Intestinal obstruction + 2 surgery with a jejunostomy and enteral feeding = Pain and other problems...

Hi,
     I had an intestinal occlusion (complete obstruction of the small intestine + complete obstruction of the bile loop with 5,5 liter of bile inside) and had 2 surgeries for that, one the 17th October and the other one the 25th October. The first one take care of the bile loop problem, they empty it, replace it at the right place and stample it, they also repair the small intestine obstruction... one week later I had another CT-Scan because I wasn't able to eat and recieve my enteral feeding in the jejunostomy without having strong nausea and intestine painl. The second CT-Scan show that all my intestine track was bigger than normal, so they do another surgery and remove all my intestine and clean them, they look if I had other obstructions, some leaks and other things like that in my intestine and they remove all the adherence in my intestine, since I had previously 2 surgeries in my belly ( one for the gastric by-pass and another one to repair a hernia) who leave me with a lot of adherence...

They don't know what is the main reason why I had those 2 problems, the intestinal obstruction and the bile loop problem... apparently, it's more frequent on the peoples who had a gastric by-pass surgery.... but I was feeling horrible since more than 9 months before all of this happen. First of all I had constipation all the time, had a lot of crisis at night with nausea, strong intestinal pain and spasm... I had a CT-Scan done last April but they don't see anything wrong with my intestine, who is strange cause I had all the symptoms of an intestinal obstruction or a bile loop problem...

Of course, i'm in a malnutrition state, since I had on and off intestinal obstruction with a major weight loose of 60 pounds in less than 6 months... They take care of the malnutrition state at first with IV nutrition for the first 2 weeks and after the second surgery they start the enteral feeding in the jejunostomy with a product call Peptamen 1,5, 80 ml/hour for 12 hours in a row each day. I had a lot of problems with the jejunostomy and the Peptamen product. It was suppose to help me with the constipation but it's not the case. In fact, i'm not suppose to have constipation, since I don't have intestinal obstruction now, but the constipation continue. I need to use 2 or 3 glycerin suppository each time I need to have a bowel movement, and even with the glycerin syppository I have a lot of difficulty to pass stool, probably because of the pain from the scar???

I have to mention that because of the malnutrition state, I didn't had enough protein in my system so they had to give to me for 1 month 2 treatments each day of IV albumin and my scar don't heal very well. I have 2 hole and one is really big, they put a V.A.C on it... it's a machine who help the hole in a scar to close faster without infection...

Anyway, my major complaints now are the constipation (the Doc try some laxative product but they all give to me a lot of pain and nausea - Lactulose, Colace, Peglyte...). Another problem is my heart who beat really fast all the time... At the hospital it was more under control, always in the 80-90 at rest, but now it's all the time in the 120 at rest... I don't understand why... Is it possible that the one month that I stay at the hospital put me in a bad physical state like a deconditioning state? I can't barely do physical things, just walk or put some cloth on me make my heart beat very fast and it's never stop, even at night. I also always wake up cover of sweat...

Well, for now i'm on the 12 hours enteral feeding + a special mash diet or soft diet... can't eat a lot of food without feeling like I will throw up...

Someone here had the same kind of problems? How many time it will take to recover... and for the fast heart beat, do you think I should call my Cardiologist for an appointment? A resting heart rate of 120 is very fast, especially when you are anxious like me... i'm lucky cause I don't have often panic attack now, only in car or in the shower... but the fast heart beat is annoying, especially because I feel out of breath and can't exercise and recover normally from the 2 surgery. Also I have some problem to urinate, I feel like my bladder is not completly empty all the time... maybe it's also related to the pain?

Anyway thanks for you help ;-)

[patient915]

Welcome to the gastroenterology community!  Any sort of abdominal surgery can cause adhesions and this can lead to blockages.  I would recommend you make an appointment with your cardiologist.  You might want to talk to your doctor about trying other laxatives like Miralax or Milk of Magnesia.