I have had an internal pouch for several years with few problems, but we are on vacation about 600 miles from my surgeon’s office and I need advice. We ate lunch out yesterday and I had spaghetti and a small Caesar salad. I ate only half the salad and tried to chew it well, I have had partial small salads before with no problems. About 3 hrs later started getting bad gas pains, but very little stool and very little gas released. I have been up all night. I tried water, simethicone, hot chocolate ( has helped in past for minor issues). Any suggestions?

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This sounds like an obstruction, hopefully partial. Stick to liquids rather than solids, and try to stay hydrated. Keep walking and moving if you can. These usually clear up on their own, but I f you start to vomit then you probably need an emergency room.

For sure don't eat.  Walk as much as you can.  Try different positions - lie on one side, lie on back with knees pulled up, tilt torso left and right, stand up straight, head to knees etc.  Hot clear beverages.  I found a hot bath helpful.   If you start vomiting  or the pain gets worse it is time to get medical help.

You guys were right, it was a bowel obstruction. What I didn’t tell you was that we are in vacation in Denver. We went to the ER at the U of Colorado Hospital. I was seen right away and after xrays they said it was an obstruction and may need surgery. They did a CT scan and put in an NG tube, gave me meds for nausea and pain. They transferred me to admit status, and moved me upstairs. They gave me a dose of Gastrograffin iodine contrast thru the NG tube and within about 2 hrs the floodgates “opened”. By the midnight XRay things had totally cleared. So spent until today getting fluids, starting clear liquids and moving to soft diet, and starting me back slowly on my Lomotil/Loperamide. So I am thankful no surgery. This was a 1st for me. I had my S pouch put in in Omaha in 2001 d/t UC. No problems. Was diagnosed with ovarian cancer in 2013 and had total hysterectomy and 4 rounds of chemo. The cancer surgery went in over the same incision, but I don’t think that probably had anything to do with it. I blame it on being on being a little dehydrated with our plane flight, and probably not making the best lunch choice the day we got here. I visited with my surgical RN and asked if she sees many of the internal pouches anymore. Granted, she was pretty young, but she said no. Primarily traditional, a lot of times d/t things not related to UC or Crohn’s. I am a hospital pharmacist and we see a lot of Entyvio and Remicade used now. 

Am back at our hotel resting up. We will be flying back home to Iowa as scheduled on Tuesday, will be doing some walking around the hotel today, and maybe a little Mall walking tomorrow, to get me in airport shape. Thanks for your help, Vickie

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