Twisted intestines and chronic constipation

Good morning all.  Just wanted to share my unfortunate happenings of the week, and share some information that my doctor gave me.  I had emergency surgery at 2am Sunday morning for a double twisted bowel...one which twisted my appendix up in it.  Then on Thursday I had a bowel resection.....not a pleasant week.  My doctor told me that this was directly related to chronic constipation and not enough fiber in my diet.  I thought I had all that covered, but apparently not. After losing so much weight, the fat wasn't holding my intestines firmly in place ....basically because low fiber causes intestines to become floppy.   I am home now and very thankful to be here.  This is my tale.  Please watch your fiber intake also.... If this story can prevent just one person from having this extremely painful situation happen to them, it will be worth it.....

--Trish

Not enough fiber of too much fiber can cause constipation.  Too much fiber with not enough water or the body ability to move the bulk can cause serious blockage.  Adding more fiber when the intestines do not work right it is like putting sand into already blocked toilet.  Just be careful what and how much fiber you add. Adding some healthy natural fats - like butter, nuts, avocado, coconut oil, etc, can help more than adding more fiber. I had to add Miralax to make sure my inside can work properly.  

1)  Please share you how you thought you had fiber/constipation issues covered before this complication?  2) What food/product/activities are you now doing? 3) What did the medical staff advise you to take/eat differently?  4) What were the events that led up to and how long before you went to the ER? 5) At support group, some have mentioned water intake and exercise are important ways to prevent twisted intestines, too---input on that please?  Thank you and Well Wishes. 

1). I did take 3 stool softeners every evening....if I didn't have a BM daily I would take some Miralax.  I drink 64 oz of water a day.  I eat veggies daily, fiber bars, but I guess I was concentrating on my protein intake more than fiber.  I always eat protein first, a little potato, and a veggie at dinner.  Oatmeal and banana every morning, and protein of some sort at lunch.

2).  Well, I just got home from the hospital less than 24 hours ago.  Had terrific gas pains in my bac****il this morning, so getting up and down are my activities for the day, along with some laps around my downstairs.  I am eating a lot of yogurt to get the good bacteria back into my intestines.  I also have thrush, so eating anything burns my tongue right now.  I am eating soft foods right now, was thinking about trying some bean soup today.  I am, very slowly, heading in the right direction. 

3).  They advised me to return to my normal diet, but to slowly increase my fiber to bulk up my colon.  Keep up with my water.  

4).  I ate oatmeal and half a banana around 8 am Saturday morning.....drank water on the road, as we were headed to our friends house for lunch/dinner.  Pain began at 2pm, went to the ER at 5 in some serious pain......they weren't too worried about my ever increasing pain until they saw the results of the cat scan, (which was done about 4 hours after I arrived).   My husband said they were like "rats when the lights came on" when they saw the pictures.  They put me in an ambulance to another hospital 1 1/2 hours away at about 11 pm.  Had surgery at 2 am.

i hope I didn't miss anything.....I have had trouble with chronic constipation and IBS for years, just didn't realize that this could happen.  Thank you for your questions.

-Trish

Stool softeners are not fiber (well, not any of the ones I have seen, but it almost never use them)... which is why I am always so surprised what how many people take them multiple times a day after RNY at rather than just eat some high fiber veggies and some healthy fats.  Hopefully you can/will now incorporate some of both to avoid future problems.

Lora

I have kind of a similar story except mine didn't end in surgery, thank God.  But the pain and ambulance ride sounds familiar.  In fact, I just had another follow up and the doctor told me she was surprised I didn't have surgery.  I really dodged a bullet there.  My problem was a bowel obstruction but have suffered with constipation forever, except the 8 years after my first WLS when I had chronic diarrhea due to bacterial overgrowth.

Anyway, what I was going to say is, what does your doctor say about daily Miralax?  I have been on it for nearly 4 years and if I miss even one dose I get constipated again.  Taking it as needed didn't work for me, I need it daily, along with the fiber.  It seems sometimes that my bowels rule my life.  I gave myself a hernia my first year after my revision from straining so I know how important it is to keep things moving.  I wish I had Miralax when I was younger, I might not have as much damage as I did.  It really is a life saver and without it my quality of life is much worse.

He said no stool softener, no Miralax for now because I will be very loose for quite a while.  I will ask though.  I had a bowel movement every day, but he said that there was still tons of fecal matter in there.....I am nervous about upping my fiber too fast because I don't want to get constipated..I mean I just had my right colon removed...there's lots of stitches etc. in there.  All I know is that I never want this to happen again.  I'm so sorry for your problems, hopefully we can figure this thing out.  

--Trish

I have just had a very scary life altering medical issue also. Life is precious, and how I am thankful for the ER staff and on call surgeon and surgery staff. Early morning surgeries are no fun. My prayers will be with you, DeeW

p.s. mine was a perforated small intestine

Wishing you a speedy recovery

I've had two bowel obstructions.  My surgeon told me to take fiber right away.  He said that I should avoid insoluble fibers (like Metemucil) and take soluble fibers ( like Benefiber) twice, daily.  Soluble fiber works by absorbing water and softening the stool.  It's VERY important to drink fluids to avoid constipation...especially when using fiber.  I have to drink about 120 ounces of fluid daily... or I have bowel issues.

 He said that insoluble fiber ( Metemucil) can actually cause more problems by building up in the intestines ... like a bottle neck effect.

 Of course, the best solution is eating more veggies and adding good fats to your diet...like almonds.  That can be difficult if you only have room for protein before your pouch reaches "capacity".