Tips for managing chronic Small Bowel Obstructions

Posted by jljacoby @jljacoby, Dec 10, 2018

Hey everybody!
I joined this group hoping to find tips for managing recurrent/chronic SBOs. I had a Ladd's procedure at 4 days old which left me with scar tissue.
I started having partial SBOs at 25 but they went misdiagnosed as biliary colic because my anatomy is weird so I presented with RUQ pain mimicking gallbladder issues.
Last year in March I was diagnosed with a closed loop bowel obstruction and had emergency surgery. They found that my intestines were adhered to my liver and gallbladder and the surgeon removed my gallbladder an resected a small portion of my small intestine. That resulted in a 21 day stay in the hospital due to post op complications.
This year in June I had yet another SBO that ultimately resulted in another surgery. My surgeon said it looked like someone had dumped super glue in my abdomen the adhesions were so bad. That surgery resulted in a 26 day hospital stay ( my bowels don't like to wake up post surgery).
I am now following a low fiber/no fiber diet, work out regularly, and drink 124 oz of water daily. I have had at least 2 SBOs since being released which were both managed with an NG. I find that eating any food sets me off and have had to stick to mostly liquids.
Any tips for how to manage this thing??
Jennifer

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Profile picture for shaleenv @shaleenv

I had a partial SBO in December that put me in the hospital for a couple days. I had major fear of food for awhile after that. They think mine are due to adhesions from prior surgery though. I have a CT scan with Dye at the end of this month with mayo, which is supposed to show if it's from adhesions or something else. I have met with the GI doc at Mayo and that is who is sending me for the scan. I have also met with the nutritionist to learn what foods to avoid etc. I have not had one since, Thank God, but I am very careful about what I eat. Also if I start feeling like I am going to have another one I stop eating and do clear liquids for a day. I also take a teaspoon of olive oil daily which has helped me stay regular. I was having to use miralax and was still struggling. I told my nutritionist about the olive oil and she said she has heard others say the same thing and if it works for me then it is ok. I also found some research on it and they did some tests and learned that it does help with SBO.
I have not had any kind of endoscopy or colonoscopy and that has not been brought up yet. But I am still sort of new to this myself. I'm so sorry you have had to join this club and I hope you find answers. I can say joining mayo and these conversations helped reduce my anxiety about it all.
Ps it took a couple weeks for my soreness to go away completely after the blockage

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Thank you for your reply. Sorry that you’ve been through this as well and with even longer duration of abdominal soreness after.

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Profile picture for janetwass @janetwass

I had an SBO last November and was in the hospital for a while. It was caused by adhesions due to a previous cancer operation. It was not fun at all... however, similar to the previous message above, I am very careful about what I eat. Nothing raw including fruit and vegetables, no nuts or seeds and only smooth food that can go down easily. There is quite a lot on line about what not to eat with an SBO. And I am also very mindful of constipation (Miralex, Senna and Metamucil!). Having said all that, there is life after an SBO. One does recover. If you keep an eye on constipation and eat carefully I am told it will probably not come back (emphasis on the probably!). Unfortunately there is no sure way of prevention as I understand it. And the only symptom that happened to me was vomiting.. then I knew there was a problem. I followed up with a gastroenterologist who was very helpful and fairly reassuring. I do hope this helps.

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Thank you for your reply and sorry to hear about your long hospital stay. I have no concerns with constipation and have not changed my diet. Unfortunately for me SBO has come back as I’ve had several episodes. Perhaps the GI doctor will recommend a change in diet. We will see. I am just anxious to find out why these recurring SBO episodes are happening.

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Profile picture for sarah303 @sarah303

Hello. I am a healthy 37 year old F suffering from recurrent SBO for a few years now. Episodes have gotten more frequent recently and soreness afterwards seems slightly worse. I’ve researched that adhesions from surgery is a primary cause yet I haven’t had any surgeries or any other health issues. I am hoping to hear from others who’ve had recurring SBO without prior surgery. Did you have adhesions? If so, what were they caused from? If not, what was the cause of your SBO. I do have a GI appointment coming up but it’s hard not to constantly think about this in the meantime. Also, my GI appt is just for an office visit but I’m sure further appointments will follow. What should I expect? Colonoscopy or endoscopy or something else?

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I do hope you have some success in finding out why this is happening, I am sure your GI doctor will be able to help. Keep us posted!

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Profile picture for sarah303 @sarah303

Hello. I am a healthy 37 year old F suffering from recurrent SBO for a few years now. Episodes have gotten more frequent recently and soreness afterwards seems slightly worse. I’ve researched that adhesions from surgery is a primary cause yet I haven’t had any surgeries or any other health issues. I am hoping to hear from others who’ve had recurring SBO without prior surgery. Did you have adhesions? If so, what were they caused from? If not, what was the cause of your SBO. I do have a GI appointment coming up but it’s hard not to constantly think about this in the meantime. Also, my GI appt is just for an office visit but I’m sure further appointments will follow. What should I expect? Colonoscopy or endoscopy or something else?

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I've had multiple SBO due to adhesions myself but my aunt started having them about 10-15 years ago without history of abdominal adhesions. The first one seemed like a fluke to her doctor but over the years they became more frequent, just like in your case. About 2-3 years ago she had another one and they decided to do small bowel resection surgery. Afterwards her doctor told her that he believes that what caused the strictures in her intestines was the prescription NSAID med she had been on for years for psoriatic arthritis. I think it may have been methotrexate. Really surprising that such an innocuous medication could have played a role in damaging her intestines this way, although I guess we never really know what the long term effects of any drug are until they arrive. Maybe you can discuss any medications or supplements with your GI that might be involved. I also highly recommend researching online any meds or supplements that you take on a regular basis to see if there are any mentions of digestive system or intestinal side effects. Praying you get some answers!

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Profile picture for sarah303 @sarah303

Hello. I am a healthy 37 year old F suffering from recurrent SBO for a few years now. Episodes have gotten more frequent recently and soreness afterwards seems slightly worse. I’ve researched that adhesions from surgery is a primary cause yet I haven’t had any surgeries or any other health issues. I am hoping to hear from others who’ve had recurring SBO without prior surgery. Did you have adhesions? If so, what were they caused from? If not, what was the cause of your SBO. I do have a GI appointment coming up but it’s hard not to constantly think about this in the meantime. Also, my GI appt is just for an office visit but I’m sure further appointments will follow. What should I expect? Colonoscopy or endoscopy or something else?

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I am 77 years old and started having bowel problems several years ago. I had 3 inpatient trips to hospital with obstructed small bowel. Last one was 6 months ago. GI doctors call it a pseudo small bowel obstruction and I have been on 2 prescriptions for over a year. They must help but I still had my last obstruction after being on those meds. GI doctors tell me to eat whatever I want. They say there is nothing further they can do and will see me in a year. They did say if I am passing gas it isnt an obstruction so if I get the terrible pain but am passing gas I dont go to the hospital but take as much pain meds as possible and hope thecpain goes away eventually.

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Profile picture for marshae @marshae

I am 77 years old and started having bowel problems several years ago. I had 3 inpatient trips to hospital with obstructed small bowel. Last one was 6 months ago. GI doctors call it a pseudo small bowel obstruction and I have been on 2 prescriptions for over a year. They must help but I still had my last obstruction after being on those meds. GI doctors tell me to eat whatever I want. They say there is nothing further they can do and will see me in a year. They did say if I am passing gas it isnt an obstruction so if I get the terrible pain but am passing gas I dont go to the hospital but take as much pain meds as possible and hope thecpain goes away eventually.

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I'm so sorry that you're going through this. May I ask what medication they prescribe for pseudo SBO?

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Profile picture for sarah303 @sarah303

Hello. I am a healthy 37 year old F suffering from recurrent SBO for a few years now. Episodes have gotten more frequent recently and soreness afterwards seems slightly worse. I’ve researched that adhesions from surgery is a primary cause yet I haven’t had any surgeries or any other health issues. I am hoping to hear from others who’ve had recurring SBO without prior surgery. Did you have adhesions? If so, what were they caused from? If not, what was the cause of your SBO. I do have a GI appointment coming up but it’s hard not to constantly think about this in the meantime. Also, my GI appt is just for an office visit but I’m sure further appointments will follow. What should I expect? Colonoscopy or endoscopy or something else?

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Hi Sarah! I had a small bowel obstruction twenty years ago, which required surgery. Turned out to be malrotation of the intestines, which is a genetic defect. I was lucky enough to have a surgeon who recognized the condition upon doing exploratory surgery. I doubt that this is what you have (it's very rare), but worth asking about. I'm sorry you are having to go through this, and wishing you the best of luck!

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Profile picture for skim3737 @skim3737

I'm so sorry that you're going through this. May I ask what medication they prescribe for pseudo SBO?

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Jamp pyridostigmine 60 mg and jamp Prucalopr8de 2 mg.

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Profile picture for sarah303 @sarah303

Hello. I am a healthy 37 year old F suffering from recurrent SBO for a few years now. Episodes have gotten more frequent recently and soreness afterwards seems slightly worse. I’ve researched that adhesions from surgery is a primary cause yet I haven’t had any surgeries or any other health issues. I am hoping to hear from others who’ve had recurring SBO without prior surgery. Did you have adhesions? If so, what were they caused from? If not, what was the cause of your SBO. I do have a GI appointment coming up but it’s hard not to constantly think about this in the meantime. Also, my GI appt is just for an office visit but I’m sure further appointments will follow. What should I expect? Colonoscopy or endoscopy or something else?

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Prucalopride

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In reply to @marshae "Prucalopride" + (show)
Profile picture for marshae @marshae

Prucalopride

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Thank you. I'm also on prucalopride.

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