Chronic small bowel obstruction from adhesions

Posted by ginpene @ginpene05, Apr 6, 2017

This is my 5th SBO with hospitalizan in 18 months, due to adhesions. No surgery yet, but am considering Small Passage treatment. Last 3 times happened in the last 4 months. This is getting old. Any idess?

Interested in more discussions like this? Go to the Digestive Health Support Group.

@ginpene05

Everybody, who uses low residue diet and who doesn't? Anybody think excercise helps? I have obstructed while on strict low residue as well as on regular diet. The GI surgeons here say fiber intake is irrelevant. I'm not sure I agree, and everyone else says to err on the side of caution. After my 4th one I started adding a few well cooked veggies to my diet and found myself back in hospital 4 weeks later. Thanks to everyone. 

Jump to this post

My doctors have all said that diet is irrelevant, too, but I have to say that just before each of my SBOs I have eaten a meal with a great deal of fiber. So, in my case, I really need to do a better job of monitoring that. The difficulty in that is that I try to eat really healthfully and those plant foods usually have more fiber. So complicated

REPLY

So just back from a visit with the local nutritionist, who had a lot of great suggestions about dealing with a low fiber - low residue - low everything diet. Since I am vegan, the big issue for me was how to get enough protein. She had a lot of good ideas... things I hadn't thought about... like grinding oatmeal before preparing it (to cut back on residue).. basically eating cream of oats, like cream of wheat... and she said that while whole grain pasta was ok, I should avoid brown rice.. things like that. In all, very helpful .. and reminded me to chew chew chew... she said that whatever I am eating should have the texture of pudding before I swallowed it.. Not sure if anyone else has had this type of consult.. but I strongly believe that one way to control my condition is to control what I eat...

REPLY
@marciakeren

So just back from a visit with the local nutritionist, who had a lot of great suggestions about dealing with a low fiber - low residue - low everything diet. Since I am vegan, the big issue for me was how to get enough protein. She had a lot of good ideas... things I hadn't thought about... like grinding oatmeal before preparing it (to cut back on residue).. basically eating cream of oats, like cream of wheat... and she said that while whole grain pasta was ok, I should avoid brown rice.. things like that. In all, very helpful .. and reminded me to chew chew chew... she said that whatever I am eating should have the texture of pudding before I swallowed it.. Not sure if anyone else has had this type of consult.. but I strongly believe that one way to control my condition is to control what I eat...

Jump to this post

I was on strict low residue for 3 months, then as soon as I tried to re introduce some fiber, the blockage and diverticulitis hit again. On antibiotics for a week, then 10 days later back in ER with almost a total blockage, but this was down in sigmoid. I then got the small bowel backing up into stomach and had dreaded NG tube. But since this last surgery everything has been ok thank God. Being very careful about what types of fiber I eat. No nuts, seeds or raw veggies yet and no fruit with skins

REPLY

@dc10 , I don't believe that diet is irrelevant, but let me clarify. I don't think that your diet will affect whether or not you have obstructions (although I believe I have a sensitivity to gluten that MAY cause inflammation that could make them more likely), unfortunately.
However, I believe that you can control their severity to a large degree by sticking as much as possible to healthy juices, smoothies, soups, and--as @marciakeren just mentioned, foods no thicker than the consistency of pudding. In an earlier comment I said that I try to think of things that I can eat that could pass as easily as possible through a straw. With sbo's from adhesions, in my experience, there is a gradual narrowing in the area where the obstruction is forming. If what you eat is able to pass through that area quickly before it really closes up, and get beyond it, it won't build up behind the obstruction and sit and cause the pain, vomiting, and bloating. After a certain point, however, nothing will pass through. So by eating liquidy kinds of things (fortunately that can include ice cream 🙂 ), you're at least decreasing the chances of larger food particles getting stuck.
My obstructions usually last for a day or two before resolving. Usually I'm in horrific pain, and have sometimes vomited like 15 times overnight.
But the last time I got one, I'd spent the day on smoothies, etc. I could feel an obstruction coming on just after I went to bed. I panicked, of course, but I got up and walked around and stretched.
Miraculously, although I definitely had some pain and bloating, it was a million times better than usual. I didn't vomit all that night--I only did once on the second night, and that was because I was so thirsty that I overdid it with water and Gatorade before the obstruction had resolved (I always know that it's over when I can comfortably lie on my stomach again--I just didn't wait long enough to get to that part before I started drinking stuff).
So, that's my theory, anyway--but it worked in practice, so I'm sticking with it!!

REPLY

Ugh.. the pain is terrible - just as @nancybev describes... so sorry to hear but glad you resolved it. I am cheered that the nutritionist gave me advice that I think I can follow... eating slowly and chewing and chewing are two things I have to work on... My other problem is that I don't eat frequently enough during the day so I get so hungry when I do sit down for a meal that I eat too fast ..

REPLY
@nancybev

@dc10 , welcome. It's such a miserable thing to deal with, and very frustrating that doctors don't seem to have many answers.
On Clear Passage, my feeling is that you should be very careful before you lay out large amounts of money for their "treatments." I have not read a shred of evidence from the legitimate medical community that what they do really works. Look carefully at the list of "authors" on any of the Clear Passage "studies" in medical journals, and you'll see that they include the people who own the company--seems sketchy to me. I figure that, if the technique REALLY worked, it would be offered by legitimate gastroenterologists all over the world to offer some relief! Just my two cents...
But if you read through these threads you should find a lot of pointers on what diets and other tips people can recommend to at least make the issue more bearable.
Feel free to ask questions!

Jump to this post

@quiteachiver76 YES I AGREE WITH WHAT YOU HAVE WRITTEN THEY LEAVE YOU WONDERING

REPLY
@marciakeren

Ugh.. the pain is terrible - just as @nancybev describes... so sorry to hear but glad you resolved it. I am cheered that the nutritionist gave me advice that I think I can follow... eating slowly and chewing and chewing are two things I have to work on... My other problem is that I don't eat frequently enough during the day so I get so hungry when I do sit down for a meal that I eat too fast ..

Jump to this post

@marciakeren and others,

Yes, eating small, frequent meals is much better for me than eating a larger meal. This is not easy, especially around the holidays when great food is in abundance, but when I recall the pain and bloating from overeating it begins to become easier to have self-control.

REPLY
@marciakeren

So just back from a visit with the local nutritionist, who had a lot of great suggestions about dealing with a low fiber - low residue - low everything diet. Since I am vegan, the big issue for me was how to get enough protein. She had a lot of good ideas... things I hadn't thought about... like grinding oatmeal before preparing it (to cut back on residue).. basically eating cream of oats, like cream of wheat... and she said that while whole grain pasta was ok, I should avoid brown rice.. things like that. In all, very helpful .. and reminded me to chew chew chew... she said that whatever I am eating should have the texture of pudding before I swallowed it.. Not sure if anyone else has had this type of consult.. but I strongly believe that one way to control my condition is to control what I eat...

Jump to this post

I too was advised by the hospital nutritionist to eat nothing with more than 2 grams of fiber. So for the past 2 years that's what i try do. If its something I like such as oatmeal and the label says that 1/2 cup is 3 grams of fiber I use 1/3 cup which I hope cuts the fiber count down. And I cook it until its like a soft pate. Its still good!! Its still hard to manage my diet though. I eat a lot of white rice and white bread and white potatoes for some bulk plus of course acceptable veggies and fruits but I miss things like baked or refried beans and lentils. Being a long-time vegetarian those foods were a large part of my diet. Eating low fiber though has cut my stomach attacks down to about 2 per year. The attacks, when they come, are after my succumbing to the urge to eat something higher in fiber that is tempting me and a very painful reminder to cut it out and get back with the program. My adhesions started after 25 days of pelvic radiation and they aren't going to go away. I am trying to stay low fiber and welcome any food suggestions that this old vegetarian might add to perk up my diet.

REPLY
@ginpene05

I have an update. Since my last obstruction I have been diagnosed with Small Bowel Cancer. Finally a reason for my problems. Oddest of all is that an exploratory surgery 3 weeks ago found no adhesions! Today I will have a resection of the malignant part of the jejunun portion of the small intestine. Life really keeps me on my toes!

Jump to this post

I’ve had 6 small bowel obstructions with no explanations other than I have a thickening in a portion of my small bowel which they think causes them. I am scheduled for surgery in a couple of weeks for a probable resection. Since I’ve had CT scans, colonoscopies, the pill camera, and endoscopes I’m wondering if cancer was still missed. Do you mind sharing if that was the case with you? Thank you

REPLY

Hello @dc10,

I realize that you were addressing another Member with your post, however, I noticed that you had previously mentioned seeing a doctor at Cleveland Clinic. Is that where you will have the surgery?

REPLY
Please sign in or register to post a reply.