Vomiting with a closed esophagus
Hello- my mom had a stent placed so she could get a liquid diet down but was having some difficulty eating with it, . So they put in a J-tube for feedings. She had been vomiting bile after the j-tube which they later found was due to a kink in the intestine above the tube. To help with the bile situation they inserted an nasogastric tube to suction out the bile. After a J-tube revision, she is still vomiting (less than before) but they’ve removed her NG tube. Now they’d like to remove the stent bc it has slipped down. My question is: if she has to vomit, how will she do that with no stent to create an opening? Has anyone experienced this? Thank you so much for any help you can offer! 🙂
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I had the stent put in back in 2021. It was originally supposed to be the first thing done. It was postponed and I had been in chemo and radiation for a couple of weeks before it was done. It was the worst of my treatment and had to be taken out a week later, and a j tube put in place. Honestly I had issues with swallowing and vomiting was never a serious side effects until the stent. Hindsight stay with the feeding tube.
Thank you for your reply, Manz. So sorry you had to go through that. My mom just had her stent taken out and has the j-tube only now. She comes home after 3 weeks in hospital after what was supposed to be a simple outpatient procedure of putting the stent in. Hopefully she’ll get enough nourishment now to undergo her first radiation/chemo treatments. I hope you are doing well now. All the best!
I'm sorry to hear of your mother's struggles. One of the more problematic aspects of esophageal carcinoma is maintaining esophageal patency which may be reduced due stricture formation post-radiotherapy or tumor growth. Palliative remediation procedures like stenting or dilation are temporary and problematic, particularly stenting.
I am a 4+ year survivor of Stage 4 squamous cell esophageal carcinoma and have been dealing with total esophageal occlusion for >2 yrs. I refused stenting because they are highly problematic. They all will either shift in position, suffer cellular over-growth, may cause esophageal tears and perforations and general discomfort. It would appear that your mother has suffered than a few of these complications as have many other respondents to your query. I agree with those who recommend installation of either a a G-J or G tube. This should allow her to recieve adequate nutrition, hydration and most of her needed medications and supplements. I've had my G-tube in place for more than two years and it has allowed me to regain and maintain a healthy weight for my age and height ( 70 yo, 5'11", 155lbs). While not ideal, as long as you clean the area around the stoma and maintain the tubes patency via adequate flushing/cleaning, they work quite well.
I have occasional bouts of nausea but as I have total esophageal occlusion, I am unable to expell my gastic contents orally. This is most uncomfortable but I manage this with various anti-emetics such as odansetron or compazine. Benadryl, valium or cloapin are also useful adjunctive therapies for reducing anxiety and anticipatory nausea and vomiting. As I am unable to swallow my oral secretions I am constantly wretching into my yak bags which is a tad gross and embarrassing but you learn to live with it. I find that benadryl
or scopolamine patches help a bit with in controlling my excessive salivation. There are other drugs available but I don't use them.
In summary, I would recommend that your mother use a G-tube. She will be should be able to gain and maintain weight, stay hydrated and reduce her nausea and vomiting.
Sounds promising for your Mom that’s fantastic. I’ll take the j tube over the stent anyday. Hope for her fast recovery and have a great day!