Do I have an obstruction or something?

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ngwen
Regular Member


Date Joined May 2007
Total Posts : 85
   Posted 10/15/2007 10:55 AM (GMT -7)   
I am working on my third week of pain. It started out the week before my period, sharp pains in the abdomen coming and going like contractions. By the end of that week I was nauseated and throwing up and blacking out. I was not able to eat for two days because of that. Then onto the next week, slightly nauseated and still with the pains pretty bad. I took Elavil to help me sleep through a lot of the night and I also take phenegran for the nausea when it is really bad. (it helps a little) I am in the third week and still the pains and the loud sounds of "stuff" having a hard time to get through my guts. All the while my doc suggested I up my pred (I am back up to 35 mg for almost a week now was down to 15mg) and start thinking about Remicade. I have not had a flare like this since before I started on pred. and no matter how much I have gone up it does not seem to help. Most of my journey I have been able to taper down to 15mg and then the pain starts up again now it is just not working and that worries me. I can't live on popcycles alone, but every time I eat solid foods it starts to kill me. I called my doc on Wednesday and he said if the pred does not work I should go to the ER. I keep waiting it out because I have been to the ER and they just sent me home with more pain meds. I don't want to waste my time or money on another trip. I really need to know if this sounds like an obstruction or something? Is it possible to have one and the meds don't work? and you still have a very small BM?? What can they do for me??? How bad does it have to be for surgery?? confused
Dx w/Crohn's 5/07
Predinsone 15mg/day
Azathioprine 100mg/day
Sulfasalazin 4000mg/day
Flax Oil, Fiber Supplement, Multi-Vitamin


Nanners
Elite Member


Date Joined Apr 2005
Total Posts : 14995
   Posted 10/15/2007 11:49 AM (GMT -7)   
Well if the Pred is not helping, that means something is going on. I would take the doctor's advice and go back to the ER. Explain all that you have been thru, and that the steroids and other meds arent working and that you are still in extreme pain. I know hospitals suck, but sometimes they are a necessary evil. Good Luck and God Bless.
Been living with Crohn's Disease for 32 years.  Currently on Asacol, Prilosec 60 mg, Estrace, Prinivil, Diltiazem, Percoset prn for pain and Calcium.  Resections in 2002 and 2005.  Recently diagnosed with Fibromyalgia and doing tests to see if I have Inflammatory Arthritis or AS.


ngwen
Regular Member


Date Joined May 2007
Total Posts : 85
   Posted 10/15/2007 2:42 PM (GMT -7)   
Did I mention I am extremely tired? What is that all about!? I don't really have anyone to watch my kids till Wed. afternoon so I am gonna try to clear fluid it until then. Also, I am gonna try to add some Aloe Vera back in and see if that helps.

If you can, describe your experience with an obstruction....Thanks again!
Dx w/Crohn's 5/07
Predinsone 35mg/day
Azathioprine 100mg/day
Sulfasalazin 4000mg/day
Flax Oil, Fiber Supplement, Multi-Vitamin


ConsideringABag
Regular Member


Date Joined Aug 2007
Total Posts : 65
   Posted 10/15/2007 3:21 PM (GMT -7)   
ngwen,

I had many of the same exact symptoms as you--sharp stomach pains that would comes and go, nausea (which for me, is extremely rare), and no improvement of the symptoms even after going onto 20mg of prednisone (usually, prednisone has me feeling back to normal in 2-4 days).

My surgeon and I believe, just based on these symptoms, that I have some type of obstruction. I also just feel that something "isn't right" in a way that is not a normal Crohn's flare. My symptoms only go away if I remain on a liquid diet--another clue that I probably have some sort of obstruction.

So anyway, you sound like you are in the same boat. I am having a barium enema to check out where the obstruction is (my colon is the only part that my Crohn's affects), and am scheduling my first resection surgery shortly after that.

My suggestions to you are: stay on a liquid diet (drink SlimFast or Ensure for calories and vitamins in the mean time), and get a CT scan or other test to see what is going on with your insides asap. If you feel any Really terrible stomach pains, you should go straight to the ER. If you stop passing stool or gas completely, you should go straight to the ER. Both could be signs that your obstruction is getting worse--and the worst thing that could happen is your bowel could perforate.

I really wish you the best. You can also google some symptom lists for bowel obstruction. This website differentiates the symptoms of small intestine vs. colon obstruction:

http://en.wikipedia.org/wiki/Bowel_obstruction

(I don't know if that is hyperlinked, you may have to copy and paste it into your web browser.)

Good luck. :-) :-)

gachrons
Veteran Member


Date Joined Mar 2007
Total Posts : 4527
   Posted 10/15/2007 4:20 PM (GMT -7)   
Hi I guess I would follow the Dr.'s advice if you are in extreme pain. If you are in extreme pain how do you manage your kids hoping they are not too little.I have never blacked out.Sounds like you could use some help. Is there at least someone who will look after your kids and help out? Hope you get some help soon .Your right you cain't live on pop.. forever. Your Bm's won't be very big without food in you I wouldn't think. What foods are you trying to eat? lol gail

njmom
Veteran Member


Date Joined Apr 2006
Total Posts : 1884
   Posted 10/15/2007 4:55 PM (GMT -7)   

The nausea, cramps, do seem to point to at least a partial obstruction. Possibly due to a stricture...a cat scan would help identify areas of narrowing.

My daughter's stricture tends to close partially during a flare. So contents of the small intestine get backed up and then the terrible pain starts, as the body initiates cramps to try to shove contents through the obstruction. Whenever these cramps start, in the case of an obstruction, there is always the danger of perforation. So if you have even a partial obstruction it is best to get the cramps and inflammation under control ASAP. 

35 mg of pred might not be enough - you might need more. 60 mg of Solumedrol via IV helped my daughter get out of a flare.  

If you do have an obstruction and it includes scar tissue, then meds cannot clear the scar. My daughter's stricture does include scar tissue, and therefore will never go away, but as long as the meds keep her free of inflammation, then the stricture poses no problem. 

However, in some cases, even when inflammation is down and Crohn's is inactive, a stricture can still pose problems. If too much scar tissue has built up, leading to obstructions that do not open up with reduction of inflammation, plus you find yourself reduced indefinitely to a liquid diet, then it becomes a quality of life issue, and perhaps time to consider surgery.      


ngwen
Regular Member


Date Joined May 2007
Total Posts : 85
   Posted 10/16/2007 5:04 AM (GMT -7)   
Thank you so much that was a great description of what happens. It is exactly what I was looking for to try to understand what my body is doing and if it is worth going in. As of yesterday after dinner (I actually ate dinner, I was too hungry) I started feeling better. No pain last night and I actually slept through the night without pains. This was after feeling rotten all day, nausea and extreme fatigue. This morning I am not feeling too bad either, just ate my piece of toast so we will see what the day brings. Maybe I am all better now, all of a sudden? I am gonna look up "stricture" to see what that is, I am not quite sure. I don't think my last cat scans really showed anything. Does a stricture show up in a cat scan? How about an obstruction?

Thanks again!
Dx w/Crohn's 5/07
Predinsone 35mg/day
Azathioprine 100mg/day
Sulfasalazin 4000mg/day
Flax Oil, Fiber Supplement, Multi-Vitamin


njmom
Veteran Member


Date Joined Apr 2006
Total Posts : 1884
   Posted 10/16/2007 9:37 AM (GMT -7)   
It's great to hear you are doing better! Yes, cat scans can show both strictures and obstructions, but they are not foolproof.
 
In my daughter's case, her first visit to ER  included a cat scan that did show narrowing of the terminal ileum -- a stricture. She had had violent vomiting and cramps all day, but was still having BMs. For the cat scan, she drank something and was also injected with something. 
 
Her second visit to ER, when she flared after trying to taper completely off Entocort, also included a cat scan (they wanted to see whether there was an abcess - it didn't show any) that clearly showed the stricture plus ballooning of the small intestine before the stricture -- the ballooning is what happened when contents got backed up - part of the small intestine had to expand to accommodate them...that stuff has to go somewhere. 

ngwen
Regular Member


Date Joined May 2007
Total Posts : 85
   Posted 10/16/2007 1:56 PM (GMT -7)   
Well, I spoke too soon. I am back to feeling some discomfort. If feels like all of my food is up top, climbing back up my throat. The top of my abdomen starts puffing out and I can feel a sort of knot moving around. I have had both types of cat scans but I am unsure of what they showed, other than I was told it was a typical flare and I should take it easy. I was only given IV pain meds, nausea meds, and electrolytes because of dehydration. I just hate to go to the ER to get that same treatment, I can do that at home. I made some jello and plan to eat that for dinner. I will get my babysitter back tomorrow, so that is when I will make a call to the doc and see what he thinks I should do.

njmom, has your daughter gone the Remicade route yet?? If so, how did that help her?
Dx w/Crohn's 5/07
Predinsone 35mg/day
Azathioprine 100mg/day
Sulfasalazin 4000mg/day
Flax Oil, Fiber Supplement, Multi-Vitamin


njmom
Veteran Member


Date Joined Apr 2006
Total Posts : 1884
   Posted 10/16/2007 3:19 PM (GMT -7)   
My daughter has been on Entocort since July 2006. One pill a day since May 2007 and no side effects. She has been in remission all that time, so we're sticking with what works.


Daughter (19) Dx'd Crohn's 3/06. Misdiagnosed for two years, including by top pediatric Crohn's specialist as stress and needing more fiber but landed in hospital in 3/06 with cramps, vomiting, stricture. In remission with Entocort 3 mg (one pill), SCD multivitamin, homemade yogurt, vit D3 1800IU, 900+ mg calcium, 50 mg B complex vit, 25 mg iron. Just quit the SCD diet.   
 

Post Edited (njmom) : 10/16/2007 4:22:46 PM (GMT-6)


ngwen
Regular Member


Date Joined May 2007
Total Posts : 85
   Posted 10/16/2007 4:26 PM (GMT -7)   
That is great. I wish it had worked for me. It seems like every single Crohn's effected person has different results with different treatments.

What is the SCD diet? What is a SCD multivitamin?

A note to the others........I do have a husband that is here helping me most of the time. He works so it is hard for him to help me during the day. Luckily the blackouts were happening on a weekend. He can not take off of work right now since he has just started a new job, don't want to screw things up since we finally have a good insurance. I am lucky to live next door to my Mom who helps out a lot. She will be back tomorrow and hopfully ready to take the kids for me so I can get this crud cleared up. Ate my jello for dinner. Hope to feel good soon. I am tired!
Dx w/Crohn's 5/07
Predinsone 35mg/day
Azathioprine 100mg/day
Sulfasalazin 4000mg/day
Flax Oil, Fiber Supplement, Multi-Vitamin


njmom
Veteran Member


Date Joined Apr 2006
Total Posts : 1884
   Posted 10/16/2007 5:29 PM (GMT -7)   
It's a good sign that you were able to eat dinner last night, because there's a greater chance the problem might be due more to inflammation than to scar tissue.

How long have you been on the azathioprine? (It's very powerful, but takes months to kick in.)

My daughter is in school abroad, this Fall term, so she decided it was too hard to continue with the SCD diet - because the Entocort has her in remission, and she never got D anyway, we couldn't tell whether the diet worked.

SCD stands for "Specific Carbohydrate Diet," developed for IBD patients. No sugar, fluid milk or grains, but honey, fruit, vegies (well cooked), meat (but not any processed food, like hot dogs), cheese and homemade yogurt (gets rid of all the lactose and is more powerful than store bought) are ok. You might want to check out the website, www.breakingtheviciouscycle.info, check out the introductory portion of the diet, and see whether it helps you. (The book, "Breaking the Vicious Cycle," is available on Amazon.com, where there are tons of testimonials for this diet.)

We get SCD multivitamins from www.lucyskitchen.com. They are not loaded with all kinds of additives, like most multis are.

Post Edited (njmom) : 10/16/2007 6:31:21 PM (GMT-6)

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