For those of you who have/had bowel obstructions

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LMills
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Date Joined Apr 2008
Total Posts : 1753
   Posted 12/8/2008 2:20 PM (GMT -7)   
I was just wondering, since I've heard so many ER stories as a result of an obstruction, if you ever know that you have one, if you know what caused or is causing it, if it's inevitable in any Crohn's case, and how, if, you can prevent it? I'm trying my best to stay away from the hospital or surgeries rather, but I'm just wondering if being as careful as you possibly can still isn't enough?
20 years old, Diagnosed with moderate to severe Crohn's and Colitis in May of 2008.
Currently taking:
Prednisone(down to 10 mg), pentasa, bentyl as needed, prilosec, tandem plus, humira, and good probiotics
Surgery for ectopic pregnancy most likely the result of severe Crohn's inflammation in July of 2008.
http://weblog.xanga.com/harlequin_garret


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 12/8/2008 2:37 PM (GMT -7)   
I obstructed after a 20 year remission that was drug free. That is one reason I advocate for someone with Crohns to always take some kind of maintainence med. While I was busy getting on with my life, Crohns was still in there ticking away. I had inflammation that was occurring and healing and I didn't know about it, and the scar tissue built up until I completely obstructed. I forget the exact number, but I think there is something like a 75% chance that you will have to have surgery at some point. They prefer to hold off as long as possible if they can, but sometimes like in the case of my first resection, it was an emergency surgery. I think if you are careful with your diet and take some type of maintainence med at all times, you can help to put if off as long as possible. But Crohns is a chronic illness and no matter what we do sometimes it is just not enough. Hope that helps a little.
Been living with Crohn's Disease for 33 years.  Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium.  Resections in 2002 and 2005.  Also diagnosed with Fibromyalgia and Osteoarthritis. Currently my Crohns is in remission.


gachrons
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Date Joined Mar 2007
Total Posts : 4527
   Posted 12/8/2008 2:56 PM (GMT -7)   
Hi Good question The first one I didn't know it was followed by a abcess surgery 2 years ago in Nov. then at xmas of that year my first obstruction and DX of CD. Next xmas a obstruction and I was on pred. that continued to Jan and ended with resection .For me it was a pain that just got worse as the day went on and finally incontinent in my sleep. At that point I was in bad shape and had gone for medical help 2 or 3 times before, took awhile to be told what was going on .I know better now I been threw it but there are so many other things a person hasn't expercienced so it makes it hard .The DR's here come and go so much that it is very discouraging and does not make for the best of help. As for pervention I follow a low residue diet because I like the idea of easy to digest. The meds weren't working for me so nothing was going to be enough I guess. lol gail
Hallarious woman over 50 ,CD ,IBS 27 years--resection,fistula's,obstructions,hemmies,and still alive.lol gail


spookyh
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Date Joined Oct 2008
Total Posts : 1342
   Posted 12/8/2008 3:17 PM (GMT -7)   
I know when I have an obstruction by the type of pain I get. It's kind of like contractions. You'll get pain, then it goes away, then 10 minutes later you get a pain, and then it goes away. The contractions eventually come closer and closer together and last longer each time. Usually, I end up in the hospital. I got lucky last time. My mom went to get dressed and get the car out, and when she came to get me, the contractions had miraculously stopped. Whatever couldn't get through my intestines had finally pushed past the narrow spot.

The usual culprit for my obstructions is food. One time it was a mango, another it was cucumbers.

I don't know that they're necessarily inevitable. If you're very careful with your diet, you might be able to avoid getting one. I started the SC diet a week ago in order to try to avoid more obstructions.

Obstructions also don't mean automatic surgery. I've had a few obstructions, but never had surgery. All I need is some pain/anti-nausea meds to get me through the first day, and then a couple days of bowel rest and a course of prednisone. They really wanted to do surgery last time, and I said no. Thank goodness! I had a full obstruction on a Wednesday night, and was released from the hospital Saturday morning. All I needed was a course of prednisone and a little bowel rest.

LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted 12/8/2008 4:07 PM (GMT -7)   
Nanners-When you were in that period of remission was it as if you had never been ill at all? And were you eating anything you liked? Not asked in a critical way...I would LOVE to have twenty years of remission even if just to be able to eat a few things still to build up bones and muscle...Also, what was your recovery process like?

Gail-Incontinence from an obstruction? Do you know the particular reason why like the pain and cramping or?...That sounds absolutely terrible..

And spookyhurst, I think I've gone through the same thing once. My mother made dinner with havari and tomatoes roasted on chicken and a salad with cinnamon pears and blue cheese so...I ate enough that it went through me in an hour. The salad anyway..but the entire night I was experiencing the WORST pain I have ever felt with Crohn's. I was ready to dig my stomach out with a blunt object or bang my head into the bathtub by the toilet...After many trips up and down and much crying though it stopped at about 7 or 8 am...so it must have gotten through.

I'm just so afraid of having that scar tissue build up. I wish there were a more definite way to prevent something like this...and it doesn't help that I'm really craving fruits and vegetables(my brother has me wanting a gyro really badly) and all I can eat is ensure. It's a battle of self control that's for sure, but with the insides bleeding again and the horrible BM pain I just wonder if it would be a cause for scar tissue build up if I DID eat.

In any case, THANK YOU for your answers!!! I have a great doctor but even with the best I still don't think I could get the best answer if I didn't ask here.
20 years old, Diagnosed with moderate to severe Crohn's and Colitis in May of 2008.
Currently taking:
Prednisone(down to 10 mg), pentasa, bentyl as needed, prilosec, tandem plus, humira, and good probiotics
Surgery for ectopic pregnancy most likely the result of severe Crohn's inflammation in July of 2008.
http://weblog.xanga.com/harlequin_garret


inflamed
Veteran Member


Date Joined Nov 2005
Total Posts : 1340
   Posted 12/8/2008 4:15 PM (GMT -7)   
I have the scarred ileum and have had a few bouts with obstructions. So far I've avoided surgery. I stick, pretty strictly, to a low residue diet - no raw veg/fruit, seeds, nuts, popcorn. I also avoid anything whole grain or high in fiber. I've learned to stay on maintenance meds too after one short failed experiment.
Hoping to stay in remission after the birth of a healthy baby girl. On Pentasa during my pregnancy, went med-free 2 months to nurse (stupid), but back on Pentasa and still nursing.


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted Yesterday 8:13 AM (GMT -7)   
Yes LMills my 20 year remission was pretty much symptom free Crohnswise at least. I used to have some joint and back pain, but at the time I didn't know that was part of Crohns. I am not the only one on this board to experience a remission that long, CrohnieToo also enjoyed a 20 year remission. She and I have similar types of Crohns (more stricturing type) which is usually a milder form of Crohns. But let me tell you that emergency surgery was a wake call for me. It taught me to take better care of myself. I stopped smoking and started eating a much healthier diet. I also live on a low residue diet. As gachrons likes to say "easy to chew, easy to digest". That works well for me too.
Been living with Crohn's Disease for 33 years.  Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium.  Resections in 2002 and 2005.  Also diagnosed with Fibromyalgia and Osteoarthritis. Currently my Crohns is in remission.


LMills
Veteran Member


Date Joined Apr 2008
Total Posts : 1753
   Posted Yesterday 2:22 PM (GMT -7)   
Nanners-were there a lot of major changes you noticed after that surgery? Did your Crohn's get a lot worse or are you still getting things back on the mend??? Glad to hear you were able to stop smoking...I had a brief stint with it but ultimately stopped when things began to run amok in my gut.
20 years old, Diagnosed with moderate to severe Crohn's and Colitis in May of 2008.
Currently taking:
Prednisone(down to 10 mg), pentasa, bentyl as needed, prilosec, tandem plus, humira, and good probiotics
Surgery for ectopic pregnancy most likely the result of severe Crohn's inflammation in July of 2008.
http://weblog.xanga.com/harlequin_garret


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted Yesterday 2:45 PM (GMT -7)   
Not alot of changes after the first surgery, but definetly after the second. I have to stay on a low residue diet at all times now. I can no longer eat red meat because it causes obstructive type episodes when I do. I find also that foods affect me differently than the used too. Alot of things I can no longer eat at all. But in general I usually do pretty well, except of course, this current flare up that just started. I will say though that the Crohns part for the most part is better, I still flare less frequently than most. Hope that helps.
Been living with Crohn's Disease for 33 years.  Currently on Asacol, Prilosec, Estrace, Prinivil, Diltiazem, Percoset prn for pain, Zofran, Phenergan, Probiotics, and Calcium.  Resections in 2002 and 2005.  Also diagnosed with Fibromyalgia and Osteoarthritis. Currently my Crohns is in remission.


MikeB
Veteran Member


Date Joined Mar 2006
Total Posts : 1169
   Posted Yesterday 3:20 PM (GMT -7)   
I have come to the conclusion that some of us are prone to obstructive disease and some simply may not be, just as some get repeated fistulas and some never do. It may be something to do with an increased tendency to scar, since the obstructions requiring surgery seem to be largely from scarring. And Nanners if correct - just because you may not have obviously active disease, it can be smoldering in thetre somewhere, causing scarring over the long term. I think the percentage of Crohns patients who eventually need some form of surgery is closer to 85% traditionally, but I would bet is it trending lower, given the many new therapies that have been introduced in the past couple of decades. The bottom line is, as always, that every case is unique and everyone's likelihood of obstructing or needing surgery is dependent on a lot of factors -- severity and duration of disease, location, meds taken or not, diet, etc.

gachrons
Veteran Member


Date Joined Mar 2007
Total Posts : 4527
   Posted Yesterday 3:24 PM (GMT -7)   
Hi I had narrowing in the TI area and it wasn't going to get better not even with pred. Surgeon said the CD had made quite a mess and the small bowel had become larger then the big one in circumference. I had had IBS too for many years so didn't suspect it was crohn's. Was used to some 8 to 10 hours of bad pain. I also had the fistula and it was from small to large bowel and it was a biggie.I could see my tummy bulging and moving around but not much coming out.Always a good thing to keep a check on things when you have a lot of pain. lol gail
Hallarious woman over 50 ,CD ,IBS 27 years--resection,fistula's,obstructions,hemmies,and still alive.lol gail


spookyh
Veteran Member


Date Joined Oct 2008
Total Posts : 1342
   Posted Yesterday 10:59 PM (GMT -7)   
My dad (who's 61) was diagnosed when he was 20 or so. He had his first and only surgery at around 33. It was a major surgery, and there was actually a 50/50 chance of whether he would make it or not. I was only 4 years old, but I remember sitting on his lap asking all about the tubes and buttons on his wheelchair. Little did I know he was saying goodbye, just in case. Anyhoo, he was given no meds until his mid-40's, not even prednisone. He had a lot of crohn's problems when I was growing up, including occasional obstructions, but it's a wonder he has never had to have a second surgery.

hspenser
Veteran Member


Date Joined Dec 2005
Total Posts : 544
   Posted Today 6:51 AM (GMT -7)   
Iwas dx'd with crohns sveral years ago but I am sure it was active for most of my life....just one of those shadow illnesses that lightly brushes you from time to time and makes you wonder what is going on....it wasn't until I was in my 40's that it really came on full blast....and in my mind (and in my dr's mind as well) it was mostly active in the large intestine.  There was never any indication that it was in my small bowel.
 
In the last two or three years there were a few times when I felt "backed up" and had some very mild pain ....I really didn't give it much thought and even wondered if it was associated with the crohns.  i did not mention it to my doctor.  Then in April of this year (2008) it was the morning of our sons wedding and I was performing the ceremony....the night before my wife and i had catered the rehersal dinner for 70 people in our own home and i did most of the work (cooking and presentation).  I was under lots of stress so i ate very little and drank almost no alcohol.  The morning of I woke up hungry as heck and ate a big breakfast....by noon of that day I was feeling terrible....for the next 4 hours I was thought I was going to die or that my stomach would rupture.  I was nausea...and constanly had the feeling that I needed to go to the bathroom.  I had a fever and my sight was blurring.  I made it to the wedding and about 15 minutes before the ceremony...I was fine.  Good to go (and i did about an hour later)  I performed the ceremony, stayed for the entire reception, ate a little bit of food but mostly just sipped water.
 
I did not know until about two months ago what I had gone through.  I really thought i had food poisining.  It never occured to me that it was my crohns, leats of all a blockage.  then it happened again and again...each time i would be in lots of pain and with about 4 hours it would pass and i would be fine.  I finally called my doctor and told him what was up (I also posted the symptoms on here and with in a few hours many folks here had me dx'd with a blockage....this is what really got me to call my doctor)
I went in to the see the doc (in late september) and told him i thought i had a blockage....based on what he knew about my medical history as it pertained to the crohns he was very surprised that I would think this...he said he dobted it, but asked why I thought so...so i described evrything, in cluding the high pitch sounds coming from my gut, the cramps above my belly button, the nausea, the vomitting of bile...he then agreed it was likely and he set up some tests....
 
before the first test I had an attack so severe I went to a local ER and was admitted for emergency surgery on a blockage (seen by a contrast Catscan)...by the next morning things had passed and they canceled the surgery and sent me home.  I live 50 miles from my gastro so he was only invloved by phone.  everyone agreed surgery is a last resort.
 
i did some tests and then I was scheduled for the pill cam on Novemebr 3rd.  November 2nd i had the mother of all attacks.  We called my doc and drove the 50 miles to his hospital.  Another scan showed a major block...emergency surgery scheduled...5 hours later just before going in...I get better.  So this time everyone agrees that i still need the surgery ...but they wait 36 hours so they can prep me with anti-b's and fluids.  They find almost 30 inches of hard, narrow affected small intestine and remove it.
 
The biggest lesson here for me is that the worst part of crohns is the silent part of crohns.  My doctor and the surgeon both think that this was something that had been festering for years...maybe a decade or two......while we were watching the large colon....we never suspected the small intestine was in bad trouble....
 
my answer to this is to have the pill cam done as often as possible or at least a barium contrast.....lesson learned for me.
 
BTW....the only change in my diet is that I cheww my food much better now and I have at leats one day a week where only eat liquids....no major solids....cream soups, teas, protien drinks.....that kind os stuff...
dx IBS 1999   UC 2000   CD 2001
Tested BIOGEN TYSABRI (gave me 2 years of remission)
tried Naltrexone Jan. 19, 2007 Stopped the Naltrexone July 28th...started Humira Aug 31st, 2007...current dose one shot every week. Also nightly dose of mesalamine.
Surgery Nov 4th, 2008 removed 30 inches of small bowel.
 Crohns is currently active and has been since April of 2005
52 yrs old

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