Bowel obstruction experiences and advice?

I have an ileostomy and was told by the surgeon never to allow anyone to irrigate or give me any sort of an enema through my stoma. He also said never to take any sort of laxative as it could blow my intestines apart.

As for obstructions, I get them 2-3 times a year and have been in and out of the ER too many times. For the most part, I know that after I eat the giant bag of popcorn at the movies with the extra butter, I KNOW I'm gonna pay for it. For the most part, I avoid anything with a skin or peel it, then chew it really well. Nuts? Forget it...I don't even go there anymore. I stick to eating relatively soft foods to make sure things can flow easily to avoid the dreaded NG tube. However, there have been 2 occasions I have actually gone into the ER and said, "GIVE IT TO ME NOW!!!" Even reinserted it once MYSELF because when I told the nurse it was going to fall out, she didn't believe me. A good cue for me is when I start throwing up the blacky/greenish bile.

Lalu, you are not an idiot!!!

Irrigation is most definitely a colostomy thing. I irrigate every 48 hours as a normal routine. This gives me a much better sense of control. Coloplast makes a setup for irrigation and it fits in with their Sensura two-piece click series of bags. The setup consists of a graduated water bag with a hand controller and a soft rubber cone that is inserted into the stoma. I run about a liter of 38 degrees C water into the bowel. There is a sleeve that click connects to the base plate which is attached to you (also takes the bag range). That channels the output to the toilet pan.

Having said all that, it is imperative that intending irrigators discuss this with their stoma nurse or surgeon or even both.

You do not need to be excused for anything. It is all a big learning situation. We all had to start somewhere.

Doug

I've had an ileostomy for 30 years now, and for years I was plagued with bowel obstructions due to adhesions until I figured out what foods to eliminate from my diet and how to deal with the onset of an obstruction.

First, I slowly started eliminating the obvious roughage from my diet ... raw fruits and vegetables, including salads with "leathery" greens, such as spinach. It made a world of difference; however, I still sometimes get an obstruction on occasion, which usually starts out as a sharp pain in my gut right after I get up in the morning.

#1 - Do not eat anything else until the obstruction is cleared. Then, for several days, eat soft foods until your gut settles down. I find that I can go right back into an obstruction if I start eating anything but soft foods for a few days afterward.

#2 - If you feel you have an obstruction (pain in gut or no output) - try this. Drink right down a large glass of water that is as hot - or very warm - as you can stand it without burning your mouth/throat. Go lie down in bed immediately and begin to roll side to side and onto your back every 5-10 minutes. If that fails, I drink one more glass of hot water and repeat the rolling routine. I have saved myself dozens of trips to the ER for the dreaded NG tube and a hospital stay of several days. I try to adhere to a 12-hour rule, meaning that if the obstruction hasn't cleared in 12 hours, you need to head for the ER.

BTW - If I have to call in sick to work, I feel it's better to take a day to beat an obstruction than to maybe be out for a week or more in the hospital - let alone a surgery, to free an obstruction.

Cary

Thank you all for the info. In the past, I heard of irrigation only for colostomies, but wanted to check just to be sure.

Lalu

I also recently had an obstruction due to adhesions all over my abdomen. This is the second time in 6 months. Then I had a second surgery for an infection. I hope this does not happen often. It seems that this is how I heal. Do any of you have the same problem? Renee

I believe obstructions can be caused by adhesions and that for some reason, MDs really do seem to like to diagnose the cause of an obstruction as such. I know, however, from personal experience, that it most definitely can be related to food or dehydration. Almost every time I have had an obstruction, I can relate it back to what I had eaten (and had a sneaking suspicion that I may regret what I had just eaten) or that I hadn't been drinking enough fluids. The last 3 times it happened, it was quinoa, spaghetti squash, and shirataki or "miracle" noodles (so much for trying to be healthy and keep my girlish figure o)). If it gets bad enough, I go to the ER, tell them I have a bowel obstruction, need an IV and a CT. The last time, even knowing it could slow down my bowel activity, I took a Percocet before I went to the ER in hopes of staving off the pain intensity. It helped initially. Pain still came later but I think I am glad I took it and may take it again if it happens again. Also, the last time, they gave me enemas, which didn't seem to do anything, and I also walked the halls (walking has always helped to get things moving after surgeries) and later they gave me Miralax which did the trick. Maybe it was the combination of all 3 but I am very glad to know about Miralax (I always thought this type of med would plug me up even worse) and have some on hand in the event that, if I feel an obstruction coming on, I will take the Miralax early on.

As far as the oranges, I just had some this evening and, as gross as it may be (and I generally don't do it unless I am alone), I still get to enjoy the orange and the juice by chewing it and then discarding the skin. I don't do this often but when I am craving them, this is the only way I will eat an orange and other fruits (ex: grapes) otherwise, I don't eat them at all. I always peel apples before eating them. Take care everyone! o)

Thank you everyone for your response to my post. Even though I had it on "notify me," I haven't been getting the prompts that there were new messages. I pulled it up because tomorrow I meet with my surgeon and I took notes on what everyone said to run things past him. Regardless of what he says (and I love him as a good and gentle person), I believe the orange and nut binge along with the area of adhesion or scarring in my small bowel led to the obstruction. I haven't touched a nut since and haven't missed them at all. The oranges I threw out. A small price to pay to avoid the horror of obstruction and ER and, God forbid, NG tube. Although I concur with the person who said there are times when you beg for it...the throwing up of the black bile times.

Shudder, shudder.

I will post tomorrow and tell you what the good doctor says.

Hi all,

I met with the doctor today and discussed the entire episode of the obstruction. He seemed a little annoyed with me actually because, I think, I complained about going through the 8 hours in the ER. Like why do I have a private doctor? Whatever. I told him about what you guys do with the warm water and the irrigation. He said he had no problem with it but it depends where the blockage is. Mine was in the small intestine and it was clear from the CT that it was filling and filling and more mucus is made to try and move the bowel along. He thought I had a kink or an adhesion there. He defended himself and said he told them to "go slow" with me in the hopes it would clear without surgery. Which it did, thank God. I didn't even discuss the food issue since honestly, I think they are clueless and I believe my peeps who say "avoid oranges and nuts" and it is a small price to pay to not have an obstruction. Why give the kink another shot at making me more than miserable?

Thank you everybody for your words of wisdom.

Cee

I was in the hospital for about six weeks - 15 minutes before a small bowel exam, colostomy was working perfectly - minutes after they brought me back to my room, stoma stopped working and for nearly four weeks now it has not had any activity...(I am on intravenous fluids - 12 hours at night) - about four days ago, the mucous side of the stoma started working - I am praying that the stoma itself will start doing something - I finally found a stoma center and hope to get an appointment this week (all my doctors have 'written me off')!

I have had an ileostomy for 13 months. I hardly watch what I eat, I was just at the movies and had a succulent big basket of buttered popcorn. I do not eat oranges because of the excessive amount of fiber it contains. I eat nuts and apples with the skin, and I'm not sure I chew as well as I should. Am I a blockage waiting to happen? I have not had a blockage yet. I eat tomatoes, salsa, corn, chips, etc., and I love Mexican food, Italian, etc. After reading these posts, I'm thinking perhaps I need to start being careful with my diet.

I am in the hospital now. I didn't know anything about blockages but thought I just had the flu. Vomiting, weakness, and overall feeling awful? My husband insisted I go to the ER where they admitted me and put the NG tube in. YUCK! It has now been 4 days since I have had anything to eat and I'm praying I can get this tube out tomorrow. Why do the stoma nurses and our surgeons not educate us in this.