Re: partial bowel obstruction

From: Howard McCollister (nospam_at_nospam.net)
Date: 08/09/04 

Date: 9 Aug 2004 07:10:24 -0500

"Damian Breem" <Breem54@hotmail.com> wrote in message
news:5be75e93.0408090256.7d4a1da1@posting.google.com...
> I am wondering what the current thinking is regarding partial bowel
> obstructions and surgery. A few years ago I had diverticulistis
> (sp?). I had very thin bowel movements, extreme gas, pressure in my
> chest after I ate,at times very loose movements and bleeding from 2 of
> the diverticuli. When they did surgery they found that I had a
> volvulus at the junction where the small intestine goes to large
> intestine. Previous to the surgery I had a colonoscopy and a barium
> enema. Neither showed or suggested that I had a volvulus. After the
> surgery the surgeon said that most of my symtoms were from the
> volvulus.
>
> About 6 months ago I started having ribbon thin stools a few times a
> week, with intermittent loose stools. It has progressed to almost
> always ribbon stools and/or just plane liquid movements, up to 6-10 in
> about 2-3 hours. It takes me all day to recovery from this, as I get
> totally wiped out. I now have the liquid movements 2-3 times a week.
> There is no bleeding and the only discomfort I have is on my right
> side and that is just an ache. Sometimes I get pressure under my ribs
> on the right side that may last a day or two. I sometimes feel stuffed
> and then nausea even if I haven't eaten. I have never vomited. One
> other symtom that is I can hear the liquid going though my intestines.
> It can be very loud.
>
> I do have an appointment with a gastroentogist on Wednesday and I have
> done google searches but there isn't much on partial obstuctions lots
> and lots on total ones. If someones knows of a site or has
> information on partials I would be very grateful.
>

You don't mention what surgery you had, and that is important information.
Likewise, you haven't told us the results of the
Intermittent cecal volvulus is difficult to diagnose, and is usually a
diagnosis of assumption. The only thing one might see is a hyper-mobile
cecum on barium enema - but maybe not - and colonoscopy will tell nothing.
The treatement for this is removal of the right side of the colon. But
recurrent diverticulitis sounds most likely in this scenario.

Yes, you could have intermittent partial small bowel obstruction from
adhesions from previous abdominal surgery. This can be difficult to diagnose
too, but such a diagnosis would be based on an xray appearance consistent
with that diagnosis. If a person were suspected of intermittent partial
small bowel obstruction, a surgeon would expect to see dilated loops of
small intesting on xray.

Ribbon thin stools is a symptom of narrowing of the sigmoid or rectosigmoid
colon, such as in colon tumors, or diverticulitis. Intermittent cecal
volvulus or partial small bowel obstruction won't have anything to do with
such stool appearance.barium enema and/or colonoscopy that was done within
the last 6 months since the onset of these more recent symptoms.

If a barium enema hasn't been done in the last 6 months since the occurrence
of your symptoms, that would certainly seem like a good place to start.

HMc

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