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"Full" Feeling on bland diet. TPN is next step, please help.

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Ulcerative Colitis
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Posted 12/9/2011 7:17 PM (GMT 0)
I posted this in my last thread about my wife being home and doing poorly after being hospitalized with severe dehydration, fatigue and abdominal pain. She was diagnosed with UC or Chrons (not sure as they were unable to do a full colonoscopy with the amount of inflammation).

After a week of IV Fluids, eating regularly, IV Steroids (Solumedrol), etc, she was released to go home. That first night she spent getting sick and having more diahrrea that set her back to her pre-admission state. Extremely fatigued, looks/feels like death, hardly able to drink fluids and eat, etc.

She's been home now for 4 days, and the doc said if she doesnt get any nutrition in her she'll have to come back for TPN for 1-3 weeks to let her bowels rest.

Her biggest complaint is that she feels like the food/drink is just sitting in her stomach, not emptying, and that's nasueating, sometimes causing her to vomit. If she can control this, and get it to be absorbed, then we can power through it, otherwise it's back to the hospital.

I have her drinking a carnation instant breakfast right now (Lactose free) and she's doing OK, but i suspect she will feel the same sensation afterwards, but we have to try something as time is ticking.

She's on Prilosec OTC (they said to block acid since she's a high risk for ulcers, but my feeling is this is the reason since she has no stomach acid to digest the food and therefore the digestive system isnt releasing digestive enzymes and the whole digestive track is stopped cuz there are no triggers telling it there's food in there...

She's also on Percocet, Ativan and Zofran....

I'm feeding her White Rice, Broiled Chicken, Water, Vitamin Water (revive as it has potassium added), ritz crackers, saltines and rice cakes....that's IT. So, she needs protein and calories.... or it's hospital time.

thanks for any help!

Posted 12/9/2011 7:22 PM (GMT 0)
Have you tried some basic soups? I find that too much sugar, starch & bread isn't the best while flaring.

Has she had stool tests to chech for bacteria?
Posted 12/9/2011 7:44 PM (GMT 0)
No, no soups yet. She was ordered to eat crackers, rice and broiled chicken, maybe scrambled eggs and nutrional drinks. She's also been drinkig Vitamin Water Revive as she cant stand Gatorade due to the sugar. I'm mindful of the sugar content she's getting.

She had A colonoscopy, X Ray, CT Scan of the abdomen, countless blood tests including C-Diff (twice, both negative), and all came back normal except for albumen, which makes sense because she hadnt ate in 3 days prior to getting admitted and not for 2 days afterwards.

I just feel like soups arent going to give her much calories or nutrients and be full of dehydrating sodium (which sounds like a catch 22 cuz isnt sodium an electrolyte?)

Do you have any recipes that are light, but pack a lot of calories, protein and nutrients? I'll make anything.
Posted 12/9/2011 8:02 PM (GMT 0)
You don't have to give her a soup that's high in sodium. You've said that you're the meal preparer, so make her a broth yourself. Get a whole chicken, put it in a pot with an unpeeled onion, some carrots, water to cover and cook it for a couple of hours. Don't add any salt at all if you don't want, or salt it lightly. You can take the chicken out and shred the meat and put it back in the soup.

Didn't her blood tests show inflammatory markers? Did the CT scan indicate where the inflammation was? Did the x-ray include a barium swallow to look for narrowing in the bowel? Does she need the percocet for pain relief? If she isn't having a lot of pain leave off the pain killers to see if that improves her gastric function. And don't sweat the prilosec - its most likely not to blame for the nausea.
Posted 12/9/2011 9:31 PM (GMT 0)
I second the homemade soup - I practically lived off homemade soup when I was sick, and it wasn't terribly difficult for me to make despite feeling like crap. Chicken soup is a very nutrient dense food and you can add healthy oils to it to give it more calories. Just don't add anything too fibrous to it... Maybe just some carrots and potatoes, or rice.

Also, I mentioned this previously in your other thread, but avocados and banana smoothies. Avocados tend to go over really well for UCers. And a banana smoothie is as simple as throwing a ripe banana and some yogurt into a blender, with some honey or coconut oi if you like.

Other than vitamin water, have you tried pedialyte? Supposedly that's a better alternative to gatorade if you're worried about electrolytes.
Posted 12/9/2011 11:24 PM (GMT 0)
I'm in the hospital right now with a UC flare and on PN (not bowel rest though - I can eat soft food), and while I'm thankful that I'm finally gaining some weight, there's the risk of clotting and the risk of an infection with the PICC line, not to mention I wish I was home!

Regarding the feeling that food is sitting in her stomach, I was seeing a holistic nutritionist and she had me adding some hydrochloric acid to water, to have with meals. It's supposed to help with absorption. I can't say I felt any different, but sometimes it's hard to tell. She also had me take a digestive enzyme supplement at one point. Maybe those would be things to look into more?

During my flare, I've seen a doctor who works holistically and focuses on nutrition, a chiropractor, and a nutritionist, and all recommended avoiding gluten. It can irritate the digestive tract. Has your wife ever tried going gluten-free? Sugar is also inflammatory, and there's sugar in the Carnation drinks. Here is a link that you might find helpful: http://www.livestrong.com/article/275688-ingredients-in-carnation-instant-breakfast/

Like someone else suggested, I think cooking chicken and then putting it through the food processor with some of the broth is a great idea for a more protein- and calorie-dense soup. You could also process some cooked quinoa or rice with it, or carrots. I've tried that and found it surprisingly flavorful! (I added some salt, too)

For the electrolytes, I also can't stand the sugary taste, and my chiropractor had recommended coconut water.

I hope this helps!
Posted 12/10/2011 6:43 AM (GMT 0)
i've always found that percocet messes with the stomach... in fact, i'm not allowed to take it anymore when i have flares. as for the full feeling, did they do a stomach x-ray? over Thanksgiving, i was feeling the same way and was unable to eat anything. my doc did an x-ray and found that i had a blockage of stool at my spine. D had been slipping around it but if it's just liquid, that means that the blockage is still there. the feeling came from the fact that i truly was full... everything was backing up in my system and there was no room for anything new.

hoping your wife feels better soon!
Posted 12/10/2011 12:46 PM (GMT 0)
Can your doc put you in touch w/ a nutritionist?
Posted 12/11/2011 8:58 PM (GMT 0)
A nutritionist would be a good idea if you can get ahold of a good one quick. I have been put on a very bland low fibre diet temporiliy to try and settle my uc symptoms. No wheat, gluten, dairy, sugar (small amount ok but no cakes!), no caffeine. I can basically eat porridge made with oatly milk and 1/2tsp agave syrup, fish, chicken, turkey, lamb, eggs, butter, safe low fibre vegetables like carrots, potatoes, quinoa or rice (2-3times week). Its very dull but it seems to be helping me at the moment. I used to eat a lot of rice cakes but my nutritionist thought it may be irratating so noe I only have the occasional one, not that I miss them! But I would definityl recommend seeing a nutrionalist for advice.
Posted 12/12/2011 3:03 PM (GMT 0)
Keep in contact with her doctor about this. Perhaps her colon has become very sluggish due to the Solumedrol in the hospital but there is also another possibility I've heard mentioned here. Sorry but I cannot remember the exact name but basically the colon stops moving and has to be monitored.

At the very least she should have an XRay to see if she is seriously constipated and to watch for toxic megacolon. I feel nauseated when I get constipated and my body is saying "Don't add any more food until you eliminate what's already here". Good luck and keep us posted if possible.
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