Getting referred to hospital in emergency- best way-bowel obstruction

[Mharhi]

Hi, hope some of you savvy Mumsnetters might be able to help with this, and maybe it could help others who are in a similar position.

I've just returned from hospital for a bowel obstruction. This, they say, is due to adhesions from surgery before Christmas. I am cross with my GP, by the by, as went to see her with abdomimal pain a couple of weeks ago, clutching a CT report from after the previous surgery showing small bowel obstruction and wondering if this could be causing the problem? She reassured me I had gastritis, which is sort of like tummyache caused by eating / drinking too much too much and prescribed a acid reliever. So, I go on a healthy eating diet involving, fruit, veg, cereal including fruit and fibre for breakfast...

This was not a good idea (beware too much fibre anyone who has had abdominal surgery- no-one told me)... last week I had to go to A and E with bowel obstruction and stay in several days, narrowly missing another op.

Now apparently it may well happen again, although I'm now eating a low fibre diet (very tentatively). I asked at the hospital, if it did, if there was any way to bypass going through A and E (where I was left for at least 4 hrs in terrible pain and vomiting without painkillers). They said i could bring my discharge summary and they might take that into account at A and E or they might not. Hmm.

I remember with ds the Walk-In centre gave us a referral letter to go straight to children's ward, but they don't really have a Gastro ward, the SAU (assessment ward) would be ok. Or the GP has a walk in and wait clinic each morning.

The problem is these things sometimes come on at night, when there's only A and E.

Any ideas welcome. Also, to anyone who has suffered from this bowel obstruction, did yours resolve itself completely or become an ongoing problem? At the moment I feel pretty scared, I know if it doesn't improve within 24 hrs it needs an op. I'm thinking, won't be able to go away anywhere, in case it happens. Scared to eat evening meal in case of trip to A and E in the night.

Today, I just got my period and it's a relief to get something normal!

Anyway, thanks for reading

I had bowel surgery in the summer and then an obstruction at the start of december. I too got fobbed off by my GP with constipation. I had to go to a&e on successive days to get it sorted and like you ended up staying in for several days with an NG tube to alleviate it

I don't have an answer as to how to bypass a&e as I got seen quickly as I was having chemo at the time.

I wonder whether if they looked at your history they would see you quicker but I don't really know and also live in fear of having to go back in.

Touch wood I haven't had any problems since december, but i am worried about it happening again.

Hi I have recently spent 3 weeks in hospital with a blocked bowel although mine was caused by inflammation from Crohn's disease rather than surgery scarring. I was admitted via A&E on a Sunday afternoon but fortunately didn't wait anywhere near 6 hours - in fact I was only in triage for 15 minutes before they moved me to the major case team (I was in an immense amount of pain & was vomiting so I think they were concerned about my appendix at first although I did tell them it was my bowel). I was always undeer the impression that any stomach/bowel problems are fast-tracked through A&E in case of appendicitis or perforated bowel but I could be wrong.

Has your consultant given you any idea of how bad the scarring is? I may have some scarring from the inflammation but will have to wait a while for the verdict on whether I need surgery or not to remove part of my bowel - my fear is that the surgery will make things worse (apart from all the usual worries about going under an anaesthetic). I was told by my consultant that if the scarring is minimal surgery won't be needed & I should be able to live a normal life although my diet may have to be modified.

While in hospital I was put on a liquid only diet to rest my bowel & stayed on this for about 2 weeks. I was allowed soups as well & jelly but no solid food. They gave me Ensure to start with but I couldn't keep it down so they put me on Modulen which is specially for IBD sufferers. I am now reintroducing foods & fingers crossed its going ok. I'm under a dietician as well as the consultant so it may be an option for you to ask to be referred. I'm on a low residue diet (low fibre) at the moment & will probably stick to that going forward.

Can't think of anyway you can get admitted quicker unless you try calling the out of hours doctor if the pain starts after your GP surgery has closed. Although from my experience prior to my own trip to A&E the OOH Drs are reluctant to request admittance for anyone.

Good luck with everything & hope you get sorted soon.

Hi KnittingNovice and MrsPinotGritio, thank you so much for writing and sorry I didn't pick this up again sooner, I fell asleep putting the children to bed.

Thank you for your stories, yes I've been looking into the low residue diet too as although they said I was tolerating a light diet I was actually still in pain and only this afternoon, when I started eating just yoghurt, things like that , has it eased.

Had a row this eve with DP who says it can't be a permanent situation, i'll be back to normal soon, and I tried to explain I thought that the obstruction was going down but adhesions, which they think it's caused by, are permanent.

Although he's been really supportive especially practically, he's gone off in a huff now. Um, think it should be me who's the grumpy one looking forward to possible changed diet.

I met a lovely lady with Crohn's in the hospital and was very admiring of her strength. Hope all goes well for you both.

Mharhi - I've had 3 bowel obstructions due to adhesions. My initial surgery was as a baby and my first confirmed obstruction was as a teen although my mum thinks I had small obstructions previous to that which settled when she had me nil by mouth for 48 hours. I had a further two confirmed and had surgery the last time to separate some adhesions and remove a length of bowel. That was maybe 25 years ago now so it settled eventually.

Each of the 3 times I was admitted it was via OOH who called an ambulance. If I thought I had another obstruction then I would probably call an ambulance myself because TBH it was worse than having any of my three children.

I think that generally the current approach is what they used to call 'sip and suck'? Basically stick a tube up your nose give you small amounts of fluid and withdraw it through the tube which rests your bowel. This didn't work with my last obstruction hence the surgery.

I think that as your initial surgery is so recent that it may well settle over the next few months - personally I found my insides weren't right for a long time post surgery - the inflammation inside takes much longer than the outside healing. Hope you start to feel well again soon.

Golly that sounds awful ,and you're sounding so calm !
And boo hiss to husband - expect he'll pull himself together ,but really .

I'm not going to be too helpful but ....have a friend who had twisted gut ( which maybe different ) and also languished in A & E and was only diagnosed at shift change . My understanding is that delay is really bad thing as obstruction can prevent blood flow ( ? ) to gut and people end up having to have a bit removed . Perhaps you could ask consultant specifically about this and how to deal with quick hospital admission
And ....for what it's worth ,when I asked ambulance crew bringing in old lady I was accompanying who had suspected pnumonia if we could have bypassed A & E ,he said something about if she'd been seen by GP within last few hours or GP had written a note ,then we could have gone straight to ward .
But really I guess you go thru A 7 E to be assessed .
Sorry ,not helpful I know .

Hi thanks Sagermakers and Gingerroots,

It's good to hear your surgery helped in the end Sager, but what a thing to go through. The surgeon has mentioned to me if I keep getting probs i could come in and have an op as an outpatient rather than an emergency hopefully. However I was thinking, well that will just mean more scar tissue but it seems in our case that hasn't caused problems- good. Yes i agree it's worse than labour, also with labour you know it doesn't generally prove fatal after 24 hrs or so! Yes I (tried) to have the tube thing it was horrible, kept gagging and choking, then kept being sick anyway, none really came up the tube so not sure it was even in the right place. They didn't get me to do the sipping at the same time, maybe that would have helped, I'll suggest it if it happens again. Thank you for the advice about things taking time and more on the inside, it's so much better getting advice here than from the docs, they are so busy.

Ginger I know, it's not easy but poor DP has been brilliant looking after our little ones plus trying to work from home, he had to take about 2 months off before Christmas and not i think the strain is just starting to show. he's had to postpone a couple of work things which are urgent but a good drive away as he doesn't want to leave us, and they're nagging at him.
Yes that was pretty much the same as your friend then, I was in A and E from about 1.30am then was seen at 4.45 by a strange doc who couldn't speak English and wierdly came in and said "Wow'. Very slow progress, given morphine, and not properly diagnosed until saw the consultant during the ward rounds around 9am. This is despite me telling them on entry I had had recent abdominal surgery and had severe abdominal pain. thanks for the tip about the GP, I did think that too after ds however not sure I could cope with the surgery with the extent of vomiting/pain I had.

feel cross that, after Christmas, small bowel obstruction, though partial, was showing in a CT from after the OP. No-one mentioned it and I was told when asked that i could eat normally. I wonder whether to suggest to the hospital and GP to please make sure any patients with suspected small bowel obstruction be advised about the fibre thing, and to rest the gut for several hours. The GP was useless too, even when I went in with the CT report complaining of pains, she didn't tell me anything except 'gastritis'. Grr.