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New to the site and I just wanted to give some input on intestinal blockages due to scar tissue, foods to avoid, and ways that I have solved it. While I may seem to be rambling, I believe that every part of this could assist "someone".

Over the past 28 years with a j-pouch, I have been to the emergency room close to a dozen times with blockages. If you have ever had a blockage, you will know it. The first sign is a lack of bowel movements, a total lack of bowel movements. This is followed over a period of hours by cramping, severe cramping, blinding pain and vomiting of your "digested" matter down to the point of the blockage. This matter does not come from your stomach but from well beyond.

The first time this happened, the emergency room doctors and attending physicians freaked out and contacted my surgeon for emergency surgery, which was not necessary and displeased my previously sleeping surgeon greatly. After the first blockage was cleared, I was able to prevent future emergency room doctor freak outs.

Foods that have sent me to the emergency room include: popcorn, pineapple, corn, spinach, asparagus. (you should see a trend)

Ways to try to solve the problem prior to an emergency room visit: warm apple or prune juice and Amrix have worked for me. The fact is that I have not been to the emergency room since discovering Amrix 10 years ago. Finally accepting that indigestible foods or foods that can clump like seaweed are not good for me also helped.

If you are unfortunate enough to experience a blockage, I can tell you how it went every single time. You will finally be willing to go to the emergency room when you begin vomiting feces. It will always be after midnight when you finally accept that you can't seem to wish the problem away. On the doctor's 1-10 scale of pain, it is a clear 10. The "good" news is that you will not be spending time in the waiting room due to violent vomiting. I was ALWAYS given a 50mg shot of demerol upon entry. (The next hour will always be the worst.) It did not help. I was then taken for x-rays (while I tried to be a good sport about it while curled in the fetal position) that ALWAYS showed a blockage. The emergency room doctors will not provide a second demerol shot for an hour and that second shot ALWAYS resulted in the seized intestines reclaiming their ability to function correctly. (The worst part for me was the knowledge that the second shot would fix the problem and knowing that no one would give me a second shot for at least an hour.) Several minutes after the second shot of demerol, I would get up and go to the bathroom and evacuate what seemed to be gallons of water. This tremendous diarrhea would repeat about every three to five minutes for at least a half hour. At that point the doctors would release me.

Post blockage: Your abdomen will be distended and extremely tender for about a week and I always had to wear pants at least two inches wider in the waist during that time.

I have a document in my computer with all of this information that I have only had to use once. I handed it to the doctor on entry. While every thing I wrote came true, it did not change the behavior of any doctor. It did reduce their fear factor, however.

I have avoided the emergency room for ten years despite my body's tendencies by finally accepting that there are foods I can not eat. My back up is having 15mg Amrix pills (30mg knocked me on my butt for 30 hours). I am not promoting the use of a specific drug as any skeletal muscle relaxant may work. I have only had to take it four times in the past 10 years. If this helps anyone, it was worth my time.
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I think it is fair here to mention that MOST blockages are NOT caused by food. 90% of blockages are caused by strictures or kinks due to scar tissue and adhesions.

I eat popcorn, fruits, salads and on and on. The only real blockage I had was over 10 years ago, and it was caused by a kink due to adhesions. Two days in the big house and they released me.

I am sorry you have a problem with foods. But others should not be afraid to eat and enjoy a wide variety of foods. Just chew your food well. I avoid carbonated drinks and certain beans, etc. I do this because I don't like dealing with the extra gas. They don't give me obstructions.
quote:
I think it is fair here to mention that MOST blockages are NOT caused by food. 90% of blockages are caused by strictures or kinks due to scar tissue and adhesions.


Yes,this is true but I think somewhat misleading after all it is rare to get an obstruction *after* eating tomato soup, that would take a twist in the bowel which typically would need a sugical cure. Food itself is usually not the root cause of the obstruction but more often than not, IMO it is the triggering factor.

One thing I have noticed is that it is very important to drink a lot with your meals to help avoid blockage issues
Thank you for the responses. The first sentence of my comment specifically mentioned "scar tissue", which are "adhesions". This was not meant to claim that every blockage has the same cause or that every result will be the same. Not everyone is willing to jump back into having additional surgeries after numerous prior surgeries. It is true that chewing your food will reduce the number of potential blockages. It is also true that certain foods can potentially cause a problem even if they are chewed. (I do understand that FOOD is not the actual problem and that it is the current state of the intestinal tract that allows for the ingestion of this food to result in the problem.) My post was meant only as a potential guide for people with specific issues that may not be addressed in detail as often as others. Many people can eat whatever they want but some can't. This post is for the latter group.
Thank you also for being "sorry" that I am having problems with some foods, however, I have to point out that the driving force behind my post was that I am NOT having problems anymore because I have, for myself, found a few potential solutions for such problems. They are non-surgical solutions. These solutions will not work for everyone but they may assist some whose causes do not fall into the "MOST BLOCKAGES ARE CAUSED BY "category.
Thanks for the heads-up for the solutions Harlean...I was not blockage prone but started having them after my surgeries in 2007. At first we thought that they were Ileus (the first ones probably were) but then I started getting them much further out from surgery and usually in the same spot.
Yup, I agree, it feels like you are vomitting from your colon (which in my case was removed in 1979!) but I was told that it just 'felt that way'...if they haven't ever felt a blockage, how in goodness name would they know?
I have only been to ER twice with a blockage...(and they turned out to be very expensive peanut butter bagles in the long run), the rest of the time I try to 'ride it out' at home and pray for devliverance.
What I did discover was that some physical activity helps. The first time my best friend drove me to the downtown ER about 20miles away...and hit every single speedbump along the way...we flew like Starsky & Hutch. That last bump must have done the job because I unblocked within minutes.
I had another in September, really bad too (are they ever good?)...it lasted 24hrs and I believe that I caused it by drinking a full can of carbonated soda too quickly. It hit me within seconds (like a donkey kick) and I was on the floor rolling into a ball...Stayed down for 15mins and couldn't straiten up for hours.
I think that I bounced it out by using a yoga ball...not sure, it may just have been a coincidence...either way, it worked and it released after 25hrs. I was extatic (and so relieved, I started work the next morning).
I have had my pouch since 79 and these blockages are new to me but there is really no rule that I can find...it must be adhesions, scar tissue or age or maybe just dumb luck.
Whatever works, works...I will try your solution if it ever happens again but I am not sure where I can find a nuro-muscular relaxant that is injectable (can't swallow anything during those blockages)
Hope that you never have to deal with them again either.
Sharon

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