Posted 4/17/2016 3:56 AM (GMT 0)
You should not be in consistent and unbearable pain, that is never normal and pain is a warning that something is wrong. Unfortunately, having CD, we have to be more conscientious than a healthy person about whether or not the pain warrants an ER visit or can be waited out at home. Personally, I will suffer horribly for days, to the point of feeling like I'm starting to go crazy over lack of sleep, before going to the ER because I have never had a ER visit that didn't result in me being admitted and hospital stays depress me horribly.
Have you ever had a baby? Obstruction or blockage pain to me feels like more located labor pains. It is essentially your body trying to push food through your intestines (where labor contractions are pushing a baby through the birth canal). Obstructions can clear on their own at home and if you are having BMs you most likely have a partial obstruction and not a full blockage. I would suggest liquids only for a few days and make sure you aren't taking any medications that can further constipate you (such as narcotic pain relievers). If it turned in to a full blockage you would most likely become really distended and stop having any BM or gas even. Then you need to go to the ER because an untreated blockage could perforate your bowel, which is life threatening.
Another thing could be strictures, which are causing mini obstructions throughout your tract, essentially small areas that require your intestines to work hard and contract strongly in order to push the food through. It is possible that the hold up on your methotrexate has resulted in some inflammation from a flare, which is causing stricture pain. Strictures can also cause intense gas pains, which are very real, but not a cause to go to the ER. You could try getting on all fours and sticking you butt in the air to better help the gas pass through if this is the case. And again, be conscious of what you're eating. At the very least, keep to foods that are soft and easy to digest (eggs, white bread, bananas, pasta, etc.). I will supplement a low residue diet with a protein shake called Orgain, it tastes great and doesn't have a lot of the chemicals and processed ingredients that shakes like Ensure have.
Pain has always been my worst symptom with this disease and I have sometimes suffered from it for long periods of time when there wasn't anything emergent going on, just plain old active inflammation wreaking havoc. You shouldn't have to live in immense pain for weeks on end, so if this is the case (ruling out any specific or serious causes) I would suggest a call to your GI or just going to the ER to get some pain relief and fluids (if you can get your GI to call ahead for you the ER staff may be much more accommodating - sometimes you get ER doctors who are clueless about IBD and therefore make it seem like the ER is not an appropriate option). Another option is to call you GI and see if he/she will prescribe a pain medication for you. My GI will prescribe tramadol for basic Crohn's pain, but admits me to the hospital for pain that is not touched by tramadol. It's amazing what a little bowel rest and a morphine pump can do for you after weeks of suffering.
I hope you get some relief soon!