Re: Partial Obstruction?

Hello,

2014 was a terrible year for me. I had major bowel surgery (jpouch reconstruction), almost lost my legs dues to surgical room incompetence (acute compartment syndrome in both legs) and now probably partial obstruction.

Two weeks ago I was feeling great and had a routine appointment with my surgeon. My surgeon did a rectal exam ( in order to ensure that I do not need a dilation). I was told everything was fine.

However, I went to lunch and that evening I starting having horrible pain. I was only able to pass very minute amounts of stool.I was unable to pass any gas / air from a seated position. I was only able to do so if I lied flat on my stomach. Pain was bad and I had mild nausea.

I endured this problem for 5 days and finally went to the emergency. I was dilated by the surgeon (for what I understand to be a stenosis) and he told me to come back if I see no improvement.

Well I was back 24 hours later at emergency as the pain was intensified to the point where I was extremely nauseated and still could only pass minute amounts of stool.

After 5 hours of waiting in pain, I was seen by the ER doctor who sent me for bloods and an X-Ray. Temperature was normal, bloods were normal, but X-Ray showed a blockage. I ended up getting an NG tube.

Around the time I started with the NG tube, I felt the pressure inside release considerably. I was finally able to pass more stool and gas, although I was still in pain.

10 hours later, I was finally seen by the surgeon who dilated me and he told not to come back to the hospital unless I was vomiting, and that it had better be more than once (for the vomiting).

Fast forward to present day (3 days later) and I still get very bad (but brief) stomach / intestinal spasm following eating (usually about 20 minutes). It is still not easy to pass gas or stool. but easier then when I went to the ER.

Does anyone have any suggestion as to what I should do for my next step?

A good friend of mine had a bowel perforation due to obstruction and NEVER vomited. I think the surgeon who saw me is quite arrogant. (the surgeon who operated on me is away on vacation and the secretary is quite mean, so no help there).

Any advice would be greatly appreciated.

Thanks in advance.

Solomin

3/9/1511:09 PM

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Jan DollarModerator, RN, retired

Gee, what a bunch of jerks (I am thinking of something else, but can't post it here)! most of us abhor going to the ER, but being basically admonished for wasting their time is certainly unexpected. Obstructions often clear on their own without specific treatment, but that does not mean it is wrong to go to the ER when you have escalating symptoms.

Sometimes I wonder why some people enter the field of medicine. Sort of like people who hate children and become school teachers! Good thing there are more good guys than bad guys...

It can take a week or two for the swelling and irritable gut to simmer down. Until you are feeling back to normal, stick with the fiet that worked for you during your early post op period. Take it easy and you should be feeling better soon.

Jan

3/10/1512:45 AM

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SolominMember

Hi Jan,

Thank you for the advice. I am also experiencing a continual urge to have a bowel movement but almost nothing comes out. On top of that, I am extremely itchy on the anus / exit point, and it is preventing me from falling asleep. Could I have some form of pouchitis too?

3/10/151:00 AM

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Jan DollarModerator, RN, retired

Sounds like you could have pouchitis. Maybe an anal stricture too. Do you have any antibiotics? You may want to call or email your doc.

Jan

3/10/155:24 PM

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Ric in TXMember

My sigmoid colon was removed along with the rectum, leaving the sphincter intact and somewhat functional (in June 2010), I had radiation and chemo.

Since my ileostomy reversal in January 2011, I have struggled EVERY DAY to eliminate. I can’t move the stool along unless I administer multiple enemas with a bulb rectal syringe. I would say that 80% of the bathroom trips result in nothing out (except for translucent, wormlike objects which may be parasites. I had a test for parasites that was negative).

When I’m successful, I get small amounts, very fragmented, but soft to medium -firm. Water, only in the amount injected by the enema, comes out.

Stool is always present, or very near the anus, and I always feel a blockage there. I can bear down, but the ‘blockage’ keeps the stool from moving until the enemas loosen the fragments. Even after pushing out fragments repeatedly, I still feel like I’m not finished.

I’ve been thinking – could the jpouch have a fold or prolapse that is essentially an obstruction? Have I allowed an impaction to establish and grow for four years because of it? The colon seems to do its job of removing water from the stool – but mucous to lubricate the anal canal seems lacking. What is a dilation? Might that give me some relief?

Has anyone here had similar experiences?

3/13/153:48 AM

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SolominMember

Hi Ric,

Dilation is basically stretching of the muscles to allow for an opening. There are risks involved with dilation - you can become incontinent (too much stretching) and you can get a perforation (low risk of happening).

Some people have used for BOTOX for this problem. It relaxes the muscles but it is not permanent as it can last anywhere from 3-6 months. This way one does not experience permanent incontinence.

As for the parasites -is it possible that the results (negative) were not correct and there was an error? I would try with a different lab.

You also might benefit from exercises. There are specific exercises one can do to assist with emptying (although I do not remember the specific name). You can search the site to get the name of these exercises.

You can also have an anal stenosis which is causing difficulty too.(http://www.listentoyourgut.com...-and-strictures.html)

Thanks,

Solomin

3/13/157:35 AM

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