Blockages -- who is at risk for them?

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Blockages -- who is at risk for them?

Postby lpas » Sat Feb 21, 2015 8:36 am

I see a lot of references here to blockages and people needing to watch out for them, watch what they eat, and so on. Is this a problem that primarily affects people who've had more extensive colon surgeries, ileostomies, etc. or is it something we all should be concerned about?

I had roughly 12 inches of my sigmoid resected and my doctor never said anything about watching out for blockages. Am just getting over a bout with stomach flu and all the Zofran, dehydration, etc has me pretty constipated, which is is what got me thinking about it. Do I need to be concerned about this or is it one of those worries I should potentially be able to cross off my list?

Thanks so much
11/14 Dx sigmoid CC @ 45yo
12/14 Colectomy + hysterectomy
Stage IIIB, T3N1bM0, 2/20 nodes, MSS, G2, KRAS(A146T), TP53, SMAD4, ERBB2, CEA 1.0
2/15-7/15 XELOX & Celebrex
2/19 clean scope
5/19 clean-ish CT (watching a new 4mm lung thingie--likely mucus plug)
Ongoing celecoxib, cimetidine & other targeted supplements
Mom to a 5 & 7yo

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Re: Blockages -- who is at risk for them?

Postby MamaN » Sat Feb 21, 2015 9:03 am

Hi Ipas
I also had over a foot of my colon removed . It looks like we are same stage . Ive never had blockages. Butt do have to watch what you eat ! Because colon is so much shorter. It does take quite a while to figure out new normal. Diet I think is key! Took years for me to figure out.
Dx@45 stage t3 n1b m unknown IIIB
Resected in 8/2010 rectosigmoid
5.5 tumor with 3 /26 lymph nodes
Lymph vascular invasion
Folfox sept 2010 to feb 2011
10 tx only stopped due to low wbc

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Re: Blockages -- who is at risk for them?

Postby Val*pal » Sat Feb 21, 2015 10:26 am

lpas - I don't think you need to be unduly concerned about possible bowel blockages. Based on my husband's experience, there were no concerns at all post-surgical recovery. He did suffer from constipation but ultimately figured out a diet and methods to overcome it. And, by the way, my DH was hospitalized 7.5 weeks following his resection due to multiple complications, so if anyone would have developed a blockage then, I'm sure my DH would have!

I think that blockages become an issue at end-stage for some colon cancer patients, particularly if there is abdominal/peritoneal involvement. The tumors and caking that form then can cause blockages by the cancer burden pressing into the small and/or large intestines. My DH did experience this several times in his last few months, but the blockages always resolved themselves with a wait-and-see, NPO treatment while hospitalized. I may not be representing this correctly, but I believe this is the case. However, as we all know, I am not a doctor. :shock:

Frankly, I was amazed at what my DH was able to eat post-surgical recovery. His doctor told him to eat whatever he fancied, and he did. :roll:
DH dx'ed May '11, age 62
Jul '11: resection Stage IV
10/11: 6 mo Folfox
8/12:thyr canc, surg/tx
2/13: peri mets
2/13: Firi/Avas
6/13: Ok
8/13: break
10/13: Lung, peri, mets
10/13: Firi/Erb
1/14: Erb Fail; spread
5/14: Tx stopped
6/20/14: At rest

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Re: Blockages -- who is at risk for them?

Postby lauragb » Sat Feb 21, 2015 11:20 am

I think anyone who has had abdominal surgery is at risk for small bowel obstructions also called blockages due to scar tissue (adhesions). The more the abdomen is messed with, the more adhesions that form. Open surgeries cause more adhesions than laparoscopic and having had radiation is also a huge factor. Some people are just more prone to them. I had my first obstruction just from the leak test before my ileostomy reversal. I found out later it was a challenge for the surgeon to do the reversal because of already present adhesions. I think if you haven't had issues or pain, I wouldn't worry about them.
RC 3B 7/2011 @ 53
Chemoradiation 5 weeks 8/11
LAR-Hysterect-temp ileo
pCR, 0/23 nodes
Folfox 1/12, Xeloda 2/12 to 5/12
Reversal 5/12
SBO,lysis of adhesions 12/12
NED 11/12, 11/13, 6/16

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Re: Blockages -- who is at risk for them?

Postby Lee » Sat Feb 21, 2015 3:14 pm

I've had a few, nothing serious that required a hospital stay. From what I've been told, our type of open surgeries and scar tissue makes us more prone to blockages. Hopefully, you will never get one.

rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

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Re: Blockages -- who is at risk for them?

Postby Jachut » Sat Feb 21, 2015 7:47 pm

I think any sort of intestinal surgery is a risk factor but particularly small intestine. I had a few hospital stays for blockages but it seemed to be a combination of Zofran and chemo that set me off - had my chemo dosage reduced a couple of time and in the end finished a few rounds early. After that, I still had my ileostomy for a couple of months and I could eat anything without problem - coleslaw, apple skin, raw carrots, nuts, none of it caused a problem. That said, I do have a lap band and don't eat large quantities at a time and have learned to chew carefully to avoid vomiting.

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Re: Blockages -- who is at risk for them?

Postby justin case » Sat Feb 21, 2015 7:55 pm

I had a major blockage. My surgeon told me the story of one, where he had to go back to surgery because of a tomato skin. My blockage was noticed soon after surgery, as when surgery is preformed, your body parts are removed to some degree, and as my surgeon put it, they just throw them all back in the cavity :shock: :shock: I had a kink in mine. This is the major reason I only had my bag for 3 weeks. Since they had to go back in to straighten out the kink, my surgeon did the reversal at the same time. Mind you, for 6 days before the surgery was preformed, I had an NG tube, and catheter.
Remember, something as simple as a tomato or apple skin can cause an obstruction, so during the beginning make sure to peel thin skinned fruits.
7/11 diagnosed Stage 2 colon and rectal cancer
lar/temp ilio
Reversal & port removal
21 round of chemo Folfox 9tx, 5fu 12 tx
Last treatment July 2012

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Re: Blockages -- who is at risk for them?

Postby chrisca » Sat Feb 21, 2015 9:42 pm

I had a small bowel blockage about a year after ileostomy reversal. There were warning symptoms, though at the time I didn't know it. After a meal, sometimes there was pain that felt a bit like severe gas pains which eventually passed after 20 or 30 minutes. The length of time for the discomfort got longer over time, until about a year on there was a complete blockage.

Your colon likely won't get a blockage unless there is a tumor present. But with abdominal surgery there is the chance scar tissue may grow into the spaces between the small intestine and eventually kink it or choke it off. Watch for these warning signs and discuss them with your doctor, and be careful about putting yourself in a situation away from emergency care.

If you need surgery, ask about Seprafilm, which is an absorbable film placed between the abdominal wall and the intestine to reduce the chance of scar tissue forming. They put it in for me after I had the blockage surgery, and so far there has been no repeat of the original discomfort.
Male, false negative colonoscopy age 48
DX: 12/2010 rectal cancer age 51
Stage T3N0M0 2 cm from anal verge
neoadjuvant rad/chemo Xeloda
Rectal resection (open surgery) straight anastomosis
Xeloda round 2
ileostomy reversal 11/2011
Successful adhesion X-lap 8/2013
Ongoing LAR syndrome but NED 7 years

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Re: Blockages -- who is at risk for them?

Postby O Stoma Mia » Mon Feb 23, 2015 6:33 pm

chrisca wrote: ... But with abdominal surgery there is the chance scar tissue may grow into the spaces between the small intestine and eventually kink it or choke it off. Watch for these warning signs and discuss them with your doctor, and be careful about putting yourself in a situation away from emergency care...

Here is an image showing how scar tissue (adhesions) on the small intestine can cause kinks to develop.


Photo credit: © Healthwise Incorporated

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