Frequent blockages post total colectomy help!

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clarabella
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Frequent blockages post total colectomy help!

Post by clarabella »

Hi,

My husband had a total colectomy 2 weeks ago for UC.

He is doing well, but recently had a blockage in his small intestine (extreme stomach pain accompanied by vomiting). We went to the ER and they fixed it and he was home the next day. Now tonight, 3 days later he feels like there is a blockage again. He is in pain, but is not nauseous or vomiting and feels like his small intestine is gurgling. Following the instruction from his nurse a few days ago he has stopped eating, had a bath and is drinking fluids and is waiting for it to pass on its own. Is there anything else he can do apart from going to the ER?

Are blockages common in the weeks following surgery?

Thanks for your help. It is much appreciated!

Clara



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skittc1976
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Re: Frequent blockages post total colectomy help!

Post by skittc1976 »

Hi,

I'm not sure it is common but you certainly need to make sure you are only eating foods that are advised for a while after the operation and also get lots of rest with no physical exertion.

I took a good few weeks before eating much to be honest but felt great after about 4 weeks and had started to walk further each day. After that, i took it a bit too far and started going out on a bike and also a bit of light jogging and subsequently had a bad blockage caused by twisted intestine which needed an emergency operation. The recovery from that surgery was alot more complicated and caused me a few adhesions which in turn then cause me alot of blockages. My experience with these is there isnt much you can do once the blockage starts other than what your husband is already doing and hopefully it will sort itself out. I'm surprised they are starting so soon after surgery so it would be best to speak to the surgeon about this and see whats causing it as it may turn into a longer term problem.

I'm sure other people on the forum have more experience than myself as i have only had 2 operations and am awaiting my third to remove the rectal stump.

Good luck.


Scott
(Diagnosed with UC 06/05/10. Started Prednisilone, Asacol. Another flare Dec '10, tried Aza & 6-MP but body would not accept. Total Colectomy & Temp Ileostomy performed 11/03/11)

clarabella
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Re: Frequent blockages post total colectomy help!

Post by clarabella »

Hi Scott,

Thank you for your reply.

My husband was able to work through it last night and around 3am it was resolved. He is still a bit sore today, but is resting.

It's been just over two weeks since his surgery so I know it's early days. It could have been something he ate. It has only occurred when he has been a home and not while he was in hospital. He is following a low residue diet (white breads, pasta, eggs, chicken, fish, mash, jelly, bananas etc). He has been walking (2 walks per day), not sure if that would contribute. I have heard adhesions can cause blockages. However, when he had the first blockage that resulted in a trip to the ER they took x-rays and found nothing.

He is a bit upset with the surgery as he expected that straight afterwards he would feel fantastic and would be able to eat and do whatever he wanted. He didn't take into account that it takes time to heal. He does feel good, just not when he has a blockage.

We are seeing his doctor in the next month so we will talk to him about this. Until then we will keep up his fluids and have small frequent meals. Is there anything else I can do?

Thanks,
Clara



Karencraig
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Re: Frequent blockages post total colectomy help!

Post by Karencraig »

Take care with fibre, as it doesn't break down. The bowel is a bit like a hosepipe, its been jiggled around during surgery, so will have kinks, or adhesions (scar tissue). Other tips for helping shift a blockage, full fat coke. Massage the area, usually around the stoma. Lie on the floor, and curl into fetal position and roll around on back. All can help a blockage move. Also he may be getting colicky pains, rather than a blockage, which is very painful. Warm peppermint cordial, or buscapan can help. I was prescribed both in hospital after my surgery.

BUT any blockage that lasts more than 24 hours or he starts being sick. Off to A&E. In my area GPs do referrals direct to the surgical triage ward, so worth checking on the procedure in your area with the stoma nurse. Can avoid a traumatic wait in A&E.

Glad its shifted.

Early days, recovery from being ill and not eating properly. Slow and steady, chew chew chew. (I'm rubbish at that!) There are recommendations of 6 small meals rather than 3 large. He may want to try that, as he builds up. Recuperation is VITAL now, He wont get this time back to sit back and rest, and enjoy little snacks!!!.


EX UC sufferer,surgery on 1 March 2012!!! Marvin (Stoma) became my life enhancer.

clarabella
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Re: Frequent blockages post total colectomy help!

Post by clarabella »

Hi Karen,

Thank you for your reply.

Thanks for the tips on removing a blockage. I didn't realise coke would help.

Yes, I have heard about fibre being bad. I talked to his stoma nurse and she thinks it could be the pasta I gave him for dinner. Today he has eaten small soft mushy meals (mash, yoghurt, jelly, eggs, custard, banana) and he is ok, his stoma keeps gurgling and he is a bit sore after last night's episode.

How do you know if the blockages are from adhesions? In the hospital they did an X-ray and said the small intestine looked fine. His Dr. said it appeared to be a food blockage. However, he's had two in the past week. Could they both be from food?

Oh I'll check with the nurses about getting refereed by the GP. Anything to avoid A&E. We were there last time on a Saturday night - oh what a crowd!

Really appreciate your help. It is so scary at the moment as we don't know how he should be feeling.

Thanks,
Clara



Karencraig
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Re: Frequent blockages post total colectomy help!

Post by Karencraig »

Non food blockages - Scar tissue causes the bowel to stick to other parts of the body, hence the name adhesions, so causing a kink in the bowel, or can twist on itself. Imagine pinching or twisting a hosepipe. So anything non food wise I imagine will show up. Yes they could both be caused by food, and that's what you want, they'll shift themselves. It will get easier, don't forget the bowel is having to start working properly again, you wouldn't be running on a leg two weeks after it being plastered.

Info off NHS site
"Diet
In the first few weeks after surgery, you'll usually be advised to follow a low-fibre diet. This is because having a high-fibre diet can increase the size of your stools, which can cause the bowel to become temporarily blocked. After around eight weeks, you'll usually be able to resume a normal diet. As you recover, you should try to eat a healthy, balanced diet that includes plenty of fresh fruit and vegetables – at least five portions a day – and wholegrains. If you decide to introduce new foods into your diet after surgery, try to introduce them slowly, at the rate of one type of food each meal. This will allow you to judge the effects of the food on your digestive system.
You may find it useful to keep a food diary so you can keep a record of the food you've eaten and how you feel afterwards. For example, you may find you experience diarrhoea after eating spicy foods, or after drinking alcohol or caffeinated drinks"

you might want to have a look at:
http://www.iasupport.org/about/publicat ... Gwod6KoLwQ


EX UC sufferer,surgery on 1 March 2012!!! Marvin (Stoma) became my life enhancer.

clarabella
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Re: Frequent blockages post total colectomy help!

Post by clarabella »

Hi Karen,

Thank you for your reply. It really does help!

True, my husband needs to remember it takes time to heal. That is hard for him and he keeps trying to push himself (and I keep stopping him).

Thanks for the link to the website regarding diet, I'll have a read. I've started a food diary and have introduced white bread today, we'll see how that goes. His stools are quite watery (not as bad when he was in hospital), but that is due to him drinking lots of water (3L) and not eating much solid foods. We are both scared of another blockage.

Also, he has lost a fair bit of weight since the surgery, around 7kg (going from 105kg to 98kg and he is a big build and over 6'2). Is it normal to lose weight after this? He hasn’t really eaten much the last couple of weeks.

Really appreciate your advice.

Thanks,
Clara



Karencraig
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Re: Frequent blockages post total colectomy help!

Post by Karencraig »

Jelly babies and marshmallows are great for thickening output, but not enough to block. Also carbs give a good thickener.
Might be worth speaking to GP, stoma nurse or dietician. I was prescribed build up drinks (complan) just after surgery to help put weight on.

Just a thought, has he been told to apply for prescription exemption? As he has a permanent ileostomy, will be entitled. Basically although the bags etc come from a supplier, you still have to claim for an exemption card, or he'll be charged for the prescriptions for the bags. But it also exempts him from all prescription charges. the GP surgery will have the forms. hubby signs his section, GP the 2nd section.


EX UC sufferer,surgery on 1 March 2012!!! Marvin (Stoma) became my life enhancer.

rogalin47
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Re: Frequent blockages post total colectomy help!

Post by rogalin47 »

It's still really early days and your hubbys small bowel still has a lot of healing to do. It usually takes at least 6-8 week's for everything to settle down. The bowel doesn't like being handled during surgery and can be quite temperamental in the weeks immediately afterwards. Stick to soft easily digestible foods and go easy on the fibre. Underground veg like carrots, potatoes, Swede etc is better than overground veg like cabbage, cauliflower and broccoli, and as Karen says......chew, chew, chew and then chew some more! Something I'm guilty of forgetting to do at times.

The pain from blockages is horrendous, for me the pain feels the same whether it's a food related blockage or bowel obstruction caused by adhesions or in my case, surgical mesh. If the stoma swells up or changes colour, if there's been no output for 24 hours or if there's vomiting then head to A&E pronto for medical advice and help

If you think it's definitely food related then full fat coke might help as Karen says, I know it's helped her in the past, as has massaging the tummy, also try a hot bath, hot clear fluids like peppermint tea and walking sometimes helps move things along too.


21 years of evil UC over on 6th April 2013, welcome to Norman the stoma whose given me my life back!!

clarabella
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Re: Frequent blockages post total colectomy help!

Post by clarabella »

Hi Karen,

Oh I'll try the marshmallows and jelly babies. He loves sweets so that should cheer him up a bit. I've started giving him more carbs throughout the day today (2 pieces of plain white bread and 2 servings of homemade mash, not in the same meal). Hopefully I haven’t given him too much mash as I have recently heard this can cause a blockage. I'm going to talk to his nurse on Monday, they aren't there on the weekend.

As he was so big they didn't prescribe him any build up drinks after hospital. Do you need a prescription for complan? If not can I just get it from the supermarket?

Yes, he has been told about the prescription exemption. His stoma nurse discussed it with him last time. I think it's sorted. I will discuss this with her on Monday as well.

Thanks for your advice. It really helps. I feel like I've been going crazy the last week constantly worried about him and the blockages make it worse. Now I know more about what to feed him and how to cope with a blockage. The first time he had one I was convinced he was going to die!



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