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Does anyone get abdominal blockages with a colostomy

Posted: Thu Apr 02, 2009 8:48 pm
Hi There
I am a 36 year old female married to a 39 year old man who has a colostomy after being diagnosed with colon cancer 5 years ago. Since he has had the colostomy he has ended up in the hospital with an abdominal blockage every year, 7-10 times a year. Its really hard to say what triggers it, could be stress, exhaustion, constipation, dehydration, eating something bad, etc, etc. We never know when it can happen and it comes on suddenly and very fast. He usually gets very sick and has to go to ER to get the IV and NG tube and spends the night or a few days. This has always been a very stressful thing for us and especially me, we have 2 young children and its getting harder and harder to cope with these episodes. I live in fear of them happening pretty much all the time. They mean all kinds of things, trouble traveling, cancelled plans, job worries due to sick days and all kinds of things.
I am wondering if anyone has a similar thing going on and if there is a way to prevent it.
Nurse
Posted: Fri Apr 03, 2009 2:06 pm
Hi Vik
Welcome to the forum. this has got to be very frustrating for the both of you and a huge disruption in your life. I think Sweede answered pretty well in another post, I'll put in my 2 cents worth:

Blockages post colostomy:  your husband should see a gastroenterologist or his colorectal surgeon and get a diagnositc work up.  Have they given you folks any thoughts or information as to why this is happening?  It would be important to find out if it is disease related, adhesions (scarring) from surgery, could be strictures (narrowing) in the intestine which could be from post radiation, adhesions or other process;  issues with motility; those would be most common.  If your spouse is taking opiate pain medication, that also may be an issue if not taking a stool softener or dietary means to soften the stool.

I'd be watching the stool consistancy and keep it on the loose side since there have been so many blockages.  Dietary (prune juice, etc. to soften, avoid high fiber foods, etc) or taking over the counter stool softeners would be a good idea until he can get proper studies done to find out why this is happening.

Another thought: is his stoma a "bud" that sticks out, or is it retracted below the skin line? The MD or  an ostomy nurse can check the stoma digitally to check if it is strictured  towards the opening.  Occasionally revisions need to be done if that is the case.  

I definetly suggest he see his surgeon or gastroenterologist for further studies to get a definitive answer.

I hope this helps, let us know how things go.
_________________
* Certified Wound and Ostomy Care Nurse
* Registered Nurse
* Bachelor of Science in Nursing
Posted: Fri Apr 03, 2009 9:03 pm
Hi
Thank you very much for answering, this is very helpful.
He has discussed it with his surgeon which is supposed to be one fo the leading ones in Canada and we did not really get any conclusive info, she said it may be due to scar tissue, there is some scar tissue in there but they don't consider it enough of an issue to to anything about it. Of course, more surgery is not an option, it terrifies us.
-no one ever said anything about strictures and we did not know to ask about it, will do so.
-there are issues with motility, we looked to IVF to have our 2 babies.
-He does not take any medication and does not take stool softeners on a regular basis at all. He only takes them if he feels he needs it because they give him a stomache ache as well. He never takes medication of any kind as some of them cause the blockages, IE, decongestant put him in the ER one time. One time it was cold medecine, he won't take anything, not even a tylenol.
-He will not do anything dietary to soften the stool. His method is essentially to ignore and deny until he is in the hospital. He does a avoid a lot of foods but does not eat anything special to promote softer stool. I beg him to drink water but of course, most days he does not drink enough.
-I don't think it is the stoma

The thing is the blockage is often a kink in the bowel and I think what causes it most often is stress and exhaustion, both mental and physical. It makes the blockages so very hard to control. The things that have put him in the hospital previously was stuff like

-job stress, working long hours and traveling.
-having a baby, he was in the hospital 2 days before the labour
-getting dehydrated after a gold game or going to the zoo
-the first year of our baby's life, being woken a lot at night
-moving houses, having to stay up late and pack

its really frustrating because he is this strong looking, young guy and people just don't know and forget his limitations. So does he. Everyone including him thinks its no problem to help someone move for instance and then the next day, hospital.
When we moved he had to do some of the physical labour himself and then the next day hospital and I had to do the move by myself.
This is where a lot of my stress and anxiety comes in, the fact that these life situations are difficult to predict and avoid and the consequences are always immediate.

Thank you so much for the advice. I am going to try to get him to see someone.
Nurse
Posted: Sat Apr 04, 2009 2:12 pm
VIK
It sounds like his surgeon does have an idea on the cause...and is handling it conservatively which sounds appropriate.  I have had other folks with this issue...some have had to be resolved surgically due to the pain and life interruption.  

My advice is the same:  it may help him to try to keep his stool on the soft/liquid side even though a colostomy; I have had people able to avoid a surgery this way.  It may not help him, but certainly worth a try.  If he has kinks/narrowing in his intestines, high fiber or a bulkier stool  will be more difficult to pass through.

Motility: was speaking of intestinal!    

Stress : I'm wondering if it is him changing his diet or ignoring what foods may be problematic more than the stress itself.  

Sometimes doing everything for everyone, being a "workhorse" is a way to ignore your own thoughts and problems, and I wonder if your hubby does that?  It is obvious you love him and want him to be healthy; you expressed it very well here.  Could you have the same discussion (in a loving way!) of how you want him around, to take care of himself for you and the kids??  Let him know you care and want to help him stay healthy?
_________________
* Certified Wound and Ostomy Care Nurse
* Registered Nurse
* Bachelor of Science in Nursing
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