May 25/12 (D+555, T+502, S1+418, S2+212, SBO+11)
I’ve been out of the hospital for five days now and my digestive tract continues to function properly. I have kept my diet very scant/simple this week but have gradually added greater amounts/complexity with each passing day. So far, so good. My energy levels are rising quickly and I expect to be back to full strength very soon.
Upon re-reading my recent journal posts I realized that I didn’t provide a very good explanation of what happened to me last week. So, in the interest promoting a better understanding of intestinal obstructions I offer the following basic information (based on discussions with my doctors and reviewing various web-sites of some repute):
What – A blockage that prevents food, fluid and gas from passing through your intestines. Symptoms typically include abdominal cramping/pain, nausea, vomiting, distention, diarrhea, constipation and an inability to pass gas. The severity of the obstruction can vary from partial to complete. Without proper treatment, they can cause the blocked part of your intestines to die which in turn can lead to a perforation. This can cause severe infections and death.
Where – Obstructions can occur in either the large intestine or the small intestine. However, small intestine/bowel obstructions (SBO) are much more common.
Why – They can be caused by a number of factors including adhesions, hernias, tumors and inflammatory bowel diseases. Adhesions are by far the most common trigger. These scar-like tissues form after surgeries and/or radiation therapy and can restrict or alter the motion and/or position of the intestines. This in turn can cause a portion of the intestine to become twisted or kinked (think garden hose) thereby leading to an obstruction. The doctors believed that my obstruction was caused by an adhesion (likely determined by process of elimination as there were no clues pointing to a different cause).
Who – Anyone can get them but you’re much more likely to if you’ve had abdominal/pelvic surgery or if you have Crohn’s disease. FYI, Bee Gees member Maurice Gibb died of an intestinal obstruction in 2003.
When – There is no reliable way to predict their occurrence. They can happen at any time.
Diagnosis – Obstructions are diagnosed by a combination of physical examination (including much poking and prodding of the belly) along with imaging tests (i.e. X-ray and CT scans). Although not perfect, these tests are fairly reliable in determining the location and severity of the obstruction.
Treatment – A complete obstruction usually requires surgery to relieve the blockage and remove any dead tissue. A partial obstruction is treated with a naso-gastric tube which removes fluid and gas from the stomach. This takes pressure off the obstructed area allowing it to release on its own (usually over a period of 2 to 5 days). At the same time, fluids are provided by way of IV. This is effective for about 85% of partial obstructions. If this fails to work, surgery is required (either open or laparoscopically).
Prevention – There is no proven method for preventing intestinal blockages. My perusal of some message boards suggests that avoiding certain foods can improve your odds but this is not supported by any reputable medical research so far as I can tell. I also came across a web-site that promotes cure of adhesions via abdominal massage (known as the Wurn technique). This seems a bit out there to me but maybe it works.
Changing gears, now seems like a good time for a healthy dose of medical humor. The video below was sent to me some time ago (thanks Donna T.) and it made me laugh. After last week’s health scare, I was compelled to watch it again…and it made me laugh again. Although our circumstances were somewhat different, I have a lot in common with this guy. Warning: This video does contain a modest amount of foul language and is not intended for children.
