regarding "emergency surgery" post on "Help Need Advice" Forum

Laurie-

You've left out some key details (e.g. how long ago was the last surgery), but I'll speculate on your behalf even though some of these ideas will make no sense in your actual circumstances.

1) The bowels often slow (or stop completely) after surgical manipulation. this can take a while to ease up. My gut was nonfunctional for 10 days post-op. YMMV.

2) If you are on strong pain meds, they are potent gut slowers. One more reason to wean off of them as you are reasonably able. The same is true for Imodium or Lomotil.

3) Sure you might have a stricture, though I'd guess it's less likely than some other explanations.

4) Your pouch just found itself in a very different (less compressed) environment. Some adjustment (by the pouch and by you) is likely necessary. Take plenty of time on the toilet to *gently* learn how your revised innards work.

5) I don't know what your current diet is, but I'd back off to liquids until I knew what was going on.

I hope some of this is helpful. Heck, I hope you're all better by the time you read this!

I agree. Since you are just weeks out from a very major resection, all sorts of things may be going on. Certainly could be a stricture, but it would likely be not at the anus. More likely to be at the site of the resection. If so, contrast imaging would likely show that. Could even be a motility issue or new adhesions. But, scoping can rule out something going on inside the pouch or nearby that is within the reach of the scope.

Jan

Thanks guys.  Yes, my surgery was only about 3 weeks ago.  I've been home about 12 days or so.  I am on pain killers, but have definitely been decreasing usage, while issues have gotten worse. Trying to get off, but I just got to the point where I lost the wound vac...so my incision isn't exactly healed.   I have to draw my knees up to chest to get anything to come out at all.  NEVER was the case before.  I am scared to death this is a change in environment that is NOT working.  I know it's early on, and I know I need to be patient.  It's just hard when it causes so much pain and feels so "wrong".

 Is what you're saying that scoping may not show anything, but would be a good thing to do to rule out things below.  He wants to do another scan, but I'm hesitant, as that to me is a much bigger deal.  I've had so many in the hospital and was so uncomfortable with the contrast.  I really do appreciate your support.  This is a tough time for me.  I find myself crying all the time, and scared to death they screwed me up inside.  I was fine one day and BAM...the next...not so much.  My kids need me to be back to myself and so do I!!!

I am sure you will resolve anything with the help of the surgeon. Maybe you just need to heal and in the meanwhile eat a very light liquid diet? 

Tough call. If you think that endoscopy is risk free and preferable to imaging, then you need to step back and rethink it. It is invasive and there is always a risk of perforation, so no doctor is willing to go there unless it is medically warranted. This is especially true when you are potentially not fully healed, and you have the history of bowel gangrene that you had. Contrast may be uncomfortable, but it is a lesser evil. Still, imaging has risks too. Just remember that your surgeon has gone through over a decade of education and training to be where he is (and that is before his experience after board certification). Bottom line, don't let your anxieties paralyze you from listening to your surgeon's advice. Of course, it important for your surgeon to listen to you too. This is why it is a tough call.

If it were me (and it isn't), I'd do the additional imaging, then see about a scope if necessary.

Jan