Frequent blockages (obstrucions) after total colectomy HELP!

Hi Clara,
Right after surgery the ileostomy diet should be relatively soft, easily digestible. Try to stay away from raw vegetables and fibrous fruits. Also no nuts or popcorn. Chewing is essential! If a food can be primarily broken down in the mouth it is safe for a new surgery. Also drink plenty of fluids. Drinks like tea, coffee and fruit juice (especially grape) will help keep food from clustering, which can clog the stoma opening. After adequate healing time, more foods can be introduced. Other causes of a blockage like adhesions (scar tissue) or a kink in the small intestine would need to be determined by your GI or surgeon. Usually a CT scan and/or ultrasound is done. There are dilation procedures that can be done on an out patient basis. I've had an ileostomy for 15 years and had a food and an adhesion blockage each 1 time.
Hope this helps! I highly recommend talking with your doctor or WOCN. I would also suggest finding a support group in your area. Ostomy.org can help you locate one. The ostomy veterans can offer many tips.

Weightless after this surgery is normal. I lost about 15 pounds after surgery and was already underweight from my Crohns flare. I'm petite so 15 pounds was a lot. It took about a month before I was able to start gaining weight. My Dr also said that healing from major surgery can increase your metabolism and some need an extra 500 -1000 calories more than normal.

Until I was able to eat more I tried to make my calories count. Like creamy peanut butter on toast, whole milk yogurt, cream of wheat made with whole milk and butter, cheese and crackers, chicken and mashed potatoes with butter. Butter, peanut butter, and cheese were my friends!!

Clara,

I had lost about 30 pounds due to Crohn's in the months prior to emergency surgery. I'm 5'8 and weighed 105 lbs. After surgery the surgeon ordered Ensure while I was in hospital and told me to continue after I went home. I didn't like the taste and since I needed to gain weight, my husband made milkshakes. To the Ensure he would add ice cream and a variety of other things. Different flavors of ice cream, ice cream toppings, bananas or other fruit, peanut butter... whatever he could think of to include calories.

My only food blockage started with cramping and I realized there hadn't been output for awhile. When the cramping got worse it occurred to me there was a blockage. I had heard at a support group meeting that grape juice was good for blockages so I started drinking it and massaging my abdomen until it broke apart.

For a year prior to the adhesion blockage my stoma would swell to about 3 times it's size. My GI looked at it and since it still was red and functioning, and abdomen only slightly distended, he suggested I use a cold pack. This happened probably 3 or 4 times and would last a few days. It was very uncomfortable, but only mild pain. The last time I thought it was the same thing, but it kept getting worse and though I had a light breakfast with coffee I realized there was no output. I happened to be visiting my cousin, whose wife is an RN so when my belly looked like I was pregnant, with intense pain, and I started vomiting blood she called 911. After the NG tube was inserted in the ER they did a cat scan to determine the blockage and admitted me. The next morning I was visited by a surgeon and WOCN who took the pouch off to look. The stoma was about 4 or 5 times it's normal size and turning a purple-black due to ischemia. After 3 unsuccessful dilation procedures I had surgery to correct. It couldn't be determined if dilation had been performed during an earlier incident, surgery might have been avoided.

To make a long story short (too late?) always check the stoma for changes. It should be red and moist. It is naturally swollen for a time after surgery, but swelling should gradually decrease not increase. Adhesions and kinks can also cause a temporary food blockage. Probably only a GI or surgeon can determine the exact cause.

One other thing... he shouldn't eat too much at one time then nothing for hours. Try to have something every 2 or 3 hours to keep the GI tract moving. (I still do this) Eat slowly and CHEW thoroughly, even with soft diet. Unless you plan to change the pouch that day, start each day with a glass of water or other liquid to jumpstart GI activity. I drink water first because I wake up a bit dehydrated.

It may not seem like it now, but after the healing process, life with an ostomy can be a blessing when compared to the disease that necessitated it.

My thoughts are with you both!

clarabella - hope all is better with your husband. I saw your list of foods - watch the mashed potatoes, they might actually block things up, especially if they are from the box. Several folks on here have had experiences with mashed potatoes like that.

chew, chew, chew, and drink, drink, drink.....once your husband is past 3-4 months, and depending on how he feels, then he can experiment with new foods a little at a time.

Hi cupcakespinkgal,

It’s great to hear that you are so well 4 months post-surgery. It’s inspiring to hear that since my husband has started to think that the surgery may have not been worth it. The blockages he said were much worse than the UC. He thought he would have the surgery and then would feel fantastic straight away. He didn’t think it would take so long to heal and he would have to watch his diet so closely.

Yes, I have a diet sheet. I’ve been using that as a reference for the food I make him and monitoring him closely after each meal. It seems pasta does not agree with him. Both blockages occurred on the nights he had pasta.

Thanks for the tip about the gum. I’ll get him to give it a try.

Appreciate your help, it makes all this not so scary!

Thanks,
Clara

Enigmawrap makes a good point. Some of the OK foods on the ostomy diet are what I call thickening foods and some I jsut stayed away from. For example rice and bananas always made my output too thick, didn't give me a blockage but preferred not toneat those foods. Sometimes pasta didn't he same. Potatoes for me make perfect output.

Early on I just did best with bread and crackers with some sort of protein and fat.

Tell your husband not to get discouraged. I had a temporary ostomy and resection last fall and that surgery was easy so when I had the total proctocolectomy I was not prepared for how much harder it was. I was in the hospital for 11 days and had the ileus which made eating very uncomfortable. My first month was hard but it does get better.