Scar tissue removal?

I admit I'm a bit puzzled. I had my J tube for 8 months... 4 before my esophagectomy and 4 after. Where the J tube enters the jejunum is a very small piercing. I'm not sure I've heard of anyone having scar tissue problems in this early segment of the small intestine. And if we did... it wouldn't be something that comes and goes... like a cancerous tumor that may grow or shrink due to treatments taking effect. Are you sure you've been dx'd correctly in this regard?

I'm no doctor... but at such an early stage of your food's journey thru the small intestines (and then on to the large intestine)... how solid would your poop be at this stage of the journey? I mean scar tissue at the surface, where we connect to our J tubes is normal (I swear I have a second belly button now where that stoma was located). But scar tissue in the jejunum itself from J tube placement... enough to block the passage of our foodstuffs... wow!

Was the original installation of your J tube problematic? Was it re-done a few times? Did you use it for all 6 months successfully?

I'm not quite sure what the fear is of resecting this section... and how the reconfiguration after the esophagectomy would affect things... is it because of the scar tissue leftover from the esophagectomy... making it hard to access this upper section of the small intestines? This is sure an interesting and difficult situation... and I understand your worry. Please tell us more... and why an experienced colorectal surgeon cannot handle this. I'm puzzled how this isn't a full time blockage for you... how can it possible "come and go"?

where are you located and is there a major medical center near by. Resecting a scarred jejunostomy sight shouldn't be a big deal for any general surgeon to perform, but I would find a local surgeon with good ratings in a big center that is closer.

Thank you so much for replying. I live in Santa Rosa Beach Florida and there are no really good medical centers in the area Anderson Houston Texas is where I had the surgery done but I’m worried that if I have the scar tissue removed, Moore will come back.

so it looks like you are 4 hours away from new orleans, Birmingham, Jacksonville and Gainsville. Not "major" medical centers, but Oschner, UAB, Baptist (MD Anderson Jax) and UF are nothing to spit at. Closer you have Sacred Heart Pensacola that should have on OK general surgery program. Not sure how much time you can tolerate when you have a blockage as I know it's quite painful and you certainly can't risk a rupture. You would be wise to be in touch with a general surgeon at your chosen center before you show up in the ER there. Even teledoc to get you established. A phone call to that surgeon that you are on your way and then a "direct admit" from the ER is a much more patient friendly experience than ER, wait to be seen, call in the on call doc and then emergency surgery. Hopefully you will be on a stool softener plan to prevent another occurrence, but I'd like to see you have a plan B. Best of luck and keep us posted.

Wow Steve. Thank you this is the best response I’ve received. Pensacola is only an hour and a half away, but the problem I’ve had with the ambulance is that they don’t want to take me anywhere except for the closest hospital, we had to insist on going to the other one and then after the CAT scan like I said they put me in a ER and sent me to another hospital. I’ll establish a relationship with a good surgeon in Pensacola since mine is in Houston and I’ve already spoken with him and he said to come back to Houston🤦‍♀️ but like you mentioned when I’m having a bowel obstruction, I am in severe pain and I need immediate attention! I’m talking like life flight urgency! I’m so scared. It’s going to burst and empty contaminants in my body. Next step, I’m going to establish a relationship with a good surgeon in Pensacola.
Maybe he can give me some advice on how to get there quickly. I live in a very high tourist area along the Gulf of Mexico. Traffic is bumper-to-bumper and there’s no way to get anywhere quickly.
Thank you so much and I will keep you posted.

You have good questions and I hope I can answer them all correctly. The diagnosis by two separate ER surgeons both believe the blockage (based on scans and x-rays) was due to scar tissue at feeding tube site. I did not have any problems while the feeding tube was in and had it for six months straight.
Both times I had the “blockage“ was when I had not gone #2 that day. I have to make sure that I have go number two every day! If I miss a day, somehow it gets stopped up and I’m more susceptible to these. I almost had one recently, and I felt the cramping in the area of the site (at my second belly button) where my J-tube was inserted. I stretched and walked around the block three or four times, drank a lot of water, etc. it eventually went away and I did not have to go to the ER My first visit to the ER, I was admitted for five days to let my stomach rest. I did not eat and they gave me liquids. The second visit. I stayed overnight and went home the next day. After the 2nd obstruction I spoke with my surgeon at MD Anderson , he wanted to wait and see if it happens again before they try to remove any scar tissue. Removal of scar tissue can be make the situation worse as it might create more scar tissue. Another post suggested that I establish a relationship with a surgeon and Anzola, which is the nearest hospital that would have a surgeon that could do the S. I’m going to try to do that and then I don’t know how I will find the fastest way to get there God forbid this happened again. Thank you guys so much for your help..

Moffitt in Tampa... major cancer center for all things EC related. Same for Mayo in Jacksonville.

All of us who go thru our treatments, have the esophagectomy, then maybe even a year or two of immunotherapy... we all have crazy poop schedules. Many of us poop daily sometimes... or every 2nd or 3rd day... depending on how our digestion is coming along. This is ALL NORMAL. I've even had times, before surgery, where I dug my own poop out with my index finger I was so constipated. But in all of those cases I was severely dehydrated and the "baby was crowning".

So I'll assume you're still in your first year post-op... many changes yet to come... MANY. My 2nd year was vastly improved over my first year post-op. Eating, pooping, sleeping... everything got better. Hang tough... get evaluated closer to home at a place that knows EC inside and out... even though this complication may not be directly related to your cancer.

Why not consult with Mayo in Jacksonville FL? They are performing EGD stretches every 3 weeks on my husband, T3N2, surgery in Dec 2023,

I’ve been thinking about Mayo in Jacksonville for overall health. I will reach out to them. My only problem is getting there quickly if /when needed. I’m 6 hours from Jacksonville. Thank you for your suggestion.