SBO due to Adhesion

Posted by 19630831 @19630831, Sep 21, 2018

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,

@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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@hopeful33250 , may I ask if you are on a permanent liquid diet? I've gone mostly liquids, smoothies, and soft, easy-to-digest foods, but I have been desperate enough to consider trying to stay on a liquid diet altogether–I know that diet doesn't actually prevent or cause sbo's caused by adhesions, but heavy meals of solid foods definitely make things a LOT worse if an sbo starts while the food is still in my stomach. I sometimes wish I could survive on nothing at all, so that I don't have to go through the misery of having food bumping up against a blockage!

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@nancybev

@hopeful33250 , may I ask if you are on a permanent liquid diet? I've gone mostly liquids, smoothies, and soft, easy-to-digest foods, but I have been desperate enough to consider trying to stay on a liquid diet altogether–I know that diet doesn't actually prevent or cause sbo's caused by adhesions, but heavy meals of solid foods definitely make things a LOT worse if an sbo starts while the food is still in my stomach. I sometimes wish I could survive on nothing at all, so that I don't have to go through the misery of having food bumping up against a blockage!

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No,@nancybev.I only use liquids when I'm having a lot of pain. I do keep my diet light, both in the amount of food I eat and the type of foods.
It is different for everyone to find what works for them. Your doctor can help.

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@nancybev

@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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Visceral massage done by a good PT can gradually break up the adhesions. That worked for me for about 20 years. Good luck!

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@nancybev

@hopeful33250 , may I ask if you are on a permanent liquid diet? I've gone mostly liquids, smoothies, and soft, easy-to-digest foods, but I have been desperate enough to consider trying to stay on a liquid diet altogether–I know that diet doesn't actually prevent or cause sbo's caused by adhesions, but heavy meals of solid foods definitely make things a LOT worse if an sbo starts while the food is still in my stomach. I sometimes wish I could survive on nothing at all, so that I don't have to go through the misery of having food bumping up against a blockage!

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@nancybev
I would also like to add that while my diet isn't completely liquid, even the foods that I do eat are high in liquid content. Fruit like watermelon is high in water content. Here is an article from the internet regarding foods high in water content, https://oureverydaylife.com/286640-list-of-water-rich-foods.html

Do you have soups, etc.?

Liked by nancybev

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@hopeful33250

@nancybev
I would also like to add that while my diet isn't completely liquid, even the foods that I do eat are high in liquid content. Fruit like watermelon is high in water content. Here is an article from the internet regarding foods high in water content, https://oureverydaylife.com/286640-list-of-water-rich-foods.html

Do you have soups, etc.?

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@hopeful33250 , so far I haven't found a doctor who can answer my questions–that's why I'm here! 🙂 My diet at present consists mostly of juices, smoothies, soups, tofu, ice cream/popcicles, fruit, and gluten-free bread that I try to chew really well. (I seem to have a sensitivity to gluten, and I think it might make the sbo situation worse). The only real meal I eat is in the morning. I will keep your good advice to try to eat "watery" foods as much as possible too!
The problem is that when I get an obstruction even water doesn't seem to get through. If I have anything at all in my stomach when an obstruction starts, it's a bad situation (as I'm sure you all know!). So I try to eat stuff that can be digested quickly, to lessen the possibility that anything will get stuck behind an obstruction before I realize one is starting.

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@nancybev

@hopeful33250 , so far I haven't found a doctor who can answer my questions–that's why I'm here! 🙂 My diet at present consists mostly of juices, smoothies, soups, tofu, ice cream/popcicles, fruit, and gluten-free bread that I try to chew really well. (I seem to have a sensitivity to gluten, and I think it might make the sbo situation worse). The only real meal I eat is in the morning. I will keep your good advice to try to eat "watery" foods as much as possible too!
The problem is that when I get an obstruction even water doesn't seem to get through. If I have anything at all in my stomach when an obstruction starts, it's a bad situation (as I'm sure you all know!). So I try to eat stuff that can be digested quickly, to lessen the possibility that anything will get stuck behind an obstruction before I realize one is starting.

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Yes, there probably aren't any good answers to this type of problem. I tried to "google" diets for SBO and didn't come up with much either.
Outside of diet I have found that I need to avoid clothing that has a restricted waist band. Everything around the waist need to be loose and not binding to any extent. I also avoid wide belts that bind the waist band area and any foundation garments that are binding as well. I have seen certain exercises that are recommended for people with gastroparesis and sometimes I try them as well. Here is a link to Youtube videos with exercises, etc. https://video.search.yahoo.com/yhs/search;_ylt=A9FJtr7S869bHBQA5PgPxQt.;_ylu=X3oDMTByMjB0aG5zBGNvbG8DYmYxBHBvcwMxBHZ0aWQDBHNlYwNzYw–?p=stomach+exercises+for+gastroparesis&fr=yhs-adk-adk_sbnt&hspart=adk&hsimp=yhs-adk_sbnt

Walking after meals is always good as well. For those of us who don't want continual hospitalizations and surgeries, it is a constant project for us to deal with, isn't it?

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@hopeful33250

Yes, there probably aren't any good answers to this type of problem. I tried to "google" diets for SBO and didn't come up with much either.
Outside of diet I have found that I need to avoid clothing that has a restricted waist band. Everything around the waist need to be loose and not binding to any extent. I also avoid wide belts that bind the waist band area and any foundation garments that are binding as well. I have seen certain exercises that are recommended for people with gastroparesis and sometimes I try them as well. Here is a link to Youtube videos with exercises, etc. https://video.search.yahoo.com/yhs/search;_ylt=A9FJtr7S869bHBQA5PgPxQt.;_ylu=X3oDMTByMjB0aG5zBGNvbG8DYmYxBHBvcwMxBHZ0aWQDBHNlYwNzYw–?p=stomach+exercises+for+gastroparesis&fr=yhs-adk-adk_sbnt&hspart=adk&hsimp=yhs-adk_sbnt

Walking after meals is always good as well. For those of us who don't want continual hospitalizations and surgeries, it is a constant project for us to deal with, isn't it?

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@hopeful33250 –this is exactly the kind of information I've been looking for! I have often wondered about wearing clothes with even slight tightness in the waist, and whether that could be something that triggers an obstruction. Have you actually noticed the problem getting worse when you wear something tight? I've been losing weight so that my jeans are looser, just in case!
And the videos look really helpful too. I've heard of gastroparesis, and I gather it has something to do with food not being able to move well through the digestive system (I'll look it up to be sure)– if so, it seems logical that things that help with that might also help with sbo's.
As I said, I will try just about anything (although the more I look at it, the more I think things like Clear Passage are kind of a scam that takes advantage of desperate people for lots of money, so that's out unless I'm proven wrong). Thank you!
P.S. I've also been scheduling walking/jogging with my dog after my main morning meal (and other times too, of course!)

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@nancybev

@hopeful33250 –this is exactly the kind of information I've been looking for! I have often wondered about wearing clothes with even slight tightness in the waist, and whether that could be something that triggers an obstruction. Have you actually noticed the problem getting worse when you wear something tight? I've been losing weight so that my jeans are looser, just in case!
And the videos look really helpful too. I've heard of gastroparesis, and I gather it has something to do with food not being able to move well through the digestive system (I'll look it up to be sure)– if so, it seems logical that things that help with that might also help with sbo's.
As I said, I will try just about anything (although the more I look at it, the more I think things like Clear Passage are kind of a scam that takes advantage of desperate people for lots of money, so that's out unless I'm proven wrong). Thank you!
P.S. I've also been scheduling walking/jogging with my dog after my main morning meal (and other times too, of course!)

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@nancybev
I don't know why snug clothes cause the discomfort but I certainly notice the correlation so I just avoid them.

Liked by nancybev

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I went to the doctor because get blockages every four months . Did a ct scan can't see any thing. So we did scan where they observe a liquid go though bowel overtime 3 hours to see if any problems. The results show my bowel makes a sharp right turn at one point and he fells the is causing problem . He feels it is most likely adhesions but wants to check to be sure by doing lyposcopic surgery to find out. My question is unless he does this surgery and just passes it of as adhesion he won't be sure its not something else causing my bowel to make the sharp right turn and my obstruction. I am 66 years old and had a bust appendix at age twelve problems with obstruction didn't start till a year after my lower hernia operation. so is the surgery a good idea even though it may cause more adhestions. thanks

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@carlwgordon

I went to the doctor because get blockages every four months . Did a ct scan can't see any thing. So we did scan where they observe a liquid go though bowel overtime 3 hours to see if any problems. The results show my bowel makes a sharp right turn at one point and he fells the is causing problem . He feels it is most likely adhesions but wants to check to be sure by doing lyposcopic surgery to find out. My question is unless he does this surgery and just passes it of as adhesion he won't be sure its not something else causing my bowel to make the sharp right turn and my obstruction. I am 66 years old and had a bust appendix at age twelve problems with obstruction didn't start till a year after my lower hernia operation. so is the surgery a good idea even though it may cause more adhestions. thanks

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@carlwgordon , hi. I'm not a doctor, but I've had 30+ small bowel obstructions due to adhesions in my lifetime (57 years). From what I've come to understand, surgery of any kind tends to be considered a last-choice option (as in when a blockage doesn't resolve with other measures and becomes life-threatening) due to the possibility of creating more adhesions.
Maybe you could ask the doctor about other kinds of tests that are not so invasive? Maybe an endoscopy or colonoscopy or something? Again, I have no real medical knowledge aside from my own experiences, but it can't hurt to ask if there are things other than surgery that they could try first.
Good luck with it!

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Welcome to Connect, @carlwgordon. You may notice that I moved your discussion and combined it with this existing discussion about abdominal adhesions. I did this as I thought it would be beneficial for you to be introduced to the many members who have discussed similar symptoms and may be able to share their insights.

Laparoscopy — surgery done through one or more small incisions, using small tubes and tiny cameras and surgical instruments – is a minimally invasive surgery. I'm tagging @19630831 @sita @thull @bradleymom1967 @ginpene05 @thull to bring them into this conversation as the've shared their experiences with adhesions and/or surgery. You can also view their posts in these discussions:
– Chronic small bowel obstruction from adhesions https://connect.mayoclinic.org/discussion/chronic-small-bowel-obstruction-from-adhesions/

Has your doctor suggested any special diet, @carlwgordon?

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@carlwgordon

I went to the doctor because get blockages every four months . Did a ct scan can't see any thing. So we did scan where they observe a liquid go though bowel overtime 3 hours to see if any problems. The results show my bowel makes a sharp right turn at one point and he fells the is causing problem . He feels it is most likely adhesions but wants to check to be sure by doing lyposcopic surgery to find out. My question is unless he does this surgery and just passes it of as adhesion he won't be sure its not something else causing my bowel to make the sharp right turn and my obstruction. I am 66 years old and had a bust appendix at age twelve problems with obstruction didn't start till a year after my lower hernia operation. so is the surgery a good idea even though it may cause more adhestions. thanks

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Hello @carlwgordon

I would like to add my welcome to that of Kanaaz in joining Mayo Connect.

You mentioned having a 3 hour test where you were scanned to watch how the digestive tract handled the liquid. Does this test have a name?

I am sorry to hear of the confusion you feel as a result of your doctor's recommendation to do a laparoscopic procedure in order to further diagnose the reason for the problem with your digestive tract.

Since you have doubts about this laparoscopic procedure have you considered getting a second opinion? A second opinion from a multi-disciplinary medical center, like a Mayo facility or a university medical center, might be a way to help you make an informed decision about the best route to take.

I look forward to hearing from you again. Will you keep in touch and post again regarding how you are doing with this decision?

Liked by thull

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Hello All:

A day or so ago, a member, @nancybev, mentioned idiopathic bowel obstruction where the symptoms of bowel obstruction are present, but there are no diagnostic findings on scans, etc. As I found this intriguing, I did a search and came up with an article on the NORD website. NORD is the the National Organization of Rare Disorders. Here is a link to that information, https://rarediseases.org/rare-diseases/chronic-intestinal-pseudo-obstruction/

I am copying the Summary from this article but please read the entire article.

"Chronic intestinal pseudo-obstruction (CIP) is a rare, potentially disabling gastrointestinal disorder characterized by abnormalities affecting the involuntary, coordinated muscular contractions (a process called peristalsis) of the gastrointestinal (GI) tract. Peristalsis propels food and other material through the digestive system under the control of nerves, pacemaker cells and hormones. CIP usually results from abnormalities affecting the muscles or nerves that are involved in peristalsis. Consequently, peristalsis becomes altered and inefficient. The symptoms of CIP resemble those caused by mechanical obstruction of the small bowel. Mechanical obstruction refers to something (such as a tumor, scar tissue, etc.) physically blocking the passage of food and other material through the GI tract. In individuals with CIP no such physical obstruction is present, hence the term pseudo-obstruction. Common symptoms include nausea, vomiting, abdominal pain, abdominal swelling (distention) and constipation. Ultimately, normal nutritional requirements cannot be met leading to unintended weight loss and malnourishment. CIP can potentially cause severe, even life-threatening complications."

This "lack of peristalsis" might be a problem for many of us who have this chronic problems.

Liked by nancybev

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@hopeful33250

Hello All:

A day or so ago, a member, @nancybev, mentioned idiopathic bowel obstruction where the symptoms of bowel obstruction are present, but there are no diagnostic findings on scans, etc. As I found this intriguing, I did a search and came up with an article on the NORD website. NORD is the the National Organization of Rare Disorders. Here is a link to that information, https://rarediseases.org/rare-diseases/chronic-intestinal-pseudo-obstruction/

I am copying the Summary from this article but please read the entire article.

"Chronic intestinal pseudo-obstruction (CIP) is a rare, potentially disabling gastrointestinal disorder characterized by abnormalities affecting the involuntary, coordinated muscular contractions (a process called peristalsis) of the gastrointestinal (GI) tract. Peristalsis propels food and other material through the digestive system under the control of nerves, pacemaker cells and hormones. CIP usually results from abnormalities affecting the muscles or nerves that are involved in peristalsis. Consequently, peristalsis becomes altered and inefficient. The symptoms of CIP resemble those caused by mechanical obstruction of the small bowel. Mechanical obstruction refers to something (such as a tumor, scar tissue, etc.) physically blocking the passage of food and other material through the GI tract. In individuals with CIP no such physical obstruction is present, hence the term pseudo-obstruction. Common symptoms include nausea, vomiting, abdominal pain, abdominal swelling (distention) and constipation. Ultimately, normal nutritional requirements cannot be met leading to unintended weight loss and malnourishment. CIP can potentially cause severe, even life-threatening complications."

This "lack of peristalsis" might be a problem for many of us who have this chronic problems.

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@hopeful33250 –this is very clear and informative (and I'm annoyed at myself for spelling "idiopathic" wrong! 🙂 ). Thank you for sharing it!
I've wondered if it's possible to have obstructions of BOTH kinds (mechanical and idiopathic) at various times. I know that I have a lot of adhesions, but sometimes scans have shown no actual "thing" causing my pain and vomiting.

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@nancybev

This might possibly be an answer for a lot of us who have the symptomatology but not the diagnosis criteria. I found it very interesting. I appreciate your mentioning it in an earlier post.

Liked by nancybev

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