by a surgeon here at Beth Israel in Boston to help prevent future obstructions. This is my first one since that adhesion removal surgery.


Question: Would you stay the course if you were me? I've had a j-pouch since the year 2000.  I've had about 5 obstructions and hospital visits over those years.

 

If obstructions keep happening, which usually results in NG tube in the hospital for couple of days or even more adhesion removal surgery, what would you do?

 

If you were in my position, would you consider BCIR, Kpouch or Ileo ?

 

It seem sometimes I get severe IBS symptoms, which makes my stomach bloat severely, then that leads to an obstruction sometimes.

 

I welcome all advice....I'm feeling depressed, but grateful I got to come home today.

 

thanks, Tyler

Original Post

Ouch, I understand that horrible pain. Have you tried diet? I used to have terrible bloating and blockages and after going on the lowFODMAP diet  the problems completely cleared up.   I've posted quite a bit of information and links on the diet on the site. 

 

My pouch failed because of pouchitis and other problems. I'm currently in hospital in Cleveland covering from the K pouch surgery. To early for me to say if it was a good decision over having a permanent ileostomy, but so far I would say it is.

 Who is your doctor at BI?   

I absolutely would NOT consider a continent or end ileostomy as a solution to end obstructions. ANY further bowel manipulating surgery could result in more adhesions and even more obstructions. Unfortunately, once you are known to be an adhesion former, you always will be.

 

The only surgery I would consider is repeat lysis of adhesions when necessary. Even that should be a last resort.

 

You can try restricting very fibrous foods, and increasing fluids, but there is no guarantee that it would help that much (besides sticking with a liquid diet).

 

Some people use deep tissue massage to break up adhesions, but it seems scary to me.

 

Jan

Tyler,

I am so sorry...I understand the pain and the frustration of the obstructions but if they are adhesion related why would the k pouch change that?

It is one thing if the pouch is suffering from a narrowing somewhere or it is stretched or folded but if the adhesions are up higher in you small bowel then they would happen with the k pouch too.

I have a k pouch and had to have surgery last year because I had repeat partial obstructions and 3 major ones (I only went to ER once...The other times I rolled around on a Pilates ball, walked, bent, stretched, twisted etc until it resolved within 24hr...that is my limit...after 24hrs it is strait to ER)...this is starting to happen more frequently to me and I need to be careful...

I have a surgeon who does every surgery through laporoscopy so we are trying to limit the danger of regrowth but they do come back...that should be your first move.

I am a k pouch fan, but not if the solution won't change the problem...talk to your surgeon first and see what he says...

Sharon

I have been in your spot. Had my j pouch for 32 years.
They took out scar tissue once. The Dr. From UC SF
Said they start growing back in two weeks. I have had
Over fifty blockages. Got one tonight. Don't eat meat
Or nuts. I use a hot water bottle ,lay upside down ,
Drink lots of water, massage it and take the meds.
I have found this to stop most of my blockages. Still
Go to ER sometimes. Have them give you morphine
And phinagin in ER. stops so no NG tube. Good luck. Gotta fill my bottle again

Just want to clarify I was in no way suggesting K pouch would be appropriate for your situation!  Guess I'm overly focused on myself, in hospital,  at this time.

 

but I am a big fan of diet  as a means to control blockages. I used to have spasms and blockages on weekly basis  until I change my diet. 

I have had my j pouch since 2007, I've since had 2 children one in 2012 and got a paralytic ileus and spent 10 days in the hospital and had my tube. I just had my second child last month and had emergency surgery 3 days later for bowel obstruction from scar tissue. Since then I have been in severe pain, I just had a second ct scan  and it looks the same as before surgery included the 8 cm bowel loop. I can barely stand the pain and I'm not sure what to do, I feel like something is wrong inside. Any suggestions? 

I had scar tissue cut out after 20 years. Now it's back. Another 13 years. So if your docs want to and you do take out the scar tissue. I might have mine done again. I have a new dr. Will meet him in 2 days. Good luck. Only thing it still grows back. Some people not as fast. Good luck!!

JLH posted:

Just want to clarify I was in no way suggesting K pouch would be appropriate for your situation!  Guess I'm overly focused on myself, in hospital,  at this time.

 

but I am a big fan of diet  as a means to control blockages. I used to have spasms and blockages on weekly basis  until I change my diet. 

Hi JLH, can i please ask what dietry requirements/restrictions seem to help you?

 

 The low fodmap  diet  eliminated bloating,  which in turn – – I think – – allowed better transit and digestion.  i’m not really certain what the process was with the diet. But it did work. It’s not an easy diet to adhere to and for that matter to even get onto in the beginning. There is quite a bit of information on this website and also links to a university in Australia.  Their app is indispensable.

It wasn’t until adhesions were remove, during the K pouch surgery, that I no longer had obstructions.  

 I wish you the best in getting an accurate diagnosis and solution. 

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