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Kinked Intestine and Pain


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#1 yogi

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Posted 13 April 2004 - 09:05 PM

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When talking with MD's, it seems difficult to communicate the way pain limits lifestyle. I guess cause they do no have the pain.Have MD appointment next week and want to give good picture of pain episodes. Husband says I must have an intestinal kink that causes me to double up, feels like someone tightly twisting my intestine near the small/large junction which is near appendix. Twice to ER in past 2 years with this pain which then shoots down to foot from nerve compression. Appendix ruled out, GI tests show nothing,ER MD said he saw "stacked stool" and ER MD on visit #2 said colon was full of stool and in spasm. GI MD says "IBS" and to drink water and keep the stool soft. Gave me RX for Enulose (2 tablespoons) when needed(about 2x weekly) and two stool softners daily.These episodes can be once daily or every other day. They do not relate to any food triggers.All episodes began after abdominal GYN (hysterectomy)surgery four years ago and have since had laparotomy to rule out adhesions. Had gall bladder with stones removed two years ago. Any input would be truly appreciated. Posted Image
"Angels fly because they take themselves lightly." Natural remedies first and prescription drugs as last resort. Living with IBS-C and patient spouse.


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#2 LaurieJ

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Posted 14 April 2004 - 02:50 PM

Hi Yogi,The only input I can give you is how to communicate pain levels to the doctors. I have been going to a pain clinic for the past 6 months or so and can give you my experience with relating pain to the doctors.First of all, as you know, most doctors want the patient to both quantify pain level (the 1-10 scale is commonly used) and then describe the quality of the pain. Both are very subjective but attempts have been made to "objectify" these.To personalize the one to ten scale, I marked on the scale my experience with pain. For example, I had acute pancreatitis once and a ruptured ovary once and gall bladder surgery....you get the idea. I marked my acute pancreatitis as a 10 because that is the worst pain I have ever experienced in my life. I then put the ruptured ovary at an 8, my gall bladder surgey at a 4, etc. Then to give them an idea of the daily pain, I inserted what I felt day to day on the scale and recorded it on a daily basis. For example, when I first saw the pain doctor I told her that on my personalized scale of 1 to 10 that my daily pain averaged between a 4 and 6 with flares to 8 at times. I also made sure that I told her what made it better (pain meds, not eating, throwing up, resting, etc) and what made it worse (exercise, eating, etc).The next thing was to describe the pain, They like to know if it is shooting, stabbing, aching, numbing, etc. I tried to personalize it again by relating it to things that I have felt. Like a knife wound, getting kicked by a horse, etc....They also like to know how it interferes with your daily life. Do you have to rest often, have you cancelled social plans? Have you lost weight from avoiding food or throwing up? Do you tire easier? That kind of stuff.I have found that the more you objectify your pain, the easier it is to communicate. Phrases such as "it is ruining my life" or "it is more than I can handle" are good to say to explain why you are seeking help, but once said, they can become more of a hindrance than help when trying to get the pain managed, if you cannot describe it in other ways.I am sorry that I cannot relate specifically to your question about what is causing your pain. I have had a small bowel obstruction but that was related to post -surgical abdominal abscesses so I cannot separate the abscess pain from the bowel obstruction pain. All that I remember was that I literally thought I was dying and the second surgeon agreed with me. It was a shooting pain like someone was sawing me in half; along with a gnawing pain like a wolf had me in his mouth and just kept chewing and chewing and chewing (my right upper quadrant of my abdomen). I also couldn't breathe deeply without it feeling like I was kicked in the side by a clydesdale horse and eating was out of the question (I vomited after eating). I was told that any time you have abdominal surgery, especially in the pelvic region for gyn related problems that the likelihood of adhesions is very high. I was also told that a person can have intermittant and / or functional obstruction of the small intestine from these adhesions - and that this may be very hard to detect (they did a barium swallow with small bowel follow through to see if I had that after my surgeries). So in my opinion, it may be wise to consider this as a possible cause of your complaint (of course I am just offering you my guess! I could be so way off.....)Ok, I am finished - sorry for being long winded.Laurie

#3 yogi

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Posted 14 April 2004 - 07:14 PM

Laurie, Thanks for your input. My concern is the time factor. When you get just 15 minutes per patient in your HMO, I want to be as brief but as descriptive as possible. I like your idea of the "Personal Pain Index" which may give the MD a clearer idea of what I suffer. By the way, I was checked for adhesions when the post-op (year later) laparotomy was done by my GYN MD. I still would like to hear from any others who get this kind of pain which feels like there are gut gremlins having a tug of war. Posted Image Posted Image
"Angels fly because they take themselves lightly." Natural remedies first and prescription drugs as last resort. Living with IBS-C and patient spouse.

#4 LaurieJ

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Posted 14 April 2004 - 09:09 PM

Hi again Yogi,you are probably right to not be too concerned about adhesions but just to be aware: I was told that adhesions can form any time after surgery - months, years and even decades later. And secondly, according to my surgeon that did a lap check for adhesions that all you can do is a really cursory check that the best way is to "run the small bowel" completely, which they cannot do by laparoscopic surgery. He cautioned me that just because he couldn't see them, it doesn't mean they aren't there (in the inter-loop area which is fairly inaccessible) but that is is likely that they are not there. Not that you should be concerned - just something to think about.LaurieHope you get better responses from others that have more pertinent information for you!Gremlins in your gut sounds like an awful thing.

#5 yogi

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Posted 15 April 2004 - 07:53 PM

Laurie, Thanks again. I am considering a look-see the small intestines but fear invasive endoscope. I want to ask about the pill/camera diagnostic test and see what the GI MD says.From what I recall, the adhesions are on the outside of the intestine. I wonder what is meant by a run-through? Sounds olympic but not anything they award medals for! Posted Image
"Angels fly because they take themselves lightly." Natural remedies first and prescription drugs as last resort. Living with IBS-C and patient spouse.





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