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Crohn's Disease
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Posted 9/15/2014 3:51 PM (GMT 0)
I have a friend who is just where I was exactly one year ago.

She has no insurance. (Also no income) She has a Crohn's diagnosis. She is getting more bloated in her abdomen every day and she has not passed stool in 4-5 days. I sent her to ER on Saturday night, but I couldn't go with her to help her advocate for herself and she is not the kind that will speak up for herself. She does not have a computer or any way to educate herself--besides the fact she has a severe case of Ostrich when it comes to her health. She would rather not know.

So anyway, the ER sent her home with a script for stool softeners and pain meds (which she did not fill as she's a recovering addict). She still has not pooped, and is having some nausea.

She was told a few months ago that she needed surgery for her crohns and she walked out AMA and has never followed up with her GI. Now, the GI tells her that she can't get in to Oct 2. I think, if she just waits it out, she could be dead by then.

I really feel like she's got a bowel obstruction and she should be admitted. i am tryinig to get her back to ER. There is a part of me that thinks I am overreacting because of what I've been through--but I hate to not trust my instincts and she gets ruptured or something.

Am I on the right track here? A week ago, she said she had blood. 4-5 days since passing stool. Very distended abdomen, some nausea.

ER did do an xray, they just said she was constipated. (Uh..DUH)
Posted 9/15/2014 6:07 PM (GMT 0)
about the only thing I can ask is, is she passing gas? Going 4-5 days w/o a bowel movement is in itself, not unusual for many people, but only she knows what's normal for her. When I've had obstructions it was extremely painful and I couldn't pass gas.

Has she tried the stool softeners?
Posted 9/15/2014 6:51 PM (GMT 0)
Good point on the gas. i will ask her that. She said she has tried the softeners, but it's not helping.
Posted 9/15/2014 6:59 PM (GMT 0)
Is she also having severe, wave-like, pain? If she's passing gas and not having severe pain, then it's unlikely to be an obstruction. Paradoxically, when my Crohn's got worse, constipation also became more common for me. I'd often not be able to for a few days or barely at all. At one stage I was having to take Miralax just to go, because it got so horribly uncomfortable if I didn't.

Will your friend accept diet advice? If so, advise that she go on a low-residue/low-fibre diet until she at least sees a GI on the 2nd October. Try and go with her to that meeting if you can, since you know more about the disease than your friend does: you can ask questions that the friend probably won't think of or will feel too shy to ask.
Posted 9/16/2014 6:20 PM (GMT 0)
I second the Crohn's and C thing. Sometimes I have D during flare and sometimes I have C during flare and even when not flaring. If she's NOT obstructed, something like Miralax may help.

I would be worried about anyone who isn't willing to go to a doctor when they feel bad- especially with Crohn's which can make you think you're ok during a time when you feel like you're in remission, but can be wreaking silent havoc on your insides and BOOM you're in trouble. Hopefully your friend starts to feel better soon.
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