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Obstruction question

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Crohn's Disease
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Posted 9/10/2010 4:29 AM (GMT 0)
It is a simple one...how do you know you  have an obstruction?  I see some say they get them daily etc..if this is true how do you relieve that obstruction without surgery? 
Posted 9/10/2010 6:52 AM (GMT 0)
Massive pain! When I had obstructions, I would get pain "contractions" (sharp pain, and then relief for a little while, then sharp pain again, ad nausem). As the hours went by, the contractions came closer and closer together until there was constant awful pain. Usually, I'd end up in the ER, where I was given pain meds, steroids, and was put on 2 or more days of bowel rest. Luckily, they always resolved with that method. I eventually had surgery to remove my stricture.
Posted 9/10/2010 12:14 PM (GMT 0)
I get obstructions, but not on a daily basis. There is no rhyme or reason to the timing of mine. I can go months then have 3 or 4 in a week. Mine usually last anywhere from 8 - 24 hours, anything longer and I am heading to the ER, or if I have extreme nausea or vomiting. I can usually hold down liquids. Spooky did a good job of describing the pain. My first sign would be that I wouldn't need to go to the bathroom. Like "hey, I haven't gone to the bathroom in 3 hours", then " OH NO, I haven't gone to the bathroom in 3 hours". I will get very bloated and look pregnant. I have no bowel sounds and can't "push" any gas out no matter how much I think it would make me feel better.

Right now my doctor thinks my obstructions are caused by adhesions wrapping around my intestines, not by active disease. So a boost of medication won't help. The reason to go to the hospital for me is pain management and bowel perforation. I don't recommend staying home for most people, the pain is pretty bad. If you are even questioning an obstruction, you should call your doctor or go to the hospital.
Posted 9/10/2010 2:46 PM (GMT 0)
Spooky described them very well. Intense pain where you would end up needing to go to the ER for pain meds, also nausea and abdominal swelling. This is not something that you can just deal with at home if it is a true obstruction. Usually for me they start off pretty mild in terms of pain (like uh oh, could this pain maybe be an obstruction) but within a few hours there is no question and it's an emergency situation. I've never been in labor but I hear that is what they feel like...
Posted 9/10/2010 4:46 PM (GMT 0)
Luckily, I've only had one obstruction and that is what led to my diagnosis of Crohn's Disease. I described the pain just like being in labor for childbirth. It was intense, rythmic pain. Actually, it might have been worse than giving birth!!
Posted 9/10/2010 5:01 PM (GMT 0)
May I ask a question? I remember you had ALOT of surgeries in just one years time, you didn't experience an obstruction during all those surgeries?
Posted 9/11/2010 3:42 AM (GMT 0)
I suffered many years with a stricture and I had perforations but I was in pain for monts prior I often wonder if the pain I sufferwith now is from adhesions which I had plenty of a few yrs ago I have percoset scripted to me for the painI will find out next week if it is in fact that, a flare or what also they want to see where the blood I have been experiencing is coming from
Posted 9/11/2010 3:17 PM (GMT 0)
I can tell you I have had multiple abdominal surgeries, and do know that I get alot of adhesion pain. Especially when I am more gassy or bloated. And I know you have had alot of surgeries too, and may be getting the same pains. I have to take Percoset 1/2 tab 3 times a day in order to keep my chronic pain in check. Good luck!
Posted 9/11/2010 10:23 PM (GMT 0)
idea  Hi Dragonfly great name by the way I think I can be named an expert in bowel obstructions I been hospitalized so many times for them cause of a narrowing in the bowel and repeated dilatation's,,so here it goes this is what happens to me but everyone is different,,I usually start with severe diarrhea for a few days than everything stops and the pain hits you it will double you over its that intense and than the nausea and vomiting starts and what you throw-up it looks something like coffee grounds and smells just like stool cause that is what it is,,than its time to go to the hospital,,they will do a stomach series and it will show the obstruction and where it is located,,next blood work to check your white count which will be up,,than they will hook u up to IV fluids with an anti nausea and some times an antibiotic and they will stop all food and liquid by mouth keeping you hydrated with the IV fluids and push pain meds through your pic (IV) if vomiting doesn't slow down or stop and the swelling in the belly is getting worse they will put in a NG tube and hook it up to suction to drain the junk from your belly some times it helps even to relieve some of the pressure on your belly,,it some times works and resolves its self in a few days of IV fluids and some times it don't surgery is the last option,,they will try a dilatation maybe several for me,,it never worked for me I had these obstructions for almost 3 years in hospital most of the time they couldn't operate on me at the time cause I was under weight and very sick and become sepsis and ended up in ICU,,after all that I finally had my operation to remove the narrowing and 2 hernias as well now I have short bowel because of it not cause of the bowel obstructions cause I've had so many resections in my life...I hope that helps you understand a little better some times I also got a low grade fever with it to..~~Jen~~ idea smilewinkgrin smilewinkgrin idea
Posted 9/13/2010 7:33 PM (GMT 0)
Spooky and onthecan is onTHEmoney on all the tips !


Had many, many partial obstructions in my 40 years of Crohns.



Notice the word partial, the difference is:



In a partial obstruction you have diarreah (what else is new!) and sharp pain (this is the main determinant.



I start with no output on the other end, I go on a liquid diet of broth and ensure (heated), and in a day or two it gets much better.



A key sign is the gurgling sounds, in my jejunum is like a bathtub draining, in the ileum are is drip-drip (this is very bad news, there is probably a stricture there.



I have spasms and dilation that I can literally move with the palm of my hand with gas / liquids moving around, it appears as it gets better but eventually everything lines up at the stricture point.



Was in the hospital for 4 days in April, they gave me Solumedrol (big hammer for inflammation), Flagil and Cipro for intestinal infection. Since then I have been with Prednisone and Humira for 5 months.

So now I am back in the hospital for the last 3 days. This time no pain, but bloating, diarreah but INCESSANT HICCUPS, a new symptom.

The CAT scan revealed an obstruction area in the ileum, was admitted and the first two days had a bowel rest of nothing but ice chips.
I was having diarreah 4-5 a day, mostly green, which lead to the suspicion that his was a partial and not total obstruction.

On day 3 they gave me three times chicken broth to see if I could generate lower abdominal activity, which it did: some solid stool and more important GAS.
They have been taking normal Xrays every day to see if the area diminishes, NO.

Today is day 4, I cannot go on with my life this way, everyone is agreeing once and for all (and me leading the parade that his stricture (or more) needs to go. If I don't do it in a few weeks I will be in exactly the same spot, go through all the preps and end up in surgery anyways.

Treatements, Waiting, Nutrition, Rest, it has been going for 8 months now. NO MORE !

Was fearful of surgery since I have had bowel resections before, its a long, long dark tunnell of recovery...I am now ready and available: knock me out and DO IT !

Post Edited (yohimbe) : 9/13/2010 1:52:21 PM (GMT-6)

Posted 9/16/2010 3:39 PM (GMT 0)
Fellow obstruction suffers, I am in a similar situation. I am presently on Remicade and every time I drop my prednisone down to about 2.5 mg or less than 5 mg. The pain hits and hits bad, bad, bad, the symptoms described by all of you is what I have. Bloating, feeling like wanting to do, frequent going, pain, and pain, nausea, vomiting, and feeling sick, sick and very very tired. Have been in the hospital several times, treatments similar to those described by others.

Yesterday, I had severe pain and had dropped to the pred to 7.5, now I had to bump it up to 20 to control and have some normal life. So everytime I taper, it comes back and it comes back big time and violently.

Leaning towards surgery, but the docs think that is not the solution, because it might come back anyway. Any thoughts why the pain comes back even after being on Remi for nearly a year now. shakehead

Thanks in advance.
Posted 9/16/2010 4:31 PM (GMT 0)
Onthecan has it spot on. Actually it was the vomiting of fecal fluid that sent me to the ER the very first time.
Up till that moment, I was determined that I could handle the pain. Ha! Stupid me. Since then I haven't allowed
it to get to that stage anymore.
Loud bowel sounds before each contraction of pain, is also a strong indication. And on some occasions my stomach
involves itself, it feels like you're being ate from the inside out, but that doesn't always occur. Good luck!!
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