A blockage, also known as a bowel obstruction, leads to the output from your stoma slowing down or even stopping completely. This can happen suddenly. Blockages can occur either in the small or large bowel. A blockage can be described as partial or complete.
In a partial bowel obstruction, a small amount of liquid output manages to bypass the obstruction in the bowel, resulting in a liquid/mucous type of bowel motion from your stoma. In a partial bowel obstruction, you may still experience windy output from your stoma. In a complete bowel obstruction, the bowel is unable to release any output at all from the stoma.
Some less severe blockages can be treated at home with the following tips:
If you suspect you have developed a bowel obstruction, you should contact your Stoma Care Nurse Specialist or GP for advice, who may prescribe laxatives to help you with the bowel obstruction.
If you feel unwell, particularly if you vomit, are distended and your stoma has not worked in 12 hours, you may need admission to hospital for treatment.
Hospital treatment for bowel obstruction typically consists of bowel rest, and intravenous rehydration. You may have a CT scan to look for the blockage site.
You may be given a drink of Gastrograffin - this is helpful for adhesional small bowel obstruction, not only showing up on Xrays, but also acting as a bowel cleaner and shifting food particulate.
In certain cases, surgery may be an option to treat a bowel blockage. This will be discussed with you by the surgical team.
Chew your food really well, until you manage to break it down in small pieces. By doing this, you reduce the chances of pieces of food getting stuck in your bowel and ultimately causing an obstruction.
Take your time. Eat slowly so you give time for your body to chew, digest and assimilate your meals properly.
Some people may have been advised by a dietician or surgeon to take a low fibre diet, as extensive internal scarring means they are more prone to bowel blockage.
As mentioned above, the most obvious sign of bowel obstruction is that the stoma output slows down or may even stop altogether. For people with a colostomy, a blockage could happen over several days and may start with signs of constipation. For people with an ileostomy, a blockage can happen quickly in less than 24 hours. An ileostomy is generally quite active, with people usually draining their stoma appliance between five to seven times in a 24–hour period. With a bowel obstruction you may notice that you pass a reduced amount of output and need to drain your stoma appliance less frequently.
Other symptoms that you may experience are:
• abdominal cramping pain (may be near the stoma or the entire abdomen);
• swelling of the abdomen and/or stoma;
• decrease in urine output; urine may be dark in colour (this may happen from dehydration due to not wanting to drink fluids because you don’t feel well); or
• nausea and/or vomiting.
Another symptom in addition to your output slowing down is stomach–ache. You may start to feel waves of cramping and abdominal pain, which may worsen if the symptoms you experience are unresolved.
It is not uncommon for people with a stoma to experience a bowel obstruction at some point. There are many different reasons why the bowel may become obstructed.
The most common reason for bowel obstruction is poorly digested food getting stuck in the bowel, often at a site of surgical scarring (adhesional).
It can also be due to other underlying causes, such as hernias, twists in the bowel, or narrowings of the bowel (strictures).
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