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Intestine Twisting

Kristy M.
on 7/27/08 5:28 pm - Washington, NJ
Has anyone experienced this problem after surgery?  I have been having some problems and my doctor seems to think this is what it could possibly be.  I am having a CAT Scan tomorrow to find out for sure but I was wondering if anyone else has had this problem and how it was resolved and what the recovery time was.

Thanks,
Kristy
sage61
on 7/27/08 5:46 pm - TX
Revision on 03/19/08 with
What are your symptoms?   
Kristy M.
on 7/27/08 5:50 pm - Washington, NJ
For quite some time now I have had horrendous pains right in between the lower part of my rib cage (gall bladder is gone).  It feels like someone is stabbing me.  These pains can go on for 20 minutes, 5 hours, one week, with no way of relief.  At first, I thought it was gas pains but no over the counter products or prescription products would work.  While I am having these pains I do not have gas but rather I am non-stop belching, and I mean belching.  About 3 weeks ago I went through a period of about 8 days where the pain was non-stop and I didn't go to the bathroom either for 8 days.  It comes and goes with nothing obvious to me as to why.  I went to my surgeon and he seems to think this is what it may be and that is why he is sending me for the CAT Scan with Contrast.  However, I have read that unless my intestine is twisting at the timee of the scan it wouldn't be recognized????
Plum1967
on 7/27/08 5:54 pm - Hawthorne, NJ
Yes... I was going to say that what I have read of this (no personal experience with it), it is hard to catch on any diagnostic test.

Keep on your doctor to find an answer... even if it means exploratory surgery.  Complications such as this can be FATAL... you need to be your own best advocate in getting a solid answer to your pain.

~wendy

I've partnered with Team In Training to raise funds for the Leukemia & Lymphoma Society.

If you want to help fight blood cancers, please consider donating at http://pages.teamintraining.org/nj/rnr12/wnystrom.

Thank you for your support!


 

Jill23
on 7/27/08 6:03 pm - Kendall Park, NJ
this is EXACTLY what I had. I was close to dying when I got to the ER they told me I was very lucky. The VERY NEXT TIME you feel the pain CALL AN AMBULANCE. Do not drive yourself there.

This is VERY serious. I thought it was gas also. I kept taking gasX. It is exactly the same feeling as the stabbing shooting pain of gas.

You need to go to the ER within minutes of feeling the pain. Do not worry about your schedule or inconvenience or anything--call an abulance. When I was waiting for the ambulance, I was throwing up clear liquid--I was told that it was my digestive juices.

Please don't wait. IT IS NOT GAS.

NHskinnygirl
on 7/27/08 6:17 pm - Nashua, NH
Hi Kristy,
Yes, I have been going through something simular to you. I do have the stabbing pain that can last minutes, hours days on end. I have had several tests, C-Scans MRI's and the only thing that shows is that I am full of stool in my intestines. The last time they did the C-Scan I was in the middle of an attack and still nothing showed other than stool. I do not want to have another surgery, so I put up with these pains when I have them. My PCP has given me a
rx for the pain that I can use and it does help. Sorry I am not sure what it is and the bottle is in my desk at work, I carry a pill case in my bag with a small supply to use if needed.  It is fustrating because I do "go" 2-3 times a day.
my surgeon and my PCP (husband & wife like having a tag team lol) thinks that my colon is not working the way it should so I am having a back up in my intestines and this back up is what is causing my pains. I can put up with it for now, shear will power cause some days I am bent in two for hours on end even with Rx.  I hope they have a better answer for you and that thy can help you without surgery.
I will keep you in my prayers.....Laurie
Laurie in NH     Expect the Best !  You will receive the Best....
283/251/150    
                
danabky
on 7/27/08 6:24 pm, edited 7/27/08 6:28 pm - NC
RNY on 11/10/00 with
It just kills me when things are so obvious... sigh ( I am talking about "obvious" to your doctor, not you)... you are having twisted bowels sweetie!! THAT is why you are backed up and in pain! 

I notice you are "BELOW GOAL."  This happens a LOT to those of us who get "too skinny" or below goal and then get some rebound.  When we loose a LOT of weight too quickly, we lose all the fat that cushions our intestines and keeps them in place.  When all that fat is gone, it creates "voids" in the intestines and causes our bowels to move around like "snakes in a snakepit"  They kink, unkink, kink, unkink.  After FOUR years of this I finally found someone who would tell me the answer other than you are "FOS" (full of ****). 

This will NOT show up on any test... even when it is happening.  The only way to find this or fix it is by exploratory surgery.  I know surgery sucks, but believe me.. it is BETTER than suffering everyday and to make it feel like it is "all in your head." 

Sure enough, when they got in there.. they found I had a "hernia" (void) in the Mesentary/Petersen's space.  They also cleaned up some adhesions/scar tissue that was pulling on some of them and causing them to kink. 

Your colon is working.. it is just getting kinked!!! 

the clue is "BENT INTO TWO".. as in .. "the fetal position" even with RX!  Demerol wont even touch this pain!

I have been pain free now for a year thanks to a surgeon who would listen to me.  He "tacked" all my intestines down so now they don't move around so much.

Please don't ignore this anymore.  We just lost someone here on this site who died from twisted bowels.  I can almost GUARANTEE you that this person had the same symptoms!


(deactivated member)
on 3/14/11 2:15 pm
Wow, a doctor  just told me the exact same thing.  But I don't ignore the pain, its too intense.  I go directly to the emergency room, and I'm admitted because the blockage is immediately spotted on a simple x-ray .  
Jill23
on 7/27/08 6:30 pm - Kendall Park, NJ
Laurie, Please keep on top of this. I was having bowel movements up until the morning of my surgery.

RIGHT AFTER THE SURGERY I FELT A MILLION TIMES BETTER!! And it was such a simple surgery--he just had to snip the scar tissue that was strangling my intestine.

Please don't rule obstructed bowel out--it was detected on my CT scan. Drugs didn't help me either, and I was doubled over in pain so many times just like you. Even on the cruise I was lying down so often from pain. The obstructed bowel surgery (which was FIVE WEEKS after my tummy tuck) saved my life.
Jill23
on 7/27/08 5:52 pm, edited 7/27/08 5:53 pm - Kendall Park, NJ
I had an obstructed bowel which I think is the same thing--or that maybe twisted intestines can cause an obstructed bowel. From what I understand, your intestines are like worms in a baggie--when they jiggle around they sorta' jiggle back to normal, so you have to get the CT scan while you are in pain and they're not back to normal. I kept thinking I was having bad gas pains, and then I went to Princeton Medical Center via ambulance in the middle of the night and had a CT scan and it detected the obstructed bowel and I had surgery within the hour.

I was feeling okay after a week from surgery (back at work). Ask your surgeon if you should wait until you feel the pain to get the CT scan, because you don't want to have it when it won't be able to see anything...

Jill
NHskinnygirl
on 7/27/08 6:45 pm - Nashua, NH
Thanks Jill and all you Ladies,

I am keeping on top of it and I thank you all for your concern. My surgeon did do an exploritory when this
first started, no kinks or obstructions, I have also gone
to 5, yes 5 gastroenterologists that frankly, they should all be proctologist, as they are the biggest arse holes I have ever met, they all,  said it was in my head...that all their tests came back the same, stool. That is why my personal surgeon is keeping up with this. From my colonoscopy they did rule that it was sluggish, and with no kink or twist.
I really want to thank all of you for your concern, it is not being ignored and as soon as I have another attack I will be at the ER asap.  
I love OH, such great wonderful friends  thank you all.
Laurie in NH     Expect the Best !  You will receive the Best....
283/251/150    
                
Michelle R.
on 7/27/08 6:09 pm
I had similar symptoms.  mine turned out to be scar tissue from my gallbladder surgery 10 years ago that grew around my intestine cutting off circulation.  I nearly died also.  CT scan did not detect it.  I also was in surgery within the hour of arriving at the ER.  Do not mess around get to the ER immediately.  It was horrible after I ate.  Obviously now I know it was because you can't push much food at a time through a small space.  The dr also said obstructions occur as we lose weight because the intestine moves and twists easier.  Be careful and go luck.  I felt 100 percent better immediately after surgery.  Michelle
danabky
on 7/27/08 6:15 pm - NC
RNY on 11/10/00 with
YEP.. this is what is going on and it will NOT show up on ANY tests.  Even IF it is happening WHILE your test, it will NOT show up.  The only way to find it is surgery.  I speak from GREAT experience with this.  I had to be VERY persistent and forced the doctor to do surgery on me.  You are having a partial bowel obstruction.  Your intestines are moving around like "snakes in a snake-pit"  It is called a "hernia" but it is more like a "void" where there is an absence of fatty tissue to cushion your intestines.  It is in the Petersens/Mesentary area.  Tell your doctor that.  You also  may have some scar tissue/adhesions that are pulling on it. 

The only thing else that can be causing pain in the right ribcage area could be an appendix rupture.  Which I have had that also.  It mimics the same kind of pain.  Have your doctor check your white blood cell count. If it is high.. then you have an infection which is probably your appendix.  If you don't have an infection, then it is twisted bowels. 

I promise this is what it is.  I have experienced just about every kind of pain imagineable in these last 7 years so I know when something is "up." 

I am so glad you have a doctor who is listening to you and who is pro-active.  I had a different bariatric surgeon tell me that I was just "FOS" which means "Full of ****"  Well DUH!! I had a kink in my bowel.. THAT's why things are backed up!  His misdiagnosis and complete dismissal of my fears almost cost me my life. 

Dana
Ruth S.
on 7/27/08 6:19 pm - Orlando, FL
NOT TO SCARE YOU OR ANYONE BUT JUST THIS JULY 14TH WE LOST A WLS FRIEND ON THE FLORIDA BOARDS (VICKIE J) AS SHE WAS OUT OF TOWN AND HAD THIS OBSTRUCTED BOWEL & THE SMALL HOSPITAL SHE WAS AT DIDN'T KNOW ANYTHING ABT BARIATRIC SURGERY AND DIDN'T TAKE CARE OF HER BY THE TIME SHE GOT PROPER HELP IT WAS TOO LATE. I AM ALSO SCARED TO DEATH BECAUSE I'VE BEEN HAVING PROBLEMS SINCE 2006 WHEN AT ANY GIVEN MOMENT I'VE HAD THE STABBING PAIN RIGHT UNDER MY RIB CAGE, VOMITING, COLD SWEATS, FAINTING & THE PAIN HAS LAST AN HR, OVR AN HR OR UP TO 4.5 HRS AND EVERYONE THINKS IT'S GAS. I SOMETIMES THINK IT'S TRAPPED GAS IN MY Y JUNCTION HOWEVER IVE TAKEN GAS PILLS, GAS X AND HAVEN'T FOUND RELIEF. IVE ENDED UP IN THE ER SEVERAL TIMES WITH 7/2/8 BEING THE RECENT ONE HOWEVER I STARTED HAVING SAME PAINS ON FRIDAY BUT IT WASN'T AS SEVERE..THAT ONE I BELIEVE WAS GAS EVEN THOUGH I BURPED FOR HOURS & FELT THE AIR BUBBLE TRAVEL THROUGH MY INTESTINE.. THE SCARY THING IS THAT THIS GAS, AND DUMPING ALSO HAVE SIMILIAR SYMPTOMS!

KEEP US POSTED!
Ruth S.
Jill23
on 7/27/08 6:26 pm - Kendall Park, NJ

I didn't want to scare the poster, but that is EXACTLY what killed the OH member Vickie J this month. I believe she was in a foreign hospital and they didn't know what to do and by the time she got to her hospital it was too late and she died.

I was suffering with terrible pain for so long and kept laughing and told everyone that I had crazy gas. After meals, very often I would need to lie down. That would let my intesines jiggle back to normal but I didn't know that at the time.

Kristy M.
on 7/27/08 6:32 pm - Washington, NJ
I wasn't aware of any of this.  I was summing it up to bad bad bad gas.  I too just recently passed out in a foreign country.  Fortunately, I woke up and got some water in me and passed it off as my blood pressure dropping because this has happened before.  However, this was the same period of time I had pain for 8 or so days and didn't have a bowel movement so maybe the passing out was related to that.  So I'm not sure what the point of my CAT Scan is tomorrow if it won't show anything?  Do I need to be forceful with my surgeon that exploratory surgery is done?  I am almost 3 years post op but I did lose my 140 pounds in about 8 months.  And, in all honesty, what I have thought were gas pains have probably been going on for about 2 years.  I should consider myself fortunate after reading some of  the shared stories.  However, what if my surgeon does not want to listen to me?
Jill23
on 7/27/08 6:42 pm - Kendall Park, NJ
you can try my surgeon Dr. Brolin http://www.obesityhelp.com/morbidobesity/bariatric+surgeon+p rofile+Robert+Brolin+cp.html

I too, lost 100% of my excess weight within a year.
Please get in an ambulance the very next time you feel any pain--even if you feel pain 10 minutes from now--don't drive--get in an ambulance.

Thank G-D you are home from the trip. I carried Gas-X with me everywhere and laughed to everyone that I had bathroom issues.

I thought it was all part of the RNY experience and that is what I signed up for. IT IS NOT GAS AND IT IS NOT NORMAL.

The surgeon told me I was very close to dying if I didn't get to that hospital fast the way I did!

Here's a clip from my blog--

I always have my camera!

APRIL2008hospital.jpg picture by findingjill

Yesterday, I started getting those terrible pains again (the ones I had on March 26th****pt thinking it was gas, even though the gas-x wasn't working. It feels like stabbing twisting pains, just like gas. It started at about 8:00 on the 14th (Monday night). I was barely able to watch the Bachelor. My intestines were making VERY VERY loud noises. I was even able to feel movements with my hand inside my body. Then I started having foamies even though I only had oatmeal for dinner.

I called my pcp and he said go to the hospital. Then I called my bariatric surgeon, Dr. Brolin, and his fellow, Dr. Ghandi said go to the hospital immediately and he would call ahead and have a cat scan arranged. He said the cat scan may save my life. At about 2 am I called an ambulance. I told my husband that there is no way it can be gas, I think I'm dying. So I went to Princeton Medical Center and got a cat scan. The surgeon came to me and said I had an obstructed bowel and need emergency surgery within the next half hour!!! The worst part was that he said that it was life threatening, since I waited so long, and that they may not be able to do it laparoscopally and my have to open me up. I JUST HAD A TUMMY TUCK FIVE WEEKS AGO!!! He said you can't think about that when your life is at risk.

I was crying and scared for like five minutes. I asked G-d for help. I pulled myself together and knew I had nothing to worry about with Dr. Brolin and Dr. Wey--I knew I was safe--the dangerous life threatening part (not diagnosing it) was over. I relaxed and said the Shema (a Jewish prayer) more than a few times, and let G-d take it from there.

I called my plastic surgeon, Dr. Wey and his service put him directly on the phone at 6:30 in the morning. He said it was my lucky day. I said "how is it lucky??" He said he lives just five minutes from the hospital and had no patients that morning. Dr. Brolin, my wls was doing my surgery, and he had worked with him before. He called Dr. Brolin and gave him his cell and home number and told him that if he could not use the laparoscope to call him and he'd be there in five minutes and he would open me from my tummy tuck incision, then Dr. Brolin would do the surgery, then Dr. Wey would close me back up.

This is another reason why surgeon selection is the most important thing!

During the surgery, Dr. Brolin called Dr. Wey and told him he didn't have to come, he would be able to do it laparoscopically. He went in with a scope and saw that scar tissue was strangling my small intestine. He made three incisions (he said they were very small--now they're covered with gauze) and he took the adhesions/scar tissue off the intestine. He checked me out top to bottom, side to side and everything else looked good.

Dr. Wey came anyway and met me in the recovery room! I was very happy to see him--wow--that was nice of him!


Now I'm in my hospital bed with my laptop, clear liquids only. I want to eat! The incisions hurt, but not too bad. Coughing hurts. I think I'm going to have to be finished with my compression garment from my abdominoplasty. It will be five weeks on Thursday. My surgeon's assistant, Dr. Patel, just came in and said that I will 99% be going home later today. I need to stay on a soft/pureed food diet for a week so my intestines can relax. Even intestines need a vacation. This morning I had some cream of wheat and some vanilla sf pudding and some apple sauce!! He just took the gauze off my incisions and they are pretty small and covered in tape. Dr. Brolin will be in later.

Wow, this really is the minute by minute update! Dr. Brolin just came in, and he said I look great. He said that based on the scope it is near impossible for me to get an internal hernia, since the area they closed off during my bariatric surgery where an area would form has stayed closed and can not re-open. He said I have very little adhesions/scar tissue left and it is unlikely that I will have another bowel obstruction, but it is not impossible. He said I don't need the soft foods only diet, but just take it easy and use my judgment for what I'm ready for.

He said I can go home as soon as Steve gets here!

Ruth S.
on 7/27/08 6:42 pm - Orlando, FL
this scary Jill....I hope if it happens again to me they will do something..maybe im becoming kinked and unkinked..and they think it's gas....i hope if it happens again..it will happen at work again so i can get some help faster...
Ruth S.
LizzyL
on 7/27/08 6:45 pm - NY
RNY on 06/08/04 with


Hi Kristy

I didn't want to scare you either by posting this , but ..Jupiter6 , another member had the samething going on with her.

Click here and read her post.

I hope you feel better soon

hang in there!!
Hugss
Lizzy


Hugs & Kisses
Lizzybee2.gif

Jupiter6
on 7/27/08 7:52 pm - Near Media, Pa- South of Philly, NJ
Thanks, Lizzy-- for people who don't click links, allow me to re-post:
__________________________________________________________

I've been reading a lot of threads about a dear OHer who passed away from an intestinal blockage, and how we need to advocate for ourselves-- and I wanted to make something clear--

If you are suffering an intestinal blockage, all the noise in the world may not save your life. Or better said, if you think you're being loud enough, BE LOUDER-- and arm yourself with knowledge so you recognize it beforehand.

My story: 3 days after having my gallbladder out in June, I started feeling very nauseous and suddenly could not keep food down. (That'd be hard for some to note because they have trouble keeping food down anyway.) I hadn't had gas or a bowel movement in 7 days, but having just had surgery suspected it was just slow in coming.

After 6 hours of this nausea and pain not passing I paged my surgeon and his assistant. I was told that neither were answering their pages. I was able to get in some water eventually and went to bed.
 
The next day the nausea and pain intensified. By 6pm I could take no more. I was home alone, and so instead of driving to the metro hospital where I had my RNY, I could only drive as far as the local ER. This choice almost cost me my life.

I was sweating and crying when I went in. I explained to the triage nurse that I had an RNY and a gallbladder removal just days before and suspected I had an intestinal blockage, and that the pain was excrutiating. An emergency. I could die. 

But It was a holiday weekend, and people who cut their fingers on beer pull tabs were taken back, women who were upset over boyfriends, the general ER riffraff BS that takes place on a holiday-- and I was left standing (couldn't sit) in the waiting room for FIVE hours-- even though I returned several times to triage to say, "I can't take this much longer-- I am very afraid I have had a blockage and need a doctor NOW."

When I was finally seen, the CAT scan was "inconclusive"...the doc told me he saw a lot of fluid in my belly but thought it might be from the gallbladder surgery, and I should follow up with my surgeon in the morning. I was discharged at 6 am with nausea meds and pain pills.

When I called my surgeon, I read him all my tests-- enzyme levels, etc. He said he didn't hear anything alarming-- but he was listening for something gallbladder related-- a bile duct blockage etc. would skew the numbers. When it didn't, he more or less said, "You'll be fine." This was Monday.

By Wednesday the pain at night was unbearable. I cried and screamed into a towel. Wednesday morning I had a regular check up with my surgeon. Luckily, his assistant knows me very well and said, "Shari, you don't look right. Seriously." The surgeon said, "I don't know what to do-- want us to admit you and run some tests?" I think he expected me to say no, but I said, "PLEASE!"

So I was admitted around 4 pm. By 7 pm the pain was back, but they wouldn't allow me pain meds until after I had a CAT scan. I didn't hve the CAT scan until 3 am. They left me on a gurney in the hallway for an hour and a half  aftyerward, sobbing in pain, because they didn't have anyone in transportation to come get me. By the time I finally received pain meds at 5 am, I would have shot myself if I'd had access to a gun.

I finally fell asleep. At 7 am, my surgeon breezed in, threw open my curtains and said, "You're having surgery today. You have a bunch of fluid backed up in your belly, and we need to find out why." He explained he'd use the lap incisions he'd made for the gallbladder and go back in.

By noon I was in surgery.

At 4 pm, I awoke in the worst pain I had ever felt in my life. I focused on a spot on the ceiling. I could not talk. I had tears streaming . The dilaudid wasn't even touching it. 

They explained to me, "You're a lucky woman. Your bowel (intestines) had twisted and actually permeated the wall of your excluded stomach. Generally when this happens, and days pass, we find a bunch of dead bowel which we have to remove. But for whatever reason when we reconnected you, you pinked up right away. Now we just have to see if it works-- if you can move your bowels or pass any gas." I was told that the lap procedure went open-- suddenly-- when they couldn't locate the source right away-- I had a large open incision now from my sternum to my navel. I'd been gutted and beat up pretty badly in the process. But I was alive.

For five days, nothing passed. My urine was dark brown, I was losing kidney function. Then it started to lighten, and returned. And finally on the fifth day, while walking in the hall, I passed gas. Sounds stupid, but I was so happy I cried. I gained 25 pounds in fluid and unpassed stool in 3 days--but within two weeks lost 40. My recovery took many weeks, but I finally  feel better now. I am grateful for the opportunity to live, and feel obligated to warn anyone who will listen.

Blockages like mine are 100% fatal if not caught in time-- usually within 72 hours. Why mine didn't take me down in the FIVE days that had elapsed, I am not sure.
 
I wanted to make sure you know what we're really discussing-- how it feels, what it looks like, how you might be treated. Your local ER will NOT be able to help you. You need to educate loved ones so that they can speak FOR you-- a medical alert bracelet will not help you. The beloved poster who passed away may have done all of the above, and still they missed her blockage until it was too late. You need to do everything you can to make sure it doesn't happen to you-- and this sort of herniation-- sometimes called a Petersen's hernia-- happens in about 5% of post bypass patients. Five out of one hundred. One in twenty. Could be anyone.

Symptoms in an RNYer include nausea, vomiting, abdominal pain and distention, inability to pass stools or gas. (Apparently in DSers, gas will still pass.)

Know the signs and symptoms. Don't allow anyone to dismiss you. Do NOT ignore pain that will not pass. Insist on prompt and appropriate treatment, and train your family to know how to help you if it should happen. You may save your own life.

 "Oh sweet and sour Jesus, that is GOOD!" - Stephen Colbert  Lap RNY 7/07-- Lap Gallbladder 5/08--  
     Emergency Bowel Repair
6/08 -Dr. Meilahn, Temple U.  
 Upper and Lower Bleph/Lower Face Lift 
12/08 
     Fraxel Repair 2/09-- Lower Bleph Re-Do 5/09  -Dr. Pontell, Media PA  Mastopexy/Massive 
     Brachioplasty/ Extended Abdominoplasty 
(plus Mons Lift and Upper Leg lift) / Hernia Repair
      6/24/09 ---Butt Lift and Lateral Thighplasty Scheduled 7/6/10
 - Dr. Ivor Kaplan VA Beach
      
Total Cost: $33,500   Start wt: 368   RNY wt: 300  Goal wt: 150   Current wt: 148.2  BMI: 24.7