Blockage?

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 okay. 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 slept 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!

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 vegetables.

Hope this has helped and be careful with certain foods.

JAx

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 little generally that you'll feel deprived of, general rule, little and often, and not too late in the evening.
Take care QD,
Tippitop

If in the future this happens again, is it okay to take a mild laxative? Like Miralax or something like that?

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 laxative without asking your doctor.
Good luck honey and I hope you feel better! 3

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 offi 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 (#1416 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 3050 cc NS into the catheter using a bulb syringe.
Remove the catheter and allow for returns into the irrigation sleeve.
Repeat this procedure instilling 3050 ccs at a time until the
blockage is resolved. This can take 12 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

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 abscess. Thank goodness it was not an abscess. 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 doctors 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 little 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 bawled my eyes out. No fun