Ileostomy blockage symptoms and duration?

What does an ileostomy blockage feel like? I am experiencing really painful cramping on my upper right side of my stomach, across from my stoma. The area around the stoma is very tender and sore but not like a skin rash sore. It is more deep inside. Thinking it was a blockage, I switched to liquids for a day but the stoma is putting out material into the bag. When it empties, it is really crampy though. I have been extra careful with my food, chewing well and not eating things that I thought would cause a problem. I was going to go to the ER last night but decided to give it another day. Can the stoma area be really achy and sore for several days after a blockage? I don't know what to expect with a blockage. I do not have a fever, nausea, or vomiting.

I have only had one blockage to my knowledge and the cramps felt like labor! They were horrible! I had to lie on my left side curled up until it passed through. Your stoma shouldn't feel anything...not even when expelling whatever is stuck.

If you think it might be a blockage...the one determining factor is that a blockage will pass after awhile. If this is still happening you really need to go to the doctor or to the hospital!

Feel better!

Hello freedancer. 

I have those terrible crampy-type pains , often in the area you describe but sometimes much lower down.  Blockages can be caused by a number of things,not just food. I'm convinced that mine is due to the combined fact that I have a hernia and peristalsis muscles just inside the stoma, which literally close up the passageway so that nothing can get past. I know this because I stick my finger up there and can feel the obstruction. I find that knowing what the problem is, goes a long way to helping to find solutions. In my case,  the horrible pain is caused by trapped wind (not food waste) and if I CAN RELEASE THE WIND, the pain goes away instantly. The most effective method for me is to use a stoma plug during the day, which is made of a sort of cotton-wool that lets the wind pass through it. The stoma plug holds the stoma passage open jst enough for this to happen. However, I don't wear these at nights and this is when I sometimes get the pain. I usually try massaging the area to see if I can loosen things up, sometimes it works but often it doesn't. Sometimes I let out a huge fart  spontaneously and everything is fine again. When the pain gets unbearable  and doesn't look like shifting, I have two types of catheta on standby. The  first is an empty one of those plastic nasal-spray devices (in the UK it's marketed as 'Vick'). It's about the length of a finger, so I am confident it gets forced  past my blockage and the hole that is in the end of it allows the wind to pass through unhindered. The second device is an anal catheta, attached to a tube so that I can pass it much further down the colon to let the wind out.

I do not recommend anyone else trying this method unless they take medical advice beforehand as it is potentially dangerous and you might not have the same problems as I have with wind. It does not work with faecal blockages because the tubes just block up and are then inneffective in releasing the obstruction.  Of course, cramps may not be caused by an obstruction at all. they could be part of the healing process or just the colon getting used to its new configuration. It is really important to find out what is causing the pain before attempting any remedies.  Diagnosis, is where the medical staff should be able to help and once that is established, a remedy should be just around the corner. 

Note from previous post: 'If' it is caused by medication or anxiety, then learning how to control these things could bring some relief. 

Best wishes

Bill      

Hi Freedancer, I too develop cramps like you describe. I thought it was a blockage. During one of the ostomy meetings that I attend, it was shared to sip some warm tea and take a warm bath if you feel that you have a blockage. This practice relaxes the muscles and allows whatever is there to be released. I tend to have gas that is trapped and will not go away. The last episode lasted about three days...each day the pain reduced but my muscles around the stoma were very sore. If you do not have any effluent passing through your stoma after 6/7 hrs, I would recommend going to the ER or to your doctor's office. With an ileostomy, our small bowel is always in production. Good luck and take care. Please post your outcome and when you are feeling better. Sincerely, LadyHope

Freedancer,

Whenever I've had these "blockage" pains over the years, they have inevitably been due to my diet. Specifically, if I have eaten too much of bulky food such as certain vegetables, nuts, and combinations. The pain is horrible and lasts for quite some time (hours). Others have given you good advice on how to remedy this problem. Yes, pain around the stoma is normal in this condition.

X_

Stories of Living Life to the Fullest from Ostomy Advocates I Hollister

Like Xerxes, almost every blockage I've had can be connected back to something "healthy" that I ate. At this point, I pretty much avoid fruit and veggies (with a few exceptions). I was never a big veggie eater, so nothing lost except vitamins. To name a few items that have partially or fully blocked me: cantaloupe, coconut, Chinese stir fry, apple, raisins, carrots, popcorn, macaroons (despite being shredded coconut), french fries.

When it comes to fruit, canned is best (as it has no skins) and veggies I just cook until really soft.

The other type of blockage I can get is narcotic-induced. I used to be able to take large doses of codeine as a means to slow my bowel movements down (before ileostomy I was 20-30 times a day). After my ostomy was installed, I couldn't take cough syrup with codeine in it without my bowel coming to a virtual stop. I was also limited to 6mg of hydromorphone, which sucks as if you have a blockage you can't take morphine orally or you make the problem worse. The pain from taking too much narcotics is identical to a physical obstruction.

One contributing factor to the amount of obstructions you get is if you have any scar tissue from past surgeries that is restricting your passage. One thing that my G.I. doctor said she could do to try and reduce the occurrence of these obstructions was:

Strictureplasty (also spelled Stricturoplasty) is a surgical procedure performed to alleviate bowel narrowing due to scar tissue that has built up in the intestinal wall from inflammatory bowel conditions such as Crohn's disease - details here: https://en.wikipedia.org/wiki/Strictureplasty

But, that is a surgical solution. What she did for me (I don't know what the procedure was called) was essentially stick her finger in my stoma, as the scar tissue was near the end, and carefully stretch the scars but not too far that they would puncture the bowel. In my mind, it didn't sound like it would really do anything (like stretching an elastic it would just return to where it started when let go). That said, I don't question my G.I. doctor's wisdom when it comes to things like this as she has been at it for decades, so I had the procedure done. It's been 2 years and I have not had a blockage since (knock on wood). She said she may need to do it again in the future, but that is better than any surgery as I can't really lose any more bowel without running into concerns of not absorbing the necessities of life. In other words, I could end up having to go on TPN.

Last comment, when the blockages are really bad, I end up vomiting over and over (until it's bile only). The body is naturally trying to reduce the pressure from the top by doing this. The hospital may also do it for you by putting in a stomach pump (goes through your nose to your stomach). For less severe blockages, my body could work them out but I needed the aid of IV pain medication to get through it. Once I better knew what was going on, I would make sure I told the ER doctor and to NOT start me on steroids as the issue was a blockage, not a flare-up. For the least severe blockages, I would stop eating and drinking (no pressure added from the top), then go to clear fluids after I felt some progress was being made. After every blockage cleared, I would be sore inside for the next day or two from all the cramping. I would keep my diet very gentle during that time (easy to digest foods with nothing rough about them).

Hello spinbot.

Thanks for your post with all that information.  I found it very interesting. I had a similar thing done when the scar tissue in my anus closed up the hole. - They cut through the scar tissue in several places and I had to use a dilator to keep the hole from closing over again. It worked to a certain degree but kept splitting everytime I had a larger hard feacal expulsion. This was part of the logic for my opting for a stoma.

Best wishes

Bill

Hi freedancer....when I experience any discomfort and or blockages....my go-to is a little bit of time on the heating pad, or lie on my right side, some side pull legs to chest a few times, walk etc....drink tons of water....remember food processes differently now, some will pass faster than others so keep the fluids going. If anything in front will pass through 1st.....you got this girl, dance on.