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Stomach, Small Bowel, or Colon Obstruction?

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Posted 8/21/2011 1:14 AM (GMT 0)
I'm a long-time indeterminate Crohn's colitis patient with treated chronic proctitis and possible small bowel involvement.

Would immediate bloating and abdominal distention after eating be more indicative of a stomach, small bowel, or colon obstruction? I'm almost certain that I am partially obstructed somewhere. I do have a thickened rectum and sigmoid colon on CT scan, which could certainly be the cause. But, unfortunately, that same scan did not show the small bowel well.

Although the colon source looks most likely, would one get such immediate, diffuse bloating if the upper GI wasn't involved at all. I was thinking possibly some type of obstruction at the stomach-duodenum junction (which Crohn's can affect, although perhaps less likely here) or anywhere in the small bowel.

For those who've had this type of immediate bloating and distention after eating (without any other acute intestinal inflammation symptoms), where was the typical location of obstruction or stricture? I know that small and large bowel obstruction can present very similarly. But, there has to be some way to tell (short of a barium scan, etc., which I will be having soon) what part of the GI system is this is likely coming from?
Posted 8/21/2011 1:52 AM (GMT 0)
All I can say is from experience it sounds like you could have strictures in the small bowel and/or terminal ileum as well.

Your barium meal will show them so suggest you eat very carefully until then and if you bloat AND start to vomit with pain get to an ER.

I also bloat after eating if I have had a food that I am intolerant too e.g. wheat, onion, legumes etc but that is just bloating without pain/vomiting and it settles on its own after a couple of hours whereas bloating due to an obstruction does not settle without ER and drugs.

Good luck with your BM hopefully it will give you the answers you are looking for.

Lesley in NZ
Posted 8/21/2011 2:29 AM (GMT 0)
Wow-I'm glad you asked this. I am not dx yet. Waiting on colonoscopy aug. 24th. When I first started feeling these symptoms I was having the painful bloating after the smallest bites of food/beverage. That is actually what prompted me to see my PCP. I never knew about the obstruction, but am wondering if back when I was really having the tummy issues if it was caused by something of that sort. I still sometimes get the bloating, like right now, tummy is feeling kinda bloated and tender, and I haven't been having the D, and not as many BM's as I'm used to having. When I am having a lot of BM's or if I'm flaring (I guess), my rectum becomes very inflamed to the point it's difficult to pass gas, much less stool. I don't know what everything is yet, so I need to research a stricture. I mean, when I was in a lot of pain with the onset of my symptoms, my doc thought (or I thought) I had a hemmarrhoid (sp-sorry) but now I'm wondering if it was something Crohn's related.

Can you guys please tell me how Crohn's affects you? I feel like whatever I have, is attacking everywhere.
Posted 8/21/2011 3:47 AM (GMT 0)
Hi, Kiwi. Yes, for some reason I feel like there is something going on further up (although I'm sure the narrowed rectum is contributing). I've been UC clinically, but I'm Crohn's by biomarker (Prometheus) study. I know that study's not perfect, but I believe I have had peri-rectal fistulas in the past and my rectum was quite thickened (more Crohn's like).

I'm fairly certain the bloating/distention is not diet, fiber, water, exercise related. I do all those things in spades and the symptoms happen with pretty much anything I eat. I suppose this suggests definite partial obstruction somewhere. It's just that question of immediate bloating and distention that is troubling me. It just seems like the stomach/duodenum/rest of small bowel may be an actor here. It's just so difficult to get clear information on that.

Shea, yes, I've had much rectal inflammation (chronic) in the past as well. Acutely, topical treatment works well for proctitis. The trouble begins when there may be more long-term narrowing or stricturing. Full wall thickening is more suggestive of Crohn's. But, there is usually also other evidence (from biopsy and small bowel, etc.).

Let us know how your colonoscopy goes and if your doctor was able to attribute the bloating, etc. to only the distal rectal inflammation. It'd be interesting to know if narrowing in that end of the GI tract can present with such immediate "upper GI-like" symptoms of stomach/small bowel (and colon) distention.
Posted 8/21/2011 10:51 AM (GMT 0)
SilverSky,

Ok-so is that what the rectal inflammation is called-proctitis? I will research.

I will definitely let ya'll know how colonoscopy goes-I'm scared to death.

I'm with you-you are more scientific with your words, but I believe I am understanding- but yes, it totally feels like something is going on with the stomach/small bowel. Like I said, that's what made me seek medical attention in the first place because I could eat a little bite of something and a sip of drink and already the severe bloating would start. I need to start a journal of how/when things occur because I can't keep track of it all.

Hope to be of help to you in a few days.....

Well wishes
Posted 8/22/2011 12:10 PM (GMT 0)
I am understanding your post better now. I'm still curious too if my problem is more in my small intestine or some area up high in GI track because I don't have the typical "lower right hand side" pain you read when you research Crohn's. Mine is all right near the ribs under my breasts, and it hurts pretty bad (not stabbing pain, just dull and tender to the touch) It also causes mild-severe nausea.

Will my colonoscopy reach these areas? I know, I'm not educated yet on the different tests. I just want the correct tests done.

Also, because you have the chronic rectal inflammation, what do you reccomend doing before colonoscopy? I'm afraid they will hurt me with scope or something.

Newbie and scared.....
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