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Tips and tricks after a bowel obstruction

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Hi Ladies,

My incredible mum was diagnosed with with stage 3 HGSC last year. She has completed front line chemo and is currently talking a PARP. In the middle of november she had a bowel obstruction and was admitted to the hospital for 1 week. The bowel obstruction was fixed with medications. There was a potential that she is have a reoccurrence, but her oncologist wants to re evaluate at the end of January with a CT scan. 

For the last few weeks she has been experiencing cramps every afternoon, they go away if she takes Tylenol and rests. She is practising a low fibre diet but not as strictly as when she was discharged from the hospital. The nurses have told her to just stick to a low fibre diet and the pain should go away. 

She asked me to reach out to this amazing group to see if anyone had any tips and tricks after experiencing a bowel obstruction? Anything diet related? or taking a laxative regularly? or anything at all that would help her! She really wants to be able to get back to doing all the things she loves, any help would be appreciated! Thank you in advance <3

Comments

  • Strongwoman
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    Hello @SM222 and welcome!   I will say that I am more adverse than not on this subject...unfortunately.  I experience these or ileus on a regular basis.  For me, I have to eat smaller portion sizes throughout the day and cannot eat too much at once or end up in trouble.  
    I take either Restorolax daily and/or mixed with a prescribed laxative called Lactulose which is like taking cough syrup (in its form).  Both do the same thing, they draw the water into the bowels via osmosis.  I find it is the gentlest on my bowels. I, personally, am unable to do the Senokot because if I am 'backed up' all it does is cause me more cramping and I can sometimes end up worse from it.  I am doing my best to do protein shakes that I make myself instead of taking Ensure but Ensure does work.  That is my own preference and budget that dictates that.  I have written a lot on this subject and you may find a lot more under 'partial bowel obstruction' or 'ileus' if you type it in the search bar.  It is a very difficult thing to live with and wears on oneself daily.  Sometimes I have no idea at all what sets it off.  I am fortunate to have a SRK kit at home which allows the nursing to come and administer intramuscular ports so that I can administer pain and nausea meds myself as directed by them until I can get past it.  A lot of soup and liquids and I always have applesauce and gingerale on hand.  Sometimes these occur due to the location of tumours and what they are doing to us on the inside.    I am finding it is taking me longer to bounce back from my episodes compared to last year. What would be a day down and then recovery is now a couple of days down and then recovery. I also go from having difficulty going to the bathroom to having to wear a depend at night or I would end up with a mess in the morning.  No explanation for it and I find it all quite embarassing but it is real and does happen. 
      Some say to watch nuts and seeds but even with IBS they are dispelling that myth these days.  I say low and slow to eating after having an episode and then journal daily what she has eaten.  It may help to discover something that is setting it off. For myself these days, it is the amount of food at one time and I now have to slow down and eat more often.  I hope that helps but feel free to reach out should you have any more questions, I would be more than happy to answer them. 
  • @SM222  As someone who has been dealing with constipation/diarrhea, I find even Restoralax can cause severe cramping and I avoid any of the stimulant laxatives for the same reason. I take a laxative that isn’t recommended by healthcare professionals any more because the research shows it has no effect. But it does for me and it’s still available over the counter. It’s docusate sodium and all it does is soften  the outside of the stool to help it dislodge and get expelled. Her doctor might raise an eyebrow but make sure you ask questions before you use it in case it causes problems for your mother’s particular condition. The other thing friends have mentioned is good old-fashioned stewed prunes. These I have to avoid because they’re full of potassium which my kidneys can’t excrete any more, but if her doctor gives the nod, go for it. Apparently they’re quite effective, they’re pleasant to eat for the most part (you don’t need a lot) and are a good way to prevent future problems. 
    I hope she finds something that works for her.
  • Strongwoman
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    Great suggestions @HoldingOn.  Thank you for sharing what works for you!
  • SM222
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    Hi @Strongwoman and @HoldingOn thank you for these suggestions, I have shared them with my mum and she is going to try them. Seems like trial and error is necessary to see what works best for her. Thank you again for taking the time to respond, we are both very grateful. I will let you know if we have any additional questions! 
  • Strongwoman
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    Okay ladies....I finally found a research article that explains (and now makes more sense to me) regarding bowel obstructions and why I find it so difficult to get the fluid intake up.  
    Basically, it slows down the bowel and bowel movement which creates an inflammatory response and inability to uptake fluids properly no matter how much one drinks amd round and round we go.  Here is the article for anyone who wants to read it:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9805709/

    Hope this helps some one.
  • Strongwoman
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    Hello All.  I do have some stuff to add here.  I had my worst bowel obstruction as of yet.  It hit Sunday night and I went directly to the hospital.  I did vomit on the way in which helped a bit. After doing a CT scan, it showed that it was obstructed at 2 ends.  This meant that I had to and I do mean had to, get a NG tube inserted. For those that have never had one, hope to everything you have that you don't have to experience it as it is very unpleasant.  I had it in a little over 5 hrs.  For those that don't know what it is, look it up.  If it had not resolved, I was possibly looking at a surgery with many risks involved.  Thank goodness it did resolve itself.  I am now on what is called a "LOW RESIDUE DIET".  This has 3 phases to it, fluid diet (when you are severe in symptoms), minimal fibre diet (in between stage) and low fibre diet (when you feel your best).  I am in the fluid one for a few more days and then will graduate over to the low fibre diet for a month.  If anyone wants a copy of this, kindly contact me and I will gladly send it to you via an attachment.  It is going against some of the things I enjoy and I know are good for me but if it wards these attacks off, well I am all for it.  I have had 4 since November.  I wish to have no more if I can help it all.  I am slowly get back to myself and energy and fatigue are still coming along.  Today I did my first outing and am fatigued.  I got home from hospital yesterday late morning before our Ontario storm really took hold.   NO more raw fruit or veg for me....I will miss them.   But on the up and up, I can still have chocolate and ice cream!  :)
    Hoping no one else has to ever have that tube inserted.  Let me know if I can help in any way. 
    Take care
  • SM222
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    Hi @Strongwoman I'm sorry to hear about your bowel obstruction and having to use an NG tube, it really does sound unpleasant. But glad to hear it did its job and that you are back home :smile: The diet sounds tough, are you able to have homemade fruit and veggie juices? We got my mum a juicer this year and she has been loving it, as she is able to still get some raw fruit and veggies in despite being on a low fibre diet! Also an update, we met with my mums oncologist today, and she thinks that she might having acid reflux and possibly early stages of an ulcer, so they have prescribed a medication for her to try for 2 weeks. Hopefully, it will help ease some pain for her!
  • Strongwoman
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    Thank you @SM222 I am going to ask about juicing.  As I didn't even think of it as an option and completely went blank on it being one.  
      Sorry to hear of your Mom's acid reflux and ulcer, I have my fingers crossed that any medication they offer will provide a solution to the issues. 
    Take care and thank you for caregiving and being open to chat about how your Mom is doing.  <3

  • SM222
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    Hi @Strongwoman wanted to check in to see how you are doing after your bowel obstruction?

    And update you about my mum. Mum has been referred to a GI doc now as she is still having some cramping, not as frequent as before but its still comes and goes. We are waiting on an appointment for an endoscopy. In the meantime she has been finding half a dose of restolax during the day and a dose of senakot at night to be helping, as well as following a low fibre diet. The low fibre diet is challenging for sure but it does seem to be helping her. She is also on 2 different types of medication that should help with the ulcer. 

    Some other holistic things that she has seen that has helped her is having yogurt everyday, having fermented rice everyday (cooked rice that is soaked in water overnight), having lots of soups and walking as much as she can. 

    Thank you for your kind words about being a caregiver <3 I'm very grateful to be here for her. And very inspired by all of you ladies and your strength! 

  • Strongwoman
    Strongwoman Moderator
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    Hello @SM222 Thank you for the update on your Mum.  Yes the low fibre/residue diet can be limiting but it does help.  I know for a fact that if I wasn't adhering to it, I would have had numerous obstructions again.  I am thankful that I have not experienced as many.  Glad to hear you Mum is on meds that are helping and that she has appts coming up that may find more discoveries that will be able to be addressed and have her feeling better soon. 
    Yogurt is quite amazing considering what it is, isn't it?  I must get back on it.  Both it and the fermented rice will have the probiotics in it that are good for the gut biome.  Walking does help with bowel motility as well and glad to hear she is doing that as well.  
    You are doing an amazing job and am sure a wonderful support for your Mum.  I am positive she appreciates it so much.  Even if this is not expressed as much as you would like, I know as a Mom myself that we do appreciate all the things you do for us. Sometimes when we aren't well, we aren't good at communicating that.  Above all else, make sure you take care of yourself so you can caregive for your Mum.  Don't forget to enjoy some things together too....take pics....create memories.....ask questions...reminisce.  All good for both of your souls! <3  
  • SM222
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    Hi @Strongwoman your kindness and words make my heart swell. Thank you for everything you do <3 Its been a roller coaster of ride caregiving for my mom but I'm so thankful and honoured to be on this journey supporting her. From your previous posts I saw that you also have adult children, and I know from experience we are also not the best communicators. But the amount of strength, grace, courage and lovingness I have seen from my mom this past year and a half are so admirable and I hope to be half the woman she is. I'm sure your children feel the same way. Moms are the best <3

    An update on my mom, is that she suffered from 3 partial bowel obstructions in the last 6 weeks, which has been incredibly tough on her. But she is doing much better now, and will be sticking to a low fibre diet for the next 6 weeks very strictly. While she was at the hospital they did evaluate if surgery would be recommended, for now they have said no but it is still on the table for evaluation if it happens again. They are unsure if the bowel obstructions are being caused by disease or adhesions, as her CA 125 is low but there are some potential signs for disease in her CT scans, but nothing concrete. She is also back on the Parp Inhibitor. So she is in a bit of wait and see stage to see what happens next.

    I wanted to share this guide that we found online, https://clearpassage.com/wp-content/uploads/2023/07/digestive-health-guide.pdf It has some information on how to manage your diet to prevent bowel obstructions. But do note this is not from a hospital or a certified medical resources, but its what has been working for her, so wanted to share.

  • Strongwoman
    Strongwoman Moderator
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    @SM222 Thank you for your update. I am truly sorry to hear your Mom has had that many partial bowel obstructions. I know what they are like and to have that often. It is hard on your Mom and her body and it hard on you the support to watch her go through it. It seems like she is just getting better and wham another hits….it gets frustrating and waring on all involved. I am happy to hear that someone talked to her about the Low Residue Diet. I included what I was given by the Dietician in the hospital in Jan of this year. It is good to know for both your Mom and yourself that surgery may be an option for her down the road. It creates some hope for both. 💕

    As for being a Mom and my boys, well yes, they have been amazing through this. I have been open and honest with them from the start. My eldest is the one that usually calls the nurses when we need them if I can't. He is calm and methodic when talking to them. For my boys, the topic of me is a hot topic in their relationships and they are fiercely protective of me. They always have been and I don't see that changing at all. I do my best to have conversations with them now that will impart wisdom on them for later. Unlike your Mom, no surgery or treatment options left for me. It rocked them when I told them and they have now processed it and we go day to day now. 🤗

    Good to hear that she is back on the PARP inhibitor. For me, I always expected some type of growth in my scans due to the symptoms I felt. I know your Mom's team will come up with a new plan for her soon enough. In the meantime, tell her to stick to that diet (gosh I despise that word) and rest up. Her insides took a hit and have to heal. Be kind to yourselves. Take care ❤️

  • HorseGirl
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    @Strongwoman I have a FB friend from NZ who has had to go on a low reside diet. She was diagnosed with Stage 3C in 2021. They don’t seem to have the amazing peer support network that we in Canada have. I mentioned that you were on a low residue diet, and she is eager to learn more if that’s something you’d be comfortable with?

  • Strongwoman
    Strongwoman Moderator
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    Sure I can share anything that is here. The diet itself should be up already but I will post it again if it makes it easier for her.

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  • HorseGirl
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    @Strongwoman I’ll take a look through, and see what I can copy and paste to her. After speaking with her, it’s clear that we have a lot more peer support here in Canada.

  • HorseGirl
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    @Strongwoman I am sorry to learn that there are no treatment or surgery options left for you. I am incredibly grateful for how you were there for me in the beginning of my journey. I follow your responses to others in this group, whether it’s by offering emotional support, helping them navigate their symptoms, providing research information, or assisting with strategies on how to interact with their health care team. You’re the example I will think of when I begin to offer peer support to other women. What would @Strongwoman say? How can I be for others what @Strongwoman has been for me? There is so much that I have learned from you! You ask questions. You really listen to what people are saying to you. There is a level of acknowledgement and understanding that comes from you, and it means so much when one feels so frightened and alone. Thinking of you❤️

  • Strongwoman
    Strongwoman Moderator
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    Thank you @HorseGirl Your meme brought tears to my eyes. 💕

  • Thank you so much ladies for your postings, I just started experiencing bowel obstructions myself and it is quite scary. I just had my second visit to the hospital, so far both times my obstructions cleared with medications and rest. I really feel for you @Strongwoman for having an NG tube inserted, I know how it can be uncomfortable; I never had one (yet) but as a nurse, I inserted a few.

    I am now on a low fibre diet, soup, apple sauce, yogurt, teas, fresh pressed juices and water. I will also start a half dose of Restorolax every morning. My doctor put me on Dexamethasone for 2 weeks, and i came home with a medication kit for pain, nausea, acid reflux so i can hopefully manage the next bout at home.

    This all make me feel like I am walking on egg shells all the time, not knowing when i will start with the cramps again. I really have to be careful with my diet, another loss. I will look up also at a low residue diet, thanks for the tip.

    I send all of you hugs and love, keep on going 💓

  • HorseGirl
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    Hi @Sylviequebecbc, I’m glad to hear that you’re planning to look up the low residue diet. I shared it with a friend of mine in NZ who is beginning to experience partial obstructions as well. Hope that it works for you! Keep us posted as to how you’re doing, and take one day at a time. Sending healing vibes!

  • Thank you @HorseGirl for your support!

  • Strongwoman
    Strongwoman Moderator
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    I think mine is still up there on the thread if you are looking for a low residue diet

    @Sylviequebecbc hoping you are finding some options to match your current eating habits