Adhesions

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risto
Posts: 41
Joined: Wed Jan 06, 2016 2:28 am
Location: USA

Adhesions

Postby risto » Sat Jan 20, 2018 10:21 pm

My DW recently started noticing a thing where she would have about 10 seconds of level 5 pain, accompanied by a firmness or hard spot in her abdomen, presumably part of the small intestine (she has an ileo so Colon is out of the picture). Then it resolves and the pain and firmness are gone. So far it has only happened a couple of times in the past week. Symptom management suggests that it may be an adhesion and not to worry about it. Should we? I know adhesions are part and parcel of abdominal surgery (of which she has now had 3) but do they tend to work themselves out or get worse over time? Her last surgery was in April 2017. In the back of our minds is also the concern that it may be related to her peri mets which is a much scarier thought if they are progressing. She is currently on bi-weekly maintenance chemo (5FU/Avastin).
DW Dx 7/15, 41 yo, st IV, 3+ liver mets: 11.3 cm, 7cm, 3cm. MSS.
KRAS, APC, SMAD4, TP53 mut.
7/15-10/15: FOLFOX+bev. x8
11/15-12/15: SIRT (Y90)
1/16: Toxic Hepatitis, chemo break
4/16: Liver resec. fail
5/16-7/16: FOLFIRI x6
8/16: Liver resec.
8/16-11/16: FOLFIRI x6
2/17: IMRT/Xeloda x25
4/17: LAR
6/17: CT: Progression. Peri, Lung, Liver mets. FOLFIRI x6
9/17: FOLFIRI+Bev x5.
11/17: CT: Stable. 5FU+bev. maintenance x5
1/18-2/18: Surgery for SBO
5/18: ascites, acute liver injury

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O Stoma Mia
Posts: 1275
Joined: Sat Jun 22, 2013 6:29 am

Re: Adhesions

Postby O Stoma Mia » Sat Jan 20, 2018 11:49 pm

risto wrote:... Symptom management suggests that it may be an adhesion and not to worry about it. Should we? I know adhesions are part and parcel of abdominal surgery (of which she has now had 3) but do they tend to work themselves out or get worse over time? ..

I don't think that adhesions work themselves out over time. Once you have adhesions you will always have adhesions unless another abdominal surgery is done to remove some of them. That's my opinion.

When adhesions are present it is important to maintain a low residue diet to minimize the possibility of Small Bowel Obstructions (SBOs)

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=50321&p=385376#p385376

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=52932&p=417613#p417613

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=59068&p=466811#p466811

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=20621&p=153797&hilit=adhesions#p153334

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=38919&p=277845&hilit=adhesions+blockage+residue+diet#p277487

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=49942&p=379612&hilit=adhesions+blockage+residue+diet#p379612

MissMolly
Posts: 487
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Adhesions

Postby MissMolly » Sun Jan 21, 2018 12:34 am

Risto:
I have had a rocky course with post-surgical adhesions/scar tissue.

For me . . Pain related to a partial “kink” of intestine is quite intense, with a rolling wave like quality. Waves of pain. This pain get my full attention.

On first symptoms, I cease eating any solid food. Clear liquids only. 100% grape juice has flavonoids that can help with intestinal motility where there is a partial obstruction.

Practicing simple yoga poses has been helpful for me in managing my adhesions. The slow stretching, especially elongation and rotation of the torso, helps mobilize connective tissue. I also use a warm buckwheat pack on my abdomen (heated in a microwave). The warmth helps reduce associated muscle spasms.
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

User avatar
susie0915
Posts: 760
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Adhesions

Postby susie0915 » Sun Jan 21, 2018 10:01 am

I had adhesions that caused a bowel blockage 4 weeks after my resection. I knew I had a blockage as I was not getting anything in my ileo bag. I eventually had to have surgery to remove the adhesions after a week of ng tube and walking in the hospital. The surgeon reversed my ileo at the same time. The pain was pretty intense when I went to the hospital and didn't subside until given pain meds. I also have a hernia that will pop out now and then that can make my abdomen hard until a get it pushed back in. My surgeon said it is small and doesn't want to do surgery unless necessary. He checks it every time I see him. I don't know if this is a possibility for your wife. My hernia really doesn't cause pain, but does make my abdominal area around my belly button very firm when it pops out.
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoid/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod
7/17 no change lung nod
10/17 Clear pel/abd CT
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, clear CT pel/abd/lung nod no change

risto
Posts: 41
Joined: Wed Jan 06, 2016 2:28 am
Location: USA

Re: Adhesions

Postby risto » Thu Jan 25, 2018 1:11 am

Thanks for all your replies.
The timing of my message was significant. She ended up getting an obstruction yesterday and is now in the hospital.
Dr's don't want to do surgery because of the peri mets, so I really really hope this blockage works itself out!
DW Dx 7/15, 41 yo, st IV, 3+ liver mets: 11.3 cm, 7cm, 3cm. MSS.
KRAS, APC, SMAD4, TP53 mut.
7/15-10/15: FOLFOX+bev. x8
11/15-12/15: SIRT (Y90)
1/16: Toxic Hepatitis, chemo break
4/16: Liver resec. fail
5/16-7/16: FOLFIRI x6
8/16: Liver resec.
8/16-11/16: FOLFIRI x6
2/17: IMRT/Xeloda x25
4/17: LAR
6/17: CT: Progression. Peri, Lung, Liver mets. FOLFIRI x6
9/17: FOLFIRI+Bev x5.
11/17: CT: Stable. 5FU+bev. maintenance x5
1/18-2/18: Surgery for SBO
5/18: ascites, acute liver injury

Sara!!!!
Posts: 34
Joined: Wed Jul 19, 2017 9:57 am

Re: Adhesions

Postby Sara!!!! » Thu Jan 25, 2018 2:06 am

risto wrote:Thanks for all your replies.
The timing of my message was significant. She ended up getting an obstruction yesterday and is now in the hospital.
Dr's don't want to do surgery because of the peri mets, so I really really hope this blockage works itself out!

Hey..my mom has peri mets and has ended up with a small bowel obstruction. So so worried. Does your wife have small bowel obstruction too?
Daughter to mom 67, colon cancer
Diagnosed Dec 16, bowel obstruction.
Hemicolectimy done,Dec 16.
4 lesions in liver on scan before chemo jan 17.
Folfox +Avastin 12 cycles,disease progression on pet Aug 17.
Attempted liver resection, failed. Mets peritoneam. Diffuse.
Mets to lungs, liver. Peri on scan Nov 17.
3 cycles of folfiri+ cetuximab. Cea down from 888 to 383.
Small bowel obstruction jan 18

User avatar
susie0915
Posts: 760
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Adhesions

Postby susie0915 » Thu Jan 25, 2018 11:28 am

Good luck to your wife. I assume she has the ng tube in and alot of walking trying to get obstruction to resolve itself. I did that and know how uncomfortable it can be. I am praying all works out for her quickly. Keep us updated.
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoid/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod
7/17 no change lung nod
10/17 Clear pel/abd CT
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, clear CT pel/abd/lung nod no change

risto
Posts: 41
Joined: Wed Jan 06, 2016 2:28 am
Location: USA

Re: Adhesions

Postby risto » Fri Jan 26, 2018 1:29 am

Yes, she has the NG tube (it was shocking watching them stick that down her throat), but she can't walk around because they still have suction on it.
DW Dx 7/15, 41 yo, st IV, 3+ liver mets: 11.3 cm, 7cm, 3cm. MSS.
KRAS, APC, SMAD4, TP53 mut.
7/15-10/15: FOLFOX+bev. x8
11/15-12/15: SIRT (Y90)
1/16: Toxic Hepatitis, chemo break
4/16: Liver resec. fail
5/16-7/16: FOLFIRI x6
8/16: Liver resec.
8/16-11/16: FOLFIRI x6
2/17: IMRT/Xeloda x25
4/17: LAR
6/17: CT: Progression. Peri, Lung, Liver mets. FOLFIRI x6
9/17: FOLFIRI+Bev x5.
11/17: CT: Stable. 5FU+bev. maintenance x5
1/18-2/18: Surgery for SBO
5/18: ascites, acute liver injury

risto
Posts: 41
Joined: Wed Jan 06, 2016 2:28 am
Location: USA

Re: Adhesions

Postby risto » Fri Jan 26, 2018 1:46 am

Sara, yes, she has a small bowel obstruction. It's confirmed on CT scan.
DW Dx 7/15, 41 yo, st IV, 3+ liver mets: 11.3 cm, 7cm, 3cm. MSS.
KRAS, APC, SMAD4, TP53 mut.
7/15-10/15: FOLFOX+bev. x8
11/15-12/15: SIRT (Y90)
1/16: Toxic Hepatitis, chemo break
4/16: Liver resec. fail
5/16-7/16: FOLFIRI x6
8/16: Liver resec.
8/16-11/16: FOLFIRI x6
2/17: IMRT/Xeloda x25
4/17: LAR
6/17: CT: Progression. Peri, Lung, Liver mets. FOLFIRI x6
9/17: FOLFIRI+Bev x5.
11/17: CT: Stable. 5FU+bev. maintenance x5
1/18-2/18: Surgery for SBO
5/18: ascites, acute liver injury

Sara!!!!
Posts: 34
Joined: Wed Jul 19, 2017 9:57 am

Re: Adhesions

Postby Sara!!!! » Fri Jan 26, 2018 2:25 am

risto wrote:Sara, yes, she has a small bowel obstruction. It's confirmed on CT scan.

How is she doing?? They've said that my moms small bowel is blocked on multiple places and might not resolve. I really hope it does. She has been npo for 48 hours. They haven't passed an NG tube though. When we ask they say it's cuz her abdomen is soft n not bloated :/
Daughter to mom 67, colon cancer
Diagnosed Dec 16, bowel obstruction.
Hemicolectimy done,Dec 16.
4 lesions in liver on scan before chemo jan 17.
Folfox +Avastin 12 cycles,disease progression on pet Aug 17.
Attempted liver resection, failed. Mets peritoneam. Diffuse.
Mets to lungs, liver. Peri on scan Nov 17.
3 cycles of folfiri+ cetuximab. Cea down from 888 to 383.
Small bowel obstruction jan 18

risto
Posts: 41
Joined: Wed Jan 06, 2016 2:28 am
Location: USA

Re: Adhesions

Postby risto » Fri Jan 26, 2018 10:10 pm

It's been almost 72 hours and only minor improvement. We're trying to get her transferred to her cancer center for better medical management.
DW Dx 7/15, 41 yo, st IV, 3+ liver mets: 11.3 cm, 7cm, 3cm. MSS.
KRAS, APC, SMAD4, TP53 mut.
7/15-10/15: FOLFOX+bev. x8
11/15-12/15: SIRT (Y90)
1/16: Toxic Hepatitis, chemo break
4/16: Liver resec. fail
5/16-7/16: FOLFIRI x6
8/16: Liver resec.
8/16-11/16: FOLFIRI x6
2/17: IMRT/Xeloda x25
4/17: LAR
6/17: CT: Progression. Peri, Lung, Liver mets. FOLFIRI x6
9/17: FOLFIRI+Bev x5.
11/17: CT: Stable. 5FU+bev. maintenance x5
1/18-2/18: Surgery for SBO
5/18: ascites, acute liver injury

henry123
Posts: 96
Joined: Sun Oct 08, 2017 3:25 am

Re: Adhesions

Postby henry123 » Thu Feb 01, 2018 12:10 am

I had lot of adhesions and obstruction once.
Could not be operated on as I was on Avastin at that time.
It was conservatively managed as that was only choice . Thankfully , it worked out .

Don't know status of adhesions now. Will ask after next CT.
46yo M
5/16 lap AR 14/21 L nodes +ve
T4N2M1
7/16 Capox 9 cyc
9/16 cea 2
1/17 550
PET CT mets in lung & peri
iri+ avast fail
3/17 10577
msi-h Lynch
4/17 regro fail
5/17 cea 28800
5/17 CT inc in size of mes nodes , new onset of multi nodules in liver.
6/17 Opdivo start
7/17 26754
8/17 5623
9/17 497
10/17 52
11/17 12
CT all clear exc a nodule in Lung. liver normal
1/18 3.6
2/18 2.3
4/18 2.0
opdivo continue
Aspirin start

Vegan yoga juicing apricot

Sara!!!!
Posts: 34
Joined: Wed Jul 19, 2017 9:57 am

Re: Adhesions

Postby Sara!!!! » Wed Apr 18, 2018 3:01 am

risto wrote:It's been almost 72 hours and only minor improvement. We're trying to get her transferred to her cancer center for better medical management.

How is your wife doing now? Is she off tpn?
Daughter to mom 67, colon cancer
Diagnosed Dec 16, bowel obstruction.
Hemicolectimy done,Dec 16.
4 lesions in liver on scan before chemo jan 17.
Folfox +Avastin 12 cycles,disease progression on pet Aug 17.
Attempted liver resection, failed. Mets peritoneam. Diffuse.
Mets to lungs, liver. Peri on scan Nov 17.
3 cycles of folfiri+ cetuximab. Cea down from 888 to 383.
Small bowel obstruction jan 18

risto
Posts: 41
Joined: Wed Jan 06, 2016 2:28 am
Location: USA

Re: Adhesions

Postby risto » Thu Apr 19, 2018 8:32 am

Sara!!!! wrote:
risto wrote:It's been almost 72 hours and only minor improvement. We're trying to get her transferred to her cancer center for better medical management.

How is your wife doing now? Is she off tpn?

She is still on TPN but it has been reduced a bit since she is over her target weight. She is taking pain meds for pain from the surgery, and dealing with a lot of fatigue. In the past week she has started feeling bloated.
DW Dx 7/15, 41 yo, st IV, 3+ liver mets: 11.3 cm, 7cm, 3cm. MSS.
KRAS, APC, SMAD4, TP53 mut.
7/15-10/15: FOLFOX+bev. x8
11/15-12/15: SIRT (Y90)
1/16: Toxic Hepatitis, chemo break
4/16: Liver resec. fail
5/16-7/16: FOLFIRI x6
8/16: Liver resec.
8/16-11/16: FOLFIRI x6
2/17: IMRT/Xeloda x25
4/17: LAR
6/17: CT: Progression. Peri, Lung, Liver mets. FOLFIRI x6
9/17: FOLFIRI+Bev x5.
11/17: CT: Stable. 5FU+bev. maintenance x5
1/18-2/18: Surgery for SBO
5/18: ascites, acute liver injury

Sara!!!!
Posts: 34
Joined: Wed Jul 19, 2017 9:57 am

Re: Adhesions

Postby Sara!!!! » Thu Apr 19, 2018 2:31 pm

risto wrote:
Sara!!!! wrote:
risto wrote:It's been almost 72 hours and only minor improvement. We're trying to get her transferred to her cancer center for better medical management.

How is your wife doing now? Is she off tpn?

She is still on TPN but it has been reduced a bit since she is over her target weight. She is taking pain meds for pain from the surgery, and dealing with a lot of fatigue. In the past week she has started feeling bloated.

Do the doctors say why!
Daughter to mom 67, colon cancer
Diagnosed Dec 16, bowel obstruction.
Hemicolectimy done,Dec 16.
4 lesions in liver on scan before chemo jan 17.
Folfox +Avastin 12 cycles,disease progression on pet Aug 17.
Attempted liver resection, failed. Mets peritoneam. Diffuse.
Mets to lungs, liver. Peri on scan Nov 17.
3 cycles of folfiri+ cetuximab. Cea down from 888 to 383.
Small bowel obstruction jan 18


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