Blockages

In my experience with the j-pouch a blockage is not really painful. And I had a full mechanical blockage in the middle of the small intestine 6 years ago that requiered a surgery. It is that feeling that something is wrong because I can't have a BM as usual and of being bloated.

And even more a feeling of nausea which makes me be careful about eating and drinking only little. If the symptoms don't clear up quickly it is advisible to go to the hospital to get a NG tube (uncomfortable, but it protects the stomach).

But there is no considerable pain (the bowel has no nerves). Perhaps others have different experiences. I think you should find out if that heavy pain is really from the blockage itself.

Blockages can cause (permanent) dilation of the bowel. I don't know how much this affects digestive function. I have such dilated bowel loops, they always show up on MRI scans.

I made an appointment yesterday.

I'm sure an mri is in order.

One thing I will certainly disagree on you with is the pain a blockage causes.

I do understand there are no nerve endings in your intestines.

But when I have a blockage and gas can't even get through the pain is through the roof.

I can't explain that. But the pain is indescribable.

Richard.

Please do NOT TAKE LAXATIVES for a bowel obstruction!  This can cause bowel rupture which is life threatening and requires emergent surgical intervention.  Just exactly what you don't want.  

The longer the bowel stays blocked, the more oedematous (swollen) and dysfunctional it becomes thus worsening and prolonging the problem.  If you start vomiting with the blockage the problem can worsen again.  As the pain increases the sympathetic nervous system kicks in which serves to decrease bowel motility and thus (again) make the problem worse.

Once the blockage is relieved the bowel takes a little while to regain tone and being to function normally again.  From my experience as a j-pouch person and ileostomy person and registered nurse I would surmise that very frequent blockages could cause a big cumulative issue.  Small infrequent partial blockages probably not but I am not a colo-rectal or GI specialist.

It seems that you know what you need to do...SLOW DOWN.  Put your knife and fork down after each mouthful. Savour each bite.  Enjoy your meal.  Make dining an experience and not a chore.  Time yourself.  Make each meal last at least 30 minutes from first bit to last.

Again, I'm going to shout it to you one more time just for emphasis DO NOT TAKE LAXATIVES FOR A BOWEL OBSTRUCTION.  Thanks for listening to my rant.

I agree to be careful with laxatives. As they may not be able to fix a total blockage and just worsen your symptoms then.

If there is a partial blockage, you could stick to fluid nutrition for some days to clear it. Only if fluids can pass through of course. If you have to do physical work, high caloric drinks can provide some energy.

Regarding pain I am sorry you have to go through that. I was just thinking that a distended bowel could also exert pressure on other organs or cause adhersions to hurt. But a MRI scan should reveal that hopefully.

A blockage can already be diagnosed by an ultrasound scan. You may get an appointment for that earlier than for an MRI.

@Jaypea posted:

Please do NOT TAKE LAXATIVES for a bowel obstruction!  This can cause bowel rupture which is life threatening and requires emergent surgical intervention.  Just exactly what you don't want.  

The longer the bowel stays blocked, the more oedematous (swollen) and dysfunctional it becomes thus worsening and prolonging the problem.  If you start vomiting with the blockage the problem can worsen again.  As the pain increases the sympathetic nervous system kicks in which serves to decrease bowel motility and thus (again) make the problem worse.

Once the blockage is relieved the bowel takes a little while to regain tone and being to function normally again.  From my experience as a j-pouch person and ileostomy person and registered nurse I would surmise that very frequent blockages could cause a big cumulative issue.  Small infrequent partial blockages probably not but I am not a colo-rectal or GI specialist.

It seems that you know what you need to do...SLOW DOWN.  Put your knife and fork down after each mouthful. Savour each bite.  Enjoy your meal.  Make dining an experience and not a chore.  Time yourself.  Make each meal last at least 30 minutes from first bit to last.

Again, I'm going to shout it to you one more time just for emphasis DO NOT TAKE LAXATIVES FOR A BOWEL OBSTRUCTION.  Thanks for listening to my rant.

Thank you.

The reason I took Mirilax is because way back in the beginning.. (14-15)...i had blockages and in calling my surgeon she said to do it immediately so I was going by that advice. It worked everytime. But sounds like I may screw things up more. So I won't.

Like when I posted I made an appointment.

I'm sure an mri and scope are in order.

Yes. Eating.

I chopped my first meal to peices yesterday and chewed. Chewed. Chewed. I ate soup prior to that.

Long story short. It's too much to write.

Hospital is 30 miles away.

My gastro retired during my first surgery. Haven't had one until a referral this last Monday. Made appointment. He is in the town I live and by a hospital in town. So I will have somewhere to go. My surgeon took my after care. But I've had no problems since 16 or 17 and I've seen no one.

I had to get set up. Have to get set up again.

Someone to call. Somewhere to go.

P. S.

I was careful not to take alot of Mirilax. Just a little.

As for the pain. You say we have no nerves. But the pain from a blockage is so intense with contractions of the intestines trying to push it through. Almost unbearable.

I'm sure someone here that has had a total block can corroborate.

The pain is where the block is. I cannot explain why the pain is so intense with no nerve endings. But I do know our body has ways to tell us when we are in trouble. Pain is one.

I appreciate the advice and responses.

Thank you.

The more ammo I have when I do a sit down with a new gastro Dr the better. (I don't even own a firearm). Lol

Richard.

P. S. S.

Excuse me.

I haven't had my coffee yet. So I hope I didn't confuse anyone.

I am so sorry to hear that you’re going through this and can definitely say if it is that painful and getting repetitive you must get it checked out — although I understand that is far easier said than done.

I experienced blockages for several years back in my early years with the pouch, and the pain was excruciating, sometimes as bad as childbirth contractions. Neither my family or medical professionals could understand it and I think just kept underestimating the problem.

When I couldn’t get through a bout of it on my own (after 2-3 days of being curled up in a ball with ice chips and no food) I would need to be hospitalized for several days of intubation with an NG tube hooked up to a pump in reverse to relieve the pressure to resolve the blockage.

During the last of a handful of these hospitalizations, I went into cardiac arrest and woke up in ICU (no prior heart issues, due to the severity of my intestinal issues.) I likely only survived because i was already in the hospital. That’s when my GI surgeon visited me and said (finally) that this couldn’t go on and we should do an exploratory surgery. Her theory was that some complication of post surgical adhesions or scar tissue along with a post surgical abdominal hernia I had developed could be causing the problems.

After a complicated two-surgeon operation (with a GI surgeon for the bowel and a General Surgeon who specialized in complex hernia repair) I was finally free of the debilitating blockages. I’ve since had to have my j-pouch revised to a k-pouch and still only get what I would call normal, occasional, partial blocks I can quickly remedy on my own.

So this is my long way of saying/writing that you are not alone, I understand, and you should definitely take this seriously. It could be a sign of something developing that could get more problematic, or it might not (hopefully not,) but better to be proactive now. I hope you find a doc that also understands and that you get the help you need!

@JenJen posted:

I am so sorry to hear that you’re going through this and can definitely say if it is that painful and getting repetitive you must get it checked out — although I understand that is far easier said than done.

I experienced blockages for several years back in my early years with the pouch, and the pain was excruciating, sometimes as bad as childbirth contractions. Neither my family or medical professionals could understand it and I think just kept underestimating the problem.

When I couldn’t get through a bout of it on my own (after 2-3 days of being curled up in a ball with ice chips and no food) I would need to be hospitalized for several days of intubation with an NG tube hooked up to a pump in reverse to relieve the pressure to resolve the blockage.

During the last of a handful of these hospitalizations, I went into cardiac arrest and woke up in ICU (no prior heart issues, due to the severity of my intestinal issues.) I likely only survived because i was already in the hospital. That’s when my GI surgeon visited me and said (finally) that this couldn’t go on and we should do an exploratory surgery. Her theory was that some complication of post surgical adhesions or scar tissue along with a post surgical abdominal hernia I had developed could be causing the problems.

After a complicated two-surgeon operation (with a GI surgeon for the bowel and a General Surgeon who specialized in complex hernia repair) I was finally free of the debilitating blockages. I’ve since had to have my j-pouch revised to a k-pouch and still only get what I would call normal, occasional, partial blocks I can quickly remedy on my own.

So this is my long way of saying/writing that you are not alone, I understand, and you should definitely take this seriously. It could be a sign of something developing that could get more problematic, or it might not (hopefully not,) but better to be proactive now. I hope you find a doc that also understands and that you get the help you need!

All that is what scares me.

More surgery. Barely made it through my first three.

Trying now to get ahead of it.

Of course I'm a male

But some women have said the pain is as bad as that. It is bad.

Three days! Wow. That is long period. I think mine would have popped if it not have broke loose and went through.

My second blockage wasn't a blockage at all

They worked on me through my stoma for ten hours and said enough

Took me to surgery. It was a twisted bowel. That was an incredibly painful experience. After the surgery I just didn't want to be here anymore. That was my third surgery.

I never want my abdomen cut open ever again

I may have no choice at some point. I've had four surgeries. Three were abdomen

First one was lapro. Still not much better

Good grief. Just going so well for so many years. I may and hope I'm worried about nothin

I will find out. I do not want to mess up what I have. It works so well.

Richard

.

We have no nerve endings INSIDE the very thin layer of lining of the bowel but the GI tract is second only to the brain for the number of nerves which control it and nerve endings.  The pain is from the muscles trying to work to clear the obstruction, the swelling and stretching of the bowel itself, the hypoxia of the tissues if blood circulation is cut off to the bowel, fascia, or other surrounding organs from the pressure.  Our GI tract is a very sensitive character indeed.

I had lysis of adhesions about 5 years ago as I had many NG's and bowel obstructions.  It was not pleasant but I have an incredible surgeon and team.  Recovery was longer than I wanted it to be and complicated with an ileus (my bowel does not like to be manipulated) but I have not had a single obstruction since and I am happier and healthier than ever.

@Jaypea posted:

We have no nerve endings INSIDE the very thin layer of lining of the bowel but the GI tract is second only to the brain for the number of nerves which control it and nerve endings.  The pain is from the muscles trying to work to clear the obstruction, the swelling and stretching of the bowel itself, the hypoxia of the tissues if blood circulation is cut off to the bowel, fascia, or other surrounding organs from the pressure.  Our GI tract is a very sensitive character indeed.

That is part of what I needed to know.  Just part

Thank you.

The rest I'll find out through a gastro Dr probably a mri first

Second. If they don't see anything probably a scope. Never had my small intestine scoped through the stoma. Not worried about that. Plenty of scopes the other way. Lol.

Reason as I may have said. That I'm going through the process of getting a new gastro Dr is to ask questions and probably procedures.

I like everyone else here have been through so many Dr appointments and procedures. I just thought maybe I was done with all that. Apparently not.

Oh well. A lifetime of or decades and finally finding "my cure" I'm back looking for answers.

Just happy I've gone this long without problems.

I consider even now how fortunate I am.  And will be.

Positive thoughts. And being careful when eating.

Thanks. For listening to me ramble.

Richard.

Thanks all.

I'm still being careful.

Just a small update.

No biggie.

Still sore. I would only guess only four days out of the block it's still healing or shock. I am leaning toward shock only because it sounds better. Healing means damage.

Trying to be light about the situation while still being serious in paying attention to it.

Have a good day to anyone reading this.

Richard.

Hello!

I agree that blockages are horrible. Many of my blockages have occurred post op, but I did have a partial blockage a few years ago with my ileostomy. I don’t remember what I ate (which is surprising) but I guess I haven’t eaten it again! The only other advice I can give is to apply a heating pad. I think I read that somewhere online. Not sure if it helped or not but I will try anything to avoid the dreaded NG tube. I completely understand where you are coming from with the no more surgery thing. I personally feel like I have gone through enough poking and prodding and the inconvenience of an ileo should give me a pass for no more surgery. I know this is not reality unfortunately. I am glad you are getting it checked out because blockages can be scary. Best of luck to you!