I am 53 and had my J pouch since 1996. This week I have been experiencing painful cramping from what I now believe is an SBO. Going in for endoscopy and ileoscopy today. I'm a bit worried since this is the first issue I have had in 20 years. Reading these boards about strictures and adhesions... well that hasn't sounded real encouraging. 

Is this going to be my routine from now on? Can I expect more difficulty as I go forward? How do I avoid more SBOs in the future?

I'm new to this - having an issue with my J Pouch/small bowel. Any advice or insight is helpful. 

Original Post

 No replies in here... that's disappointing.

After and EGD and a ileoscope this morning there were no apparent reasons for what seems to be obstructions/adhesions in the small bowel. The next step is a lower GI/barium study of the entire  small bowel. 

After eating lunch today, an hour after I am cramping again as the food seems to have hit the snags in my small bowel. I'm still in the same place. 

Any suggestions for how to break these "blockages/slowdown" myself? Laxatives? Anything over the counter?

Yuthgi, your question was about the future, and no one can really predict that very well. A partial obstruction like this is most often caused by the bowel twisting or kinking around an adhesion. Once it gets fully unkinked it will act like it has for the last 20 years. The kink or tight turn narrows the path through the gut, and solid food can get backed up quite painfully (though the food generally doesn't cause the obstruction).  Liquids should cause you much less trouble. If it hasn't cleared up on its own by then, the barium sometimes unkinks the bowel. It's a heavy, thick liquid that seems to force the issue, even though that's not why it's given. 

Once the bowel unkinks you may never have a recurrence. Other folks seem to get them more commonly after their first. "Fixing" adhesions requires a careful cost/benefit assessment, since the surgery tends to create more adhesions. If they are very troublesome then the surgery becomes worth the risk of possibly making things worse.

I hope it clears up soon, and that you never have another problem like this.

I agree with Scott. Until this becomes a chronic problem, there is no way to predict whether it will become one. Also, there is probably nothing you did or didn't do to contribute to this. Just one of those things. If studies could find no evidence of obstruction, my guess is that this is temporary or something else.

Last year I could swear that I yad obstructive symptoms or gallbladder attacks. Investigations were negative. Turns out it was all pouchitis and maybe small intestine bacterial overgrowth (sibo). Antibiotics fully resolved it. But, I became antibiotic dependant and wound up on Remicade for the chronic pouchitis. Will this happen to you? I have no idea. Each case is different and what is true for one person is not necessarily true for anyone else.

The good news is that your doctor wants to get to the bottom of this. Good luck!

Jan

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