bowl obstruction

I am a nurse.  I had rny last Aug 27th and have recently been having pain after eating.  I researched and asked the surgeon about the internal hernias that can cause a bowel obstruction.  He said that it is a possibility that I have that but that he hasn't seen that much trouble with that.  I am wondering also if with the increased numbers of laprascopic rny surgeries if this problem won't increase.  I am actually considering writing a journal article about this subject to educate emergency room nurses.  I think that we will see this number change.  I also think that many may have symptoms of this problem for some time before it is actually severe enough for them to seek help.  As overweight people are often afraid to advocate for themselves, I think many suffer pain in silence.  We have taught ourselves, many of us, to be as unnoticeable as we can possibly be and are too nice to complain to our docs.  Perhaps some think they must be doing/eating wrong that is causing the pain and they deserve it? Anyway----I think we are going to be hearing a lot more about this in the future, and we need to educate ourselves and our docs.  I will keep your friend in my prayers.  Just remember that if you have pain, it needs to be evaluated by your  WLS, as many ER docs don't have a clue.  They work from algorhythms many times which tell them what to do, what tests to run. etc.  Until this gets into the literature, you will need to tell them what you know and about how they are sometimes nearly impossible to diagnose without surgery to explor for the problem.  Someday, perhaps it will be in the ER docs algorhythm that if the person has had WLS, this warrants a call to the WLS and/or an exploratory surgery.   Janet

You are absolutely correct!! I was once a medical librarian so I did a search of the literature.  Please note the internal hernia that seems to occur after lap rny is in the "peterson space" and is being seen more often as more and more people have gastrric bypass.  The incidence is 2-3% My friend who is in her third week in iICU hadd in insuccession (I hope I spelled that correctly) of the bowelwhere the bowel closes in on intself....different that my friend  Patty's problem (she died 16 mos ago).  this is also related to wls. I think there is much that is really unknown.  I think I made a deal with the devil in having this surgery.....and now I must live with it. Rochelle

I had weight loss surgery in 2004.  On May 28, 2007, I was rushed to the hospital, I could not breathe and had a faint pulse.  I was immediately placed on a ventilator and the surgeons asked my husband to give permission for them to do exploratory surgery.  The surgeons discovered that my small intestine had tied a knot around my colon, strangled and grangrened.  The surgeons removed my entire small intestine and a small piece of colon.  The doctors told me that I will never be able to eat or drink again unless I have a small bowel transplant which I am currently on the waiting list.  I receive my nutrients intravenousley by TPN (Total Parental Nutrition).  Prior to going to the emergency room I had begun to have severe stomach pains which began in 2006.  I would go to the ER but the doctors would contribute it to me being constipated or that I possible ate to much.  I am blessed to be alive that night on May 28 I went through Kidney failure and respiratory distress.  My transplant doctor said that he is seeing alot more patients coming through his office for transplant because of small bowel obstruction.

God Bless you Denise.  I hope you get your transplant.  We really have made a deal witht he devil when we had this surgery, I never thought that I would be this scared this far out. (rny Nov 10 2003). I believed I had done thorough research and was led to believe that If I survived the surgery and took all my vitamins regularly I was in no danger. Now I know differently. 

I never recommend the surgery any more.

 

Any abdominal surgery can result in obstructions, and so can massive NON-surgical weight loss. It's not neceesarily caused by WLS.

I agree with you, and wish that I never had the surgery, and the only complication that I have had is a one bowel obstruction 3 1/2 years after my lap-RNY.  I too don't remember bowel ob. as a mentioned complication, and I did  a lot of research.  When I had my surgery for bowel ob. three weeks ago my general surgeon (the on call dr. for the emergency room) said that it is 10% chance of having a bowel ob. with ANY ab. surgery.  I guess that I am really lucky to be okay after waiting 3 days to go to the emergency room and didn't lose any of my bowel.

Good luck to all of you.  I am thankful that I have this site.

Reply
I am so glad your outcome was good.  My friend was in the hospital 7 weeks (6 in ICU) and 6 weeks with home health care and the full time care of her siblings.    she lost her stomach, spleen much of her colon, part of her pancreas and some small intestines.  Her survival is a miracle.   What scares me is that she was 5 years past surgery......it is supposed to be very rare that far out. 

Hello!

I was reading this thread with interest as I am wondering if I might have an internal hernia?  I get woke up at night from time to time, with an excrutiating pain in the center of my abdomen, which goes right through to my back.  It is under my breast bone.  It is a real stabbing twisting pain.  I break out in a sweat sometimes from it.  All that seems to help is literally walking around the house in circles and trying to breath deeply until it passes.  Usually it does subside after awhile.  Sometimes it lasts longer than others.  I am 4 1/2 years post op.  I don't have a GB so know it's not that.  I get really bloated feeling sometimes, and feel as though there's a rock in my stomach.  I wonderd about an ulcer also, but can't really say that I notice any correlation between what I eat and how I feel.  I do notice that i am having this really "full" sensation more often lately, and a pins and needles type pain off and on throughout the day, in my abdomen.  I know I have alot of adhesions, as I had an diag laprascope several years ago due to pelvic pain.  I had a CT and they thought it was retained ovararian tissue, following a hysterectomy.  My OBGYN who did the scope sent me to a general surgeon.  he said my upper rectum was being pulled out of it's normal position, and attached to my abd wall.  There was a note on the report form my CT sayin g they saw a partial SBO then, but the Surgeon said he wouldn't touch me unless I was fully obstructed. My WLS Dr moved across the country, so not sure what if anything I should do?  I'd appreciate any opinions!  DeeAnn

DeeAnn, I have been getting the exact pain as you describe,,, Ive been getting them since a year post op,,, Im almost 6 years post op,,,, one bariatric surgeon told me that its the intestines getting kinked,,,on  April 6 08,,, I just had emergency surgery, I had a stranguleted bowel and part of it died and had to be removed,,, it was a living hell,,, but I still get  the pain like you,,, I had a few of them in the middle of the night last night,, I was terrified,,, Im more scared now after what Ive been through,,,, if you read my profile you can see what Ive been through,,, I just hate living with this pain,,, the surgeon told me that its common with RNY.....  good luck  Amy

Please go to a surgeon asap (preferably one who is familiar with gastric bypass surgeries). Ask for a cat scan and it must be read by someone who is familiar with weight loss surgery patients.  Sometimes a bowel obstruction kinks and unkinks b4 the the big kink.  My surgeon says 4-5 % post surgery obstructions.

Please let me know what the outcome is.  Do not be shy about demanding care.