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

Interested in more discussions like this? Go to the Digestive Health Support Group.

@nancybev

@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.

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THANKS THIS INFORMATION IS HELPFUL AND I WILL BE TRYING SOME OF THE SUGGESTIONS TERESA

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@dc10

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

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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?

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@dc10

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

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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.

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@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.

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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!

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

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I have always suffered from IBS but it worsened around menopause. Five years ago I was hospitalized for 9 days with a total bowel obstruction. They removed my appendix, a foot of my colon and a bunch of small intestine. I chronically feel blocked although I have had all the tests. I’m in and out of urgent care and always feel miserable. Any suggestions?

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@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.

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Hi, I just came across your post and it is identical to what is going on with me. I just had my 6th SBO/w hospital stay and NG tube. This last one told me it had to do with adhesions, not the 2 hernia's I also have from previous surgery. If you find out how to prevent them, let me know and vice versa. We are looking at Mayo and Cleveland Clinic for possible surgery to fix the hernia's (one could possibly make me have a colostomy bag the rest of my life since it is at the site of a temporary colostomy) and remove the scar tissue/adhesions to see if this helps. I am tired of living life like this - afraid another SBO is around the corner if I eat something decent.

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I'm sorry you're going through this too! Just a word of warning/advice. A few years ago a laparoscopic surgeon assured me that he could remove my adhesions so that the SBO's would stop. I will try just about anything except for that Clear Passage thing (which sounds to me like a scam), so I went ahead with the surgery. It broke my heart when I had several SBO's after that!
So I would ask a LOT of questions--how likely would the colostomy bag be (that would be awful), and do they really think that they can remove ALL of the adhesions? The other thing to consider is that from what I understand surgery to remove scar tissue can sometimes cause MORE scar tissue, especially if they end up having to do open (instead of laparoscopic) surgery--and sometimes they don't know if they will have to do that until they've already "gone in."
I'm not saying that you shouldn't consider it, but ask a lot of specific questions about efficacy versus risk.
Good luck, and keep us posted!

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@nancybev

I'm sorry you're going through this too! Just a word of warning/advice. A few years ago a laparoscopic surgeon assured me that he could remove my adhesions so that the SBO's would stop. I will try just about anything except for that Clear Passage thing (which sounds to me like a scam), so I went ahead with the surgery. It broke my heart when I had several SBO's after that!
So I would ask a LOT of questions--how likely would the colostomy bag be (that would be awful), and do they really think that they can remove ALL of the adhesions? The other thing to consider is that from what I understand surgery to remove scar tissue can sometimes cause MORE scar tissue, especially if they end up having to do open (instead of laparoscopic) surgery--and sometimes they don't know if they will have to do that until they've already "gone in."
I'm not saying that you shouldn't consider it, but ask a lot of specific questions about efficacy versus risk.
Good luck, and keep us posted!

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The more surgery, the more scar tissue. I had surgery 8 months ago for excision adhesion's & there was a tear in my small bowel so the surgery was not completed. Now I'm suffering more pain than ever. Be careful & I wish you the best of luck.

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@grammiec

Hi, I just came across your post and it is identical to what is going on with me. I just had my 6th SBO/w hospital stay and NG tube. This last one told me it had to do with adhesions, not the 2 hernia's I also have from previous surgery. If you find out how to prevent them, let me know and vice versa. We are looking at Mayo and Cleveland Clinic for possible surgery to fix the hernia's (one could possibly make me have a colostomy bag the rest of my life since it is at the site of a temporary colostomy) and remove the scar tissue/adhesions to see if this helps. I am tired of living life like this - afraid another SBO is around the corner if I eat something decent.

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Hi! I am so sorry that you are dealing with this as well. It is not fun. I've had two open bowel resections with removal of adhesions. My last surgery was in June of 2018. They spent 6 hrs removing every adhesion they could find. I have had 7 SBO's since that surgery. I have seen 2 GI docs, a motility specialist, and 4 surgeons. All of them have told me that surgery to remove the adhesions will only make the problem worse because it will simply cause more adhesions to form. I will be traveling to Mayo in a couple of months to see a battery of specialists there who, I am hoping, will help me figure out how to live with the condition I have and hopefully prevent more surgery. Ask lots of questions! And fight for yourself and your care! I have had to push to get as far as I have and I WORK in the medical field. Good luck and keep us posted.

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