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

@nancybev

@thull , I am SO sorry to hear what you're dealing with! Please know that my thoughts will be with you for your upcoming surgery. It must be so frustrating.
I know that for the most part you're on clear liquids right now, but I've been meaning to post a recipe for my go-to homemade super-healthy smoothie, etc. It takes like 5 minutes to throw together, but it has a lot of protein and other nutrients, and it's delicious (it can be tweaked according to people's tastes), and it's cheaper than a lot of the pre-made stuff. It also contains a good amount of calories to help you put on weight (when you're able to drink them).
Another thing I often drink for breakfast is also easy and healthy, and has no fiber to cause issues. It's my own version of Indian lassi. I don't know if your doctor will give you the OK for it yet, but for when you (and others here) can try it:

1/2 cup Greek yogurt (with active cultures–I use Chobani)–I use plain, non-fat (easier to digest), but vanilla would be sweeter and also taste good

1/2 cup coconut, soy, or almond milk–I use the sweetened vanilla kind…cow's milk might be fine, but might be a little harder to digest

A few drops of vanilla

Spices (I use cardamom and turmeric, but nutmeg or cinnamon would be good too) and, if you want it sweeter, honey to taste

2-3 ice cubes

Throw it all in a blender and drink! It goes down easily, but it's a healthy start to the day (with a giant cup of coffee, of course! 🙂 ).

I'll post the other recipe at some point as well, if anyone is interested.

Again, best of luck and warm wishes to you, @thull !

P.S. Happy New Year to everyone!

Jump to this post

Nice recipe. Will try it soon. How 'bout the other one? Thanks.

Liked by nancybev

REPLY
@hopeful33250

Maybe it's time for the three of us to meet at a McDonalds for a milkshake?

Jump to this post

@hopeful33250 , I'm totally up for that…as long as someone can be the designated person in charge of keeping me away from the fries! 🙂

REPLY

Ok, that will have to be me!

REPLY
@ginpene05

Nice recipe. Will try it soon. How 'bout the other one? Thanks.

Jump to this post

@ginpene05 , the other one varies in ingredients, depending on one's tastes and mood and need for calories and fiber. I generally start with a banana and a cup or so (more or less depending on how thick you like your smoothies) of milk (cow or soy or coconut or almond). Then I add some or all of the following, blend it up, and call it a meal! It's pretty tasty…

1/2 avocado (great for calories and creaminess and feeling full, and weirdly tasty in a smoothie)

Plain or vanilla Greek yogurt (with live cultures)–fat-free or full-fat, depending on your needs–roughly 1/4 cup

Tablespoon or so of peanut butter

Tofu (about 1/5th of a cake, plain)–more protein and calcium and texture!

Protein powder of your choice

Vanilla

Handful of fresh spinach (for iron–looks weird, but you really don't taste it)

About 1/4 cup rolled oats

Berries or other fruit (I've been buying bags of frozen fruit so stuff doesn't go bad)

Of course, you can add your own variations!

If you keep everything on hand at home, it takes like 5 minutes to throw together, and it tastes better and is cheaper than Ensure, etc.

REPLY

By the way, make sure your banana and avocado are nice and ripe–otherwise it doesn't taste nearly as good.

REPLY

MY STOMACH SOUNDS LIKE , ITS LIKE YOURS I HAVE HAD MAJOR SURGERY AND LOSING 3/4 LARGE BOWL ALSO 12 INS OF THE SMALL BOWL MY DAILY EATING IS LIMITED DUE TO WIND NAUSEA AND FEEL LIKE I AM GOING TO BE SICK. TIREDNESS MY DOCTOR HAS SAID THERE’S NO ONE WITH A STOMACH LIKE YOURS HOPE TO HEAR FROM YOU SOON. GOOD LUCK 👍

Liked by nancybev

REPLY

I’ve been struggling for years to find something that will help control the chronic nausea. I’ve tried different meds and they’ve helped but can take a long time to kick in, some make me so tired I can’t do anything. What has worked for you? Both meds and over the counter. Have any of you tried essential oils? Did they help?

REPLY
@dc10

What helpful information may you have for someone who is experiencing this problem? Doctors who specialize in this?

Jump to this post

Hello @dc10 and welcome to Mayo Connect. I'm sorry to hear of your problem but happy that you found Connect and are looking for help and answers. On Mayo Connect we encourage everyone to advocate for themselves and to seek out the best specialists for their problems and most importantly to ask questions.

We actually have two discussions on Connect regarding this topic. If you click on these links you will see what others are saying about this problem.

https://connect.mayoclinic.org/discussion/chronic-small-bowel-obstruction-from-adhesions/ and
https://connect.mayoclinic.org/discussion/chronic-small-bowel-obstruction/

As you read these posts from Members who have also experienced this problem you will undoubtedly get some good information. If you find a post especially helpful, you can click on the "Reply" box and post a question or comment to that Member. I would like to invite two Members who have been quite active in these discussions to join you. Please meet @thull and @nancybev. Both of these Members have had repeated surgeries and have lots of practical ideas on eating, drinking, and exercises that will help with this problem

Most of us who have this problem have had repeated surgeries (or at least one surgery) of the digestive tract which is had led to these obstructions. If you are comfortable sharing more, will you let us know if that is your case as well? If so, could you give us some background on how many surgeries and over what time period?

I look forward to getting to know you better. Will you post again and let me know how you are doing?

REPLY
@dc10

What helpful information may you have for someone who is experiencing this problem? Doctors who specialize in this?

Jump to this post

I am currently in the hospital with my 6th SBO. They began 3 years ago and are becoming more frequent. I’ve had all the tests that gastroenterologists do, all the endoscopes and colonoscopies. They think I have some scar tissue from a laparoscopy that I had back in 1980. When I feel an obstruction coming on, it’s like a moving train that I’m unable to stop, and progresses to the point where I’m so violently ill, that I have to get to the hospital to get pain and nausea medication, and of course, the terrible NG tube. My obstructions have resolved on their own in the hospital with their usual protocol, but I have not had any helpful information from the numerous doctors I’ve seen about how to prevent them. It is beyond frustrating and I basically don’t know where to turn to get help with this. Otherwise I am very healthy, but to say that it’s impacting my life is an understatement.

REPLY
@dc10

I am currently in the hospital with my 6th SBO. They began 3 years ago and are becoming more frequent. I’ve had all the tests that gastroenterologists do, all the endoscopes and colonoscopies. They think I have some scar tissue from a laparoscopy that I had back in 1980. When I feel an obstruction coming on, it’s like a moving train that I’m unable to stop, and progresses to the point where I’m so violently ill, that I have to get to the hospital to get pain and nausea medication, and of course, the terrible NG tube. My obstructions have resolved on their own in the hospital with their usual protocol, but I have not had any helpful information from the numerous doctors I’ve seen about how to prevent them. It is beyond frustrating and I basically don’t know where to turn to get help with this. Otherwise I am very healthy, but to say that it’s impacting my life is an understatement.

Jump to this post

Mine were caused by adhesions from previous surgeries. (I had 4 this year). The last surgery , 1/07/19, they started to try laparoscopic but when they saw all the adhesions, they switched to open and spent the first 2 hours clearing the adhesions before they could start the actual bowel procedure. Ended up perforating the small bowel during that and had to fix that too. I am now 2 months post surgery and everything seems to be passing through ok so far. The liquid nutrition I have mentioned in previous posts are good, plus the gentle abdominal massage . I wouldn't be surprised if they put you on a low residue diet.
Good luck and feel better!
Also, I hate the NG tube as well, but it does work. Had 4 of those this year too! UGH!

REPLY

Hi. I have had abdominal pain and nausea since August. In September I had an upper GI scope which showed a duodenal stricture. At that time, the stricture was ballooned open. I felt better initially, then the symptoms come back. I have since had an ERCP and 4 more GI scopes (including 1 to place a stent in that stricture, and 1 to remove the stent). While the stent was in, I had a little bit of pain/nausea initially and had a barium swallow which showed delayed gastric emptying (however, it emptied after approximately 15 minutes). Due to the delayed emptying, I was diagnosed with gastroparesis. I had been on Reglan prior to this diagnosis, but afterwards my dosage was increased. Between either the stricture or the Reglan my symptoms were better, however I had bad side effects from the Reglan and had to go off of it. I was off of it for approximately 2 weeks prior to the stent removal. For about a month after the stent removal, I was symptom free. Unfortunately, in January the symptoms started up again and I had another scope where the stricture was ballooned again.

I recently saw a GI doctor for a second opinion who felt that majority of my symptoms were due to the stricture and that there was no evidence to support the diagnosis of gastroparesis. He recommended a consult with a surgeon for possible surgery for that stricture (he mentioned a few different possibilities). I saw the surgeon today. He is doing more testing (gastric emptying study, CT scan, and another upper GI scope in order to get a biopsy of the stricture), but didn't feel that my symptoms were consistent with the stricture. I am getting quite frustrated, have been dealing with this for quite a while. I have been on a liquid diet since January, and have lost almost 50 pounds since September.

Anyway, has anyone else experienced anything like this? Anyone have thoughts? Thank you.

REPLY

Hi @kibe75,

You may notice that I moved your message and combined it with this existing discussion. I did this as I thought it would be beneficial for you to be introduced to the many members who are discussing much of what you are experiencing.
If you click on VIEW & REPLY in your email notification, you will see the whole discussion and can join in, meet, and participate with other members talking about their or their loved ones' experiences.

I would like to invite @jlfisher56 @robatk17 @katmandoo @irreverent @nonnie1 @upartist @techmom @gabigirl26 @darlia @fourof5zs @jlfisher56 to join in as they’ve discussed slow gastric emptying and/or gastroparesis on Connect, and may have some insights and information that could help.

REPLY

With regard to drinking liquids to manage SBO, do you find that you can blend nutritious foods to a liquid? For instance, I’m drinking a smoothie with blueberries, cherries and a banana. I’m trying to find what works for me to prevent my SBOs, but still get the nutrition I need. Thank you for your thoughts!

Liked by nancybev

REPLY

@dc10 , some of the things I blend into smoothies to make them healthier (and still not too bulky) are Greek yogurt, protein powder, spinach, tofu, flax meal (for fiber that is, again, not too chunky), and occasionally a little peanut butter (although I'm more careful with that, as it's a little harder to digest, I think). I have a bunch of different kinds of frozen fruit that I can throw in, too.
I also use different kinds of milk–cow, soy, almond, and coconut–at different times, because they all have different nutritional benefits.

REPLY
@dc10

With regard to drinking liquids to manage SBO, do you find that you can blend nutritious foods to a liquid? For instance, I’m drinking a smoothie with blueberries, cherries and a banana. I’m trying to find what works for me to prevent my SBOs, but still get the nutrition I need. Thank you for your thoughts!

Jump to this post

@dc10
For me, as far as the nutrition went, getting enough protein was my doctors biggest concern along with enough calories. I pretty much stuck with the high protein Boost and the Boost Breeze which is clear. I didn't have the energy while recovering from the surgeries to make my own smoothies. And definitely lots of water, and I did a gentle massage which I feel really helped.

REPLY
Please login or register to post a reply.