Abdominal pain

I am a 36 year old male with an extensive history of small bowel obstructions & dense adhesions since the age of 3. 20 years ago I obstructed & a jejunal transverse colostomy anastimosis for bypass was done to get me thru after a back to back surgery for obstructions. This past Feb I obstructed again, lyses of adhesions done and the bypass from 20 years ago was reversed, basically I was reconnected as normal. After 2 weeks CT still showed an acute obstruction & another laparotomy was attempted, due to very dense intra abdominal adhesions the surgery was aborted, surgeon said to risky to continue.

Over a period of about 7 weeks my bowels slowly began to open  back up & function close to normal. Normalcy lasted about 2 months until I had an episode of cramping, rushing/ gushing noises & diarrhea lasting about 1 week. A CT with contrast didn't show any obstructions, but obviously these are signs of a partial obstruction. Thru August I seem to be having these  episodes more often-  about once per week lasting 1-2 days.

My questions:
1. Would it be expected to have these symptoms off & on for a
   while just to subside or could this be leading upto another
   obstruction?
2. The fact that my ascending colon & cecum were bypassed and
   had very little function for 20 years(GlycoLax is a must in
   order to have a BM at least every 2-3 days)- Could this be
   causing part of my problem now & would it take a number of
   months for the function of my colon to return to normal?
3. Sould a high fiber diet, that I'm on now, be beneficial to
   my condition? I do avoid green leafy veges, nuts, popcorn,
   etc..  

Thanks for your time.



        

[Kevin Pho, MD]

To answer your questions:
1) Adhesions are prone to reoccur.  Colectomy of the affected areas can be considered for a more permanent solution.

2) The prior surgery likely is playing a role in the current symptoms.  If further surgery (i.e. a colectomy) is not indicated, conservative therapy may help resolve the symptoms.  The time frame can range from days to weeks.

3) I am not aware of studies showing a specific diet having influence on the recurrence of small bowel obstruction.  However, I would discuss this question with your surgeon.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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