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19630831
@19630831

Posts: 1
Joined: Sep 21, 2018

SBO due to Adhesion

Posted by @19630831, Fri, Sep 21 4:31am

This is my first time reaching out to such an outlet but my frustration with my reoccurring issues is completely distressing me. I am a 55 year old woman who has just experienced an eighth SMO due to adhesions. This has happened throughout a ten year period. My first surgery was at 17 and mid life many additional surgeries. Has anyone gambled on having adhesions removed (even though the risk for more is high) as an attempt to curtail these episodes? It has been discussed each time I have been hospitalized yet when I sultatioday arrives I am convinced to waito for the time. I find theNG tube traumatic and have only had it placed once. I would appreciate any advise or thoughts from your experiences.

Thank you,

REPLY

Hello @19630831

As I see this is your first post on Mayo Clinic Connect, let me begin by welcoming you to this online patient community. I'm so glad that you posted your question here. I can certainly appreciate your comment about the NG tube and the trauma of it. I have had three surgeries of the upper digestive tract (to remove neuroendocrine tumors), the NG tube seems to be among the worst of those experiences. I have also had adhesions in the pyloric area and they were stretched during an EGD procedure.

It might be helpful if you were to explain a little more about these adhesions (please share specifics only as you are comfortable doing so): for example, where are they located; was there an original surgery that resulted in these adhesions, if so what part of the digestive tract? Please tell a little about the type of symptoms you have with SBO?

Yes, I had my first stomach surgery in 1981. About ten yeas later I started having almost monthly partial obstructions due to adhesions. I finally was able to deal with these by doing clear liquids for a few days and then gradually adding in food and by using visceral massage. It worked for twenty years and then I had a bad episode and was hospitalized and has surgery. That surgery had changed my life terribly. I have had a five year period of increasing stomach and entire body problems. In hindsight I wish I had never done that second surgery. Everyone has to make their own path. I know well the pain that adhesions cause and detest NG tubes. My best to you that you may find the best path for you!

@sita

Yes, I had my first stomach surgery in 1981. About ten yeas later I started having almost monthly partial obstructions due to adhesions. I finally was able to deal with these by doing clear liquids for a few days and then gradually adding in food and by using visceral massage. It worked for twenty years and then I had a bad episode and was hospitalized and has surgery. That surgery had changed my life terribly. I have had a five year period of increasing stomach and entire body problems. In hindsight I wish I had never done that second surgery. Everyone has to make their own path. I know well the pain that adhesions cause and detest NG tubes. My best to you that you may find the best path for you!

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@sita
Yes, the liquid diet for a few days can be quite helpful. I do that at least twice a month as well.

You also mentioned visceral massage. Is this something that you have learned to do, or do you see a massage practitioner?

@hopeful33250

@sita
Yes, the liquid diet for a few days can be quite helpful. I do that at least twice a month as well.

You also mentioned visceral massage. Is this something that you have learned to do, or do you see a massage practitioner?

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I saw a PT who did it, some OTs are also trained to do it.

I am currently recovering from SBO from adhesions. Had an ostomy reversal surgery 7/31, developed the SBO and had an unsuccessful second surgery 8/11. Had 2 NG tubes placed during the 17 days I was in the hospital. I had one prior in January when I had to have the colostomy. They are awful. When getting the first one this time, they tried 8 times in the room with Just KY jelly before they sent me to radiology to have it done. There they used lidocaine jelly 3 times to get my sinus numb and while it was still horrible, not as bad as in the room. When they had to do it the 2nd time, they gave me s small dose of morphine in my PICC line and back to radiology I went. Came home with the obstruction and PICC line in order to get nutrition. Clear liquid diet, then full liquid. It took a couple of weeks to start clearing and is much better now. PICC line out, on low residue diet now. I also did gentle massage while lying in bed on the area that had the blockage. It seemed to help.
The surgeon told me adhesions thin out over time so that is why they were waiting instead of jumping back in a third time. I do not want to have anymore surgery for fear of getting more adhesions.
I hope you get some relief!

Question about bowel obstructions. I went to ER with all symptoms nauseau, vomiting, abdominal pain no BM for over 1 week. CT was negative in April. Happened again for over 1 week . .can bowel obstructions be missed on CT? I've been ill since April and all tests and bloodwork are normal. Maybe I should try the liquid diet for several days? I have had stomach problems all my life but this year everything has escalated. Constant avdominal back pain is exhausting. Next step colonoscopy?

My CT's only showed where everything stopped, not actual adhesion. I know when they opened me up the second time, the adhesions were all over. I think also an X-ray where you drink the barium stuff and then they watch and take pictures as it goes through your digestive system might be helpful as well. I was vomiting up green bile from my intestines which is a symptom as well. I hope this helps!

Hello @michrn

I am sorry to hear of your current symptoms. I can understand that you want some answers and a way to treat those symptoms.

Your question about whether a bowel obstruction can be missed on a CT scan is not something I could answer. You should really contact your GI doctor to see what he/she thinks about that. It would be a good thing as well to discuss your current symptoms.

Regarding the liquid diet, it has helped many of us, but there is no way to be sure it would work for you, especially since you do not know what is causing your problems. If you do decide to try it, get a lot of nutrition with a liquid nutrition product like Ensure, which will be high in protein. I also use the Atkins shake because I'm pre-diabetic and it is lower in carbs than some of the other liquid nutrition products, yet high in protein.

It sounds like a call to your GI doctor's office is an important next step for you. Having nausea, vomiting, abdominal pain and constipation for long periods of time does make it difficult to maintain weight as well as nutrition.

Will you post again and update me on your progress?

@hopeful33250

Hello @michrn

I am sorry to hear of your current symptoms. I can understand that you want some answers and a way to treat those symptoms.

Your question about whether a bowel obstruction can be missed on a CT scan is not something I could answer. You should really contact your GI doctor to see what he/she thinks about that. It would be a good thing as well to discuss your current symptoms.

Regarding the liquid diet, it has helped many of us, but there is no way to be sure it would work for you, especially since you do not know what is causing your problems. If you do decide to try it, get a lot of nutrition with a liquid nutrition product like Ensure, which will be high in protein. I also use the Atkins shake because I'm pre-diabetic and it is lower in carbs than some of the other liquid nutrition products, yet high in protein.

It sounds like a call to your GI doctor's office is an important next step for you. Having nausea, vomiting, abdominal pain and constipation for long periods of time does make it difficult to maintain weight as well as nutrition.

Will you post again and update me on your progress?

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Yes thank you so much for your suggestions. I make smoothies with veggies and protein powder in the morning but need something I can take with me. The Atkins shake is a great suggestion. I dont have a GI doctor right now. Had one years ago but werent very helpful with IBS. Im trying a new drug called Constella for Chronic Idiopathic Constipation but maybe the barium test is a good idea. Thank you for taking the time to reply.

@michrn

Yes thank you so much for your suggestions. I make smoothies with veggies and protein powder in the morning but need something I can take with me. The Atkins shake is a great suggestion. I dont have a GI doctor right now. Had one years ago but werent very helpful with IBS. Im trying a new drug called Constella for Chronic Idiopathic Constipation but maybe the barium test is a good idea. Thank you for taking the time to reply.

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When I had obstructions the liquid diet I was referring to was short term and only clear liquids like chicken broth and apple juice. NO FiBER because my intestines couldn’t process them. Just my two cents…

@sita
Good addition to this discussion, thank you!

@michrn

Yes thank you so much for your suggestions. I make smoothies with veggies and protein powder in the morning but need something I can take with me. The Atkins shake is a great suggestion. I dont have a GI doctor right now. Had one years ago but werent very helpful with IBS. Im trying a new drug called Constella for Chronic Idiopathic Constipation but maybe the barium test is a good idea. Thank you for taking the time to reply.

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@michrn I would encourage you to connect with a GI doctor again. Remedies suggested by others will not help you if your diagnosis is different. Will you make a call to a GI specialist?

Yes Ill have to get my family md to refer me..

@michrn

Question about bowel obstructions. I went to ER with all symptoms nauseau, vomiting, abdominal pain no BM for over 1 week. CT was negative in April. Happened again for over 1 week . .can bowel obstructions be missed on CT? I've been ill since April and all tests and bloodwork are normal. Maybe I should try the liquid diet for several days? I have had stomach problems all my life but this year everything has escalated. Constant avdominal back pain is exhausting. Next step colonoscopy?

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@michrn , there is something called ideopathic bowel obstruction–I believe it mimics the symptoms of a mechanical bowel obstruction, but with no discernible actual blockage. You may want to google it. Good luck, and I hope you find some relief and answers!

@19630831 , I have had at least 30 adhesion-related small bowel obstructions from various surgeries over the past 45 years or so. So far I have refused the NG tube in the hospital, because all of the sbo's, although severe and horribly painful (and, of course, dangerous), have fortunately tended to resolve by themselves overnight. In the ER I just get pain meds, Zofran for vomiting, and fluids. I hope that I never HAVE to get the tube!
I had regular surgery when I was 12 or 13 to try to deal with the adhesions I'd gotten as an infant from surgery for an intusseception (I can never remember how to spell that!). That was in the mid-1970's, and probably eventually just made things worse.
Then, a few years ago, a laparoscopic surgeon pretty much assured me that he could permanently solve the issue with laparascopic lysis of my adhesions. I was desperate, so I went for it. Afterwards, he told me that he didn't think I'd have any more sbo's. However, I have had at least three or four since then. Perhaps results are different for different people, but based on my experience I wouldn't endorse surgery. For me, it was a waste of time and money, and my heart was broken when I realized that it had done no good!
There HAS to be a better solution…I wish someone would do the research and find out soon.

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