Help: constipation or partial obstruction

So my saga goes on. Four days after my last bout of severe pain and distention, it has happened again. I am confused as to whether this is IBS, partial obstruction or inflammation. I was feeling fine and suddenly all bowel sounds disappeared and my stomach blew up again, so rocking the 12 month pregnancy look! I stopped eating and it seems to have started working, again. Lots of watery stool, yay! But ugh, it smells noxious. The pain is in my lower right hand quadrant, but it is not cramps. Rather a constrictive pain that goes around the back, and horrid wind pains in my upper back. I am wondering whether the lack of cramps means that it is the IBS, although fibre is making things worse now. My ankles hurt as well. I gave in and rang my IBD nurse as I am wondering whether I can use a laxative, and what kind. Any ideas on what this could be.

I think the only was you'll really know is from undergoing some tests. The symptoms are too general. Personally I think IBS is the label doctors use when someone has digestive symptoms but they think nothing serious is wrong, and if you have a Crohn's diagnosis I'd lean towards thinking that your symptoms are due to that than some other digestive disorder. According to official definitions, a lack of cramps wouldn't mean it's not IBS - rather the opposite, cramps are a common symptom attributed to IBS, and fibre can make many digestive problems worse, so again, it's not a good clue to diagnosis.

Blood tests could probably tell you if you have some inflammation going on, and if you have a temperature that could be a sign that something serious is happening. Laxatives can be very hit and miss - if you're in any doubt, I'd avoid them when you have undiagnosed issues going on,.

So I saw my GP but she won't prescribe anything. IBD nurse rang just as I was about to go in, so she will ring me back. My GP was cross because I had stopped eating for a couple of days, but nothing was moving and I was scared of blocking myself up and ending up in hospital. If I am honest, I am very depressed and exhausted with it all.

It could be down to your bowels not actually moving, stimulation needed perhaps? I think I have a similar problem and have to do things to get them 'moving', it seems to mostly be mental..annoyingly

The saga goes on. IBD nurse prescribed Movicol. That was fun, ended up making things worse. But at least I got confirmation that I wasn't imagining things and that I do have multiple strictures in my distal ileum. I continue to get horrible distention but the constipation has gone. Instead I am more or less incontinent, but it is better than not being able to go. Went it GI appointment who mentioned a new procedure, double balloon Enteroscopy, but said that funding will need to be applied for and he didn't want to do that at the moment. I could have screamed. So the the IBD nurse rings me, to say that my GI had presented my case at a case conference, or whatever it is called, and a decision was made to arrange a small bowel follow through (I think all this has to do with me asking how much the double balloon would be privately) to see whether this is inflammation or scar tissue and what to do next. I am pleased that something is being done.

I take it you're in the UK and using the NHS? It's odd how there are some tests where funding seems to be an issue. Personally, I wouldn't try going privately. I've had a couple of private consultations in the past, but the only real benefit was the waiting times being much shorter. I've never had any tests or procedures done privately - I presume they tend to be very expensive, and I feel the NHS should cover whatever care you need. Was there a particular reason the doctor thought the enteroscopy would be useful? I hope the small bowel follow through brings you some answers.

I agree with you that diarrhoea is preferable to constipation, but I'm sorry you're having such awful symptoms and hope things will be sorted for you soon.

The double balloon Enteroscopy is not automatically funded by the NHS, funding has to be applied for before I can have it done and I think there are real cutbacks at the NHS under our current government. I was desperate, am desperate. The sbft should give sufficient evidence for the procedure and/or upgrading my crohns meds. I don't think my GI understands how much pain I am in, I suspect he wants me to loose weight. But on low residue, I just put it on instead :ysmile:

Have you considered finding a new gastroenterologist? Having a good doctor can make all the difference. Not that your current one has done anything wrong necessarily, but it may be that another doctor would be better at communicating with you and understanding the pain you're in.

Can you talk to your GP about pain relief? That may be something that you don't need to wait to see a consultant for.

I'm also on a low fibre, low residue diet, though with the opposite problem - I'm struggling to gain weight. There are some foods you can eat which are low fibre but also low calorie - lean meat, fish, yoghurt, white rice, plain crackers, etc. You may be able to tolerate some tinned fruits, or you can stew them. If you post on this support group, I'm sure people there will have more suggestions. http://www.crohnsforum.com/showthread.php?t=50340

I hope you don't have too long a wait for the SBFT. :hug:

This is my second hospital. I have been with them for nearly 30 years. My surgeon is fantastic and at this hospital. My GI has changed constantly. I am on pain meds, oramorph and codeine (which I take for diarrehea), but stop them if I feel I am getting blocked. I could go back to pain management but I work and don't want to take anything else. I think part of it is my fault, I wasn't forceful enough at my last appointment or I didn't communicate how bad things are. My GI is lovely but not very proactive.

UnXmas said:

Have you considered finding a new gastroenterologist? Having a good doctor can make all the difference. Not that your current one has done anything wrong necessarily, but it may be that another doctor would be better at communicating with you and understanding the pain you're in.

Can you talk to your GP about pain relief? That may be something that you don't need to wait to see a consultant for.

I'm also on a low fibre, low residue diet, though with the opposite problem - I'm struggling to gain weight. There are some foods you can eat which are low fibre but also low calorie - lean meat, fish, yoghurt, white rice, plain crackers, etc. You may be able to tolerate some tinned fruits, or you can stew them. If you post on this support group, I'm sure people there will have more suggestions. http://www.crohnsforum.com/showthread.php?t=50340

I hope you don't have too long a wait for the SBFT. :hug:

Click to expand...

Good advice, a bit of fibre is usually helpful but certainly not too much, everything in balance I say.

Having nothing with much fibre in it, in a day, is going a bit beyond the 'low-fibre' diet

Also regarding laxatives, the sort of laxative that might help is something that does stimulate mass movements rahter than bulks up stools, Pico sulfate, cascara and bisacodyl are three types of laxative that do this . They work directly on your muscles to stimulate movement (some medication uses a mix of this method and other methods)

Because of the strictures the IBD nurses don't really want me to take laxatives that will irritate the bowel. As far as fibre, I just can't at the moment. I know my diet sucks but I have to work and can't afford to get blocked again. Thanks for all the advice