Could This Be an Ileostomy Blockage?

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Quietdreamer28
Feb 26, 2010 4:53 am
I'm a new ileostomate, not a new ostomate (had a colostomy since Oct 2008). I just had my surgery Feb 4th, things are going mostly ok. I hear the word blockage thrown around often enough and would like to know the symptoms. Last night I had some abdominal pressure and growliness with very little to no output. I took my temp last night because I couldn't stop shivering and it was 100.8F. I took some tylenol and went to bed. My fever broke before morning, but also came back when the tylenol wore off and that time it was 102.2F. I've never had a blockage before but I was convinced that had to be what was going on. I slet most of the day but also only took in liquids. It seems to have worked though, no fever and as the day went more output came and now my bag is filling up again as normal. I guess my question is does this sound like a blockage?? I'm pretty sure I know what I ate that caused it and I won't have that food again and honestly knew when I was eating the food that I probably shouldn't but well I was being STUPID HA! won't do that again, no fun!
Jax
Feb 26, 2010 9:51 am
Hi QD



It does sound like you were well on your way to having a blockage. Some foods do take longer to digest. The main symptoms of a blockage are : little or no output into your appliance and bad abdominal pain to what I have experienced anyway. You did do the right thing by just taking in water or fluids (clear I hope) and soft foods if any.



I had a massive blockage last year and nearly lost my life, so be very careful with some foods, like raw veges.



Hope this has helped and be careful with certain foods.



JAx





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tippitop
Feb 26, 2010 12:25 pm
Hi QD,

Jax is spot on there, that was a close shave. Her advice is bang on, try and remember what you ate the day before, and avoid in future!! Plus fibrous foods, leeks put me in hospital for 3 days!!

Don't be afraid though, just be aware!And chew really well and long if it's something you can't resist.We ostomates are supposed to avoid mushrooms but I love them, chew well and enjoy.

The treatment for imminent blockage is exactly as Jax described.There is very litle generally that you'll feel deprived of,general rule, little and often, and not too late in the evening.

Take care QD,

Tippitop

,
Quietdreamer28
Feb 26, 2010 4:48 pm
If in the future this happens again is it ok to take a mild laxitive?? Like Miralax or something like that??
Txgirl
Feb 26, 2010 6:57 pm
as long as there is no infection anywhere, that is exactly how I would feel when I would get a blockage.

Low residue diet and lots of water, I would be scared to do a laxitive without asking ur doc.

Godd luck honey and I hope you feel better! 3

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eddie
Feb 27, 2010 4:05 pm


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Information that helpped me on blockage from UOAA!

HOW TO TREAT ILEOSTOMY BLOCKAGE


Symptoms:
Thin, clear liquid output with foul odor; cramping

abdominal pain near the stoma; decrease in amount of or


dark-colored urine, abdominal and stomal swelling.




Step One: At Home


1. Cut the opening of your pouch a little larger than normal because


the stoma may swell.


2. If there is stomal output and you are not nauseated or vomiting,


only consume liquids such as Coke, sports drinks, or tea.


3. Take a warm bath to relax the abdominal muscles.


4. Try several different body positions, such as a knee-chest


position, as it might help move the blockage forward.


5. Massage the abdomen and the area around the stoma as this might


increase the pressure behind the blockage and help it to “pop


out.” Most food blockages occur just below the stoma.


Step Two: If you are still blocked, vomiting, or have no stomal


output for several hours:


1. Call your doctor or WOC/ET Nurse and report what is


happening and what you tried at home to alleviate the


problem. Your doctor or WOC/ET Nurse will give you instructions


(ex., meet at the emergency room, come to the of
fi ce). If you are

told to go to the emergency room, the doctor or WOC/ET Nurse


can call in orders for your care there.


2. If you cannot reach your WOC/ET Nurse or surgeon and


there is
no output from the stoma, go to the emergency

room immediately.


3.
IMPORTANT: TAKE THIS CARD WITH YOU TO THE EMERGENCY

ROOM AND GIVE IT TO THE PHYSICIAN.


4.
IMPORTANT: TAKE ALL OF YOUR POUCH SUPPLIES

(eg., pouch, wafer, tail closure, skin barrier spray, irrigation


sleeve, etc.)


United


Ostomy


Associations of


America, Inc.


United Ostomy Associations of America


P.O. Box 66


Fairview, TN 37062


800-826-0826, www.uoaa.org


EMERGENCY ROOM STAFF:


ILEOSTOMY OBSTRUCTION


Symptoms:
No stomal output; cramping abdominal pain; nausea

and vomiting; abdominal distention, stomal edema, absent or faint


bowel sounds.


1. Contact the patient's surgeon or WOC/ET Nurse to obtain history


and request orders.


2. Pain medication should be initiated as indicated.


3. Start IV
fl uids (Lactated Ringer's Solution/Normal Saline)

without delay.


4. Obtain
fl at abdominal x-ray or CT scan to rule out volvulus

and determine the site/cause of the obstruction. Check for local


blockage (peristomal hernia or stomal stenosis) via digital


manipulation of the stoma lumen.


5. Evaluate
fl uid and electrolyte balance via appropriate

laboratory studies.


6. If an
ileostomy lavage
is ordered, it should be performed by a

surgeon or ostomy nurse using the following guidelines:


• Gently insert a lubricated, gloved
fi nger into the lumen of the

stoma. If a blockage is palpated, attempt to gently break it up with


your
fi nger.

• Attach a colostomy irrigation sleeve to the patient's two-piece


pouching system. Many brands of pouching systems have


Tupperware®-like
fl anges onto which the same size diameter

irrigation sleeve can be attached. If the patient is not wearing


a two-piece system, remove the one-piece system and attach a


colostomy irrigation sleeve to an elastic belt and place it over


the stoma.


• Working through the top of the colostomy irrigation sleeve, insert


a lubricated catheter (#14–16 FR) into the lumen of the stoma


until the blockage is reached. Do not force the catheter.


Note: If it is possible to insert the catheter up to six inches, the

blockage is likely caused by adhesions rather than a food bolus.


• Slowly instill 30–50 cc NS into the catheter using a bulb syringe.


Remove the catheter and allow for returns into the irrigation sleeve.


Repeat this procedure instilling 30–50 ccs at a time until the


blockage is resolved. This can take 1–2 hours.


7. Once the blockage has been resolved, a clean, drainable


pouch system should be applied. Because the stoma may be


edematous, the opening in the pouch should be slightly larger




than the stoma.

GOOD LUCK EDDIE

Quietdreamer28
Mar 01, 2010 6:35 pm
My fever of 102 came back the next day and my output was not coming again. I contacted my GI nurse and I was told to go to the ER and I did. I got x-rays and a CT scan. They thought with such high fevers and me being so newly out of surgery that it could have been an abcess. Thank goodness it was not an abcess. It wasn't really a blockage either. I was really dehydrated and that simply caused my intestines to "fall asleep" aka stop moving things along. They said there are 2 things that can cause that to happen 1. infection (which I did not have) 2. an imbalance in electrolytes and being I was dehydrated I would feel safe my electrolytes were way off. They admitted me so I spent Fri evening- Sun Noon in the hospital. My belly is still growly and I don't think it is fully awake, but the Drs were confident enough to let me go home to keep recovering. This is really miserable and tiring. It feels like a million gas bubbles floating around inside me and I have no way to get them out and really wish I could. At least when my rectum was intact I could put a butt in the air and let some of the gas out haha, this way I try moving in many positions to maybe help the air along and it doesn't seem to work this time around. I have to go back to work March 10 so I'm a lil stressed out, ok A LOT stressed out. This whole month of Feb just wasn't pleasant to me. I know I'll learn to love my ileostomy but man if a thousand issues didn't come along with it. If I could just get rid of all the tag along problems I could really be a happy person. Only time will help with this all I am sure and it is all new, so positive thinking is what I must do and not lose hope/heart it's just soooooo hard. I had a complete breakdown Saturday night while in the hospital and just balled my eyes out. No fun

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