Intestinal blockage advice needed

[CurlyQ284]

SD2 has been battling constipation for months. I just found out about it maybe 3 weeks ago, DH 5 weeks ago. She had an xray and the doc says she has an intestinal blockage. She is with us all week and if it doesn't clear by the time she goes back they have to go in after it.

They live about 2 hours away, we weren't at the doctors appointment and all BM told us was to give her a dose of laxitives every day, no dairy and as few carbs as possible. I'm doing some online "research" and mostly everything says high fiber diet but a few say LOW fiber but doesn't say why.

She was supposed to have an enema Thursday but freaked out and wouldn't let her mom do it. Friday she told her mom she was ready but was told there wasn't enough time. So I'm truing to make her comfortable with the idea of me doing it, it looks like a lot of people have success clearing it after an enema.

Any tips or advice would be great since the doctor info I get is coming through like a game of telephone.

[Deleted]

Poor thing. Purple grape juice works for us. Within 1-3 hours after drinking a cup, he has a bowel movement. I might try a kids suppository before an enema.

[CurlyQ284]

Oh I forgot, she's supposed to take laxatives daily as well. The last visit/ she was supposed to start them and had packets of miralax. Her mom stopped the miralax because SD was nauseous and she thought it was caused by miralax. Now she sent a generic liquid laxative. Are all laxatives the same? Everything I'm reading says miralax is the best so should I go get that instead?

[CurlyQ284]

Jul 12, 2014 8:16:38 GMT -5 @cse1960 said:

How long will you have her with you?
I'd do a serving of Metamucil every morning, and I'd clear that blockage with some milk of magnesia.

She is here all week. She goes home Sunday and her doc appointment is Monday so its pretty much in our hands.

I was posting about the laxatives when you were posting. Does the brand matter? Her mom sent a generic one.

[Deleted]

DH's roommate in the hospital last week had a blockage. He was nauseous because of the blockage, your body knows nothings going through, so it sends it out the other way.

Definitely do the miralax. Lots of fluids and broth too if she's having trouble eating.

[circa1978]

So, the thing with fiber is that you also have to drink a lot of water. Fiber without water could make constipation worse, which might be why you are seeing the low fiber advice?

[CurlyQ284]

Jul 12, 2014 8:29:36 GMT -5 circa1978 said:

So, the thing with fiber is that you also have to drink a lot of water. Fiber without water could make constipation worse, which might be why you are seeing the low fiber advice?

Ohh OK thanks for clearing that up!

[persa]

How old is she? If she's a bigger kid, I would do a capful of Miralax in 8 Oz of fluid at least twice a day and can do even more. You basically can give her a lot more Miralax. Honestly, if she ends up going to the hospital for a cleanout, they'll give her GoLytely which she'll get through a nasogastric tube and is almost 14 doses of Miralax given over 8hrs.

Our GI doc likes to do 3 caps of Miralax in 8 Oz of fluids each, given every 6-8 hrs until they go. And she needs to drink plenty of fluids.

Get some foods that are natural stool softening/laxative: plums, blueberries, apples, pears, grapes, prunes or apricots (fresh or dried) if she'll eat them? I like prune juice mixed with pear juice.

Can you make a smoothie and add flax seed meal?

[CurlyQ284]

Jul 12, 2014 8:40:10 GMT -5 persa said:

How old is she? If she's a bigger kid, I would do a capful of Miralax in 8 Oz of fluid at least twice a day and can do even more. You basically can give her a lot more Miralax. Honestly, if she ends up going to the hospital for a cleanout, they'll give her GoLytely which she'll get through a nasogastric tube and is almost 14 doses of Miralax given over 8hrs.

Our GI doc likes to do 3 caps of Miralax in 8 Oz of fluids each, given every 6-8 hrs until they go. And she needs to drink plenty of fluids.

Get some foods that are natural stool softening/laxative: plums, blueberries, apples, pears, grapes, prunes or apricots (fresh or dried) if she'll eat them? I like prune juice mixed with pear juice.

Can you make a smoothie and add flax seed meal?

Yeah she's a good eater, not picky so we can try this. Not sure about a smoothie since she's not supposed to have dairy but I'm sure I can use a substitute for milk.

ETA and she's 11, I think she's somewhere between 80-100 lbs.

[tacom]

Please please please call your doctor before trying anything, especially fiber. I am so nervous reading this thread! A bowel obstruction absolutely needs to be treated differently than typical constipation.

I have Crohn's disease and suffered from multiple obstructions before my intestines perforated (basically blew out). I was not allowed to have ANY fiber - no raw fruits or veggies and certainly no fiber supplements like Metamucil. It adds bulk to BMs and can exacerbate an obstruction. If her intestines perforate, that could be a life threatening situation.

[CurlyQ284]

Jul 12, 2014 8:46:36 GMT -5 carrotsmakemefat said:

Jul 12, 2014 8:18:24 GMT -5 CurlyQ284 said:

Oh I forgot, she's supposed to take laxatives daily as well. The last visit/ she was supposed to start them and had packets of miralax. Her mom stopped the miralax because SD was nauseous and she thought it was caused by miralax. Now she sent a generic liquid laxative. Are all laxatives the same? Everything I'm reading says miralax is the best so should I go get that instead?

No not all laxatives are the same.

Metamucil is pretty tame
Miralax is also tame and takes some time to work effectively (but it's pretty mild in taste and you can mix it with just about anything)
Dulcolax is pretty great and takes a few hours to work. Very gentle.
I've only done an enema once that I can remember and it is VERY reflective but also pretty awful in terms of experience. But it was 100% necessary in my case as part of my colonoscopy cleanse. Of all the items out there (if she really needs to get moving) enema is it. Just make sure you do it next to a toilet bc she will need to go right away.

I assume she's too young for a prescription like Linzess? That stuff is also very effective without the cramping and awfulness of he enema.

I am sorry to say that your SD will need to take out the big guns and get it over with if it's that bad

She's worried its going to hurt to put something up her butt (her words!). I never had an enema, I'm assuming it doesn't hurt but you said its awful so maybe it does?

I don't know how to make her do it, I think she has to cooperate. Maybe I'll offer a bribe of some kind.

[Deleted]

Can you give her the enema or take her to the doctor to have it done?

[thatgirl2478]

Jul 12, 2014 8:52:59 GMT -5 tacom said:

Please please please call your doctor before trying anything, especially fiber. I am so nervous reading this thread! A bowel obstruction absolutely needs to be treated differently than typical constipation.

I have Crohn's disease and suffered from multiple obstructions before my intestines perforated (basically blew out). I was not allowed to have ANY fiber - no raw fruits or veggies and certainly no fiber supplements like Metamucil. It adds bulk to BMs and can exacerbate an obstruction. If her intestines perforate, that could be a life threatening situation.

THIS!! All the advice offered is great if you're just a little a constipated, but blockages (even if it's poop) are a different story!!

[CurlyQ284]

Jul 12, 2014 8:52:59 GMT -5 tacom said:

Please please please call your doctor before trying anything, especially fiber. I am so nervous reading this thread! A bowel obstruction absolutely needs to be treated differently than typical constipation.

I have Crohn's disease and suffered from multiple obstructions before my intestines perforated (basically blew out). I was not allowed to have ANY fiber - no raw fruits or veggies and certainly no fiber supplements like Metamucil. It adds bulk to BMs and can exacerbate an obstruction. If her intestines perforate, that could be a life threatening situation.

We texted her mom to ask for the doctors phone number. After dropping SD off with a bottle of laxatives she had to go get drunk at a concert. She will probably be asleep until 1ish.

No hostility. None. I swear.

[persa]

I doubt she's really obstructed, I would think they would have admitted her right then and there. At least I would hope so!

[CurlyQ284]

She has poo coming out, its mostly liquid so I think partial obstruction?

[auntie]

Jul 12, 2014 8:52:59 GMT -5 tacom said:

Please please please call your doctor before trying anything, especially fiber. I am so nervous reading this thread! A bowel obstruction absolutely needs to be treated differently than typical constipation.

I have Crohn's disease and suffered from multiple obstructions before my intestines perforated (basically blew out). I was not allowed to have ANY fiber - no raw fruits or veggies and certainly no fiber supplements like Metamucil. It adds bulk to BMs and can exacerbate an obstruction. If her intestines perforate, that could be a life threatening situation.

THIS!!!

Either talk to her doctor or return her to her home for treatment.

An intestinal blockage is not the same as constipation. Do not do anything other than what the child's physician prescribed for her care. Miralax is not the same as fiber, MoM, Mag Citrate, Ducolax or chemical laxatives.

It's usually given for a child who withholds stools or has encopresis. If there is a risk that she has some physical issue, fiber or a chemical laxative could harm her and in doing so, set the whole bowel retraining issue back a few months at best. 

[auntie]

Jul 12, 2014 10:05:45 GMT -5 CurlyQ284 said:

She has poo coming out, its mostly liquid so I think partial obstruction?

That's encopresis. 

Difficult to treat. It generally requires medical as well as psychological support to conquer.


www.mayoclinic.org/diseases-conditions/encopresis/basics/definition/con-20029758

[CurlyQ284]

Jul 12, 2014 10:10:15 GMT -5 auntie said:

Jul 12, 2014 8:52:59 GMT -5 tacom said:

Please please please call your doctor before trying anything, especially fiber. I am so nervous reading this thread! A bowel obstruction absolutely needs to be treated differently than typical constipation.

I have Crohn's disease and suffered from multiple obstructions before my intestines perforated (basically blew out). I was not allowed to have ANY fiber - no raw fruits or veggies and certainly no fiber supplements like Metamucil. It adds bulk to BMs and can exacerbate an obstruction. If her intestines perforate, that could be a life threatening situation.

THIS!!!

Either talk to her doctor or return her to her home for treatment.

An intestinal blockage is not the same as constipation. Do not do anything other than what the child's physician prescribed for her care. Miralax is not the same as fiber, MoM, Mag Citrate, Ducolax or chemical laxatives.

It's usually given for a child who withholds stools or has encopresis. If there is a risk that she has some physical issue, fiber or a chemical laxative could harm her and in doing so, set the whole bowel retraining issue back a few months at best. 

OK thank you!

[auntie]

Jul 12, 2014 10:13:12 GMT -5 CurlyQ284 said:

Jul 12, 2014 10:10:15 GMT -5 auntie said:

OK thank you!

I'm sorry you and your DSD are dealing with this. It's a real challenging situation even when all the adults are on board and working together. 

I can't believe mom agreed to leave her in your care if things are not going well in the moment. This is a weirdly common medical concern for kids on the autism spectrum for some reason- probably sensory based complicated by low tone. So folks on my support forums tend to be real experts in dealing with this- I've not lived it but know many who have. Good luck.

[CurlyQ284]

Jul 12, 2014 10:17:58 GMT -5 auntie said:

Jul 12, 2014 10:13:12 GMT -5 CurlyQ284 said:

OK thank you!

I'm sorry you and your DSD are dealing with this. It's a real challenging situation even when all the adults are on board and working together. 

I can't believe mom agreed to leave her in your care if things are not going well in the moment. This is a weirdly common medical concern for kids on the autism spectrum for some reason- probably sensory based complicated by low tone. So folks on my support forums tend to be real experts in dealing with this- I've not lived it but know many who have. Good luck.

This isn't the first time. She also sent a bunch of books on periods/puberty/sex when they were with us a few summers ago. I'm pretty confident there's a pattern.

Plus boyfriend/concerts and booze y'all! Thanks for posting on Facebook for me to see!

[CurlyQ284]

Jul 12, 2014 10:11:30 GMT -5 auntie said:

Jul 12, 2014 10:05:45 GMT -5 CurlyQ284 said:

She has poo coming out, its mostly liquid so I think partial obstruction?

That's encopresis. 

Difficult to treat. It generally requires medical as well as psychological support to conquer.


www.mayoclinic.org/diseases-conditions/encopresis/basics/definition/con-20029758

This sounds right. And I think I got her to agree to an enema so it should be a fun afternoon!

[cinnamoncox]

Jul 12, 2014 9:56:22 GMT -5 CurlyQ284 said:

Jul 12, 2014 8:52:59 GMT -5 tacom said:

Please please please call your doctor before trying anything, especially fiber. I am so nervous reading this thread! A bowel obstruction absolutely needs to be treated differently than typical constipation.

I have Crohn's disease and suffered from multiple obstructions before my intestines perforated (basically blew out). I was not allowed to have ANY fiber - no raw fruits or veggies and certainly no fiber supplements like Metamucil. It adds bulk to BMs and can exacerbate an obstruction. If her intestines perforate, that could be a life threatening situation.

We texted her mom to ask for the doctors phone number. After dropping SD off with a bottle of laxatives she had to go get drunk at a concert. She will probably be asleep until 1ish.

No hostility. None. I swear.

I am so sorry. Your poor SD. She is so lucky you are caring enough to research this and be sensitive about it . Honestly, I'm very wtf about her bm here . I have had a step mom since I was 6 (dad is now divorced from her but I maintain a close relationship) and I truly love her like a second mom and have the utmost respect for her, but I cannot imagine being 11 and having this go on and NOT have my mom.
Maybe I've missed back story here and SD is better off with you guys for the week, but a blockage is a big deal, it's so far from just being constipated, she needs the doctor or something more than a laxative it seems to me.
I'd be super hesitant to do anything I didn't personally hear from her doctor.
If "going out to get drunk" was more important than her dd's health , I wouldn't trust her instructions. I'd want to talk to or have your dh talk to her doctor first .
I am so sorry. This is a lot to put on you, since you guys are more removed from the situation, as in haven't spoken to her doctor and stuff.
This is freaking me out I'm worried.

Good luck curly and curly's SD.

[CurlyQ284]

Jul 12, 2014 10:43:45 GMT -5 cinnamoncox said:

Jul 12, 2014 9:56:22 GMT -5 CurlyQ284 said:

We texted her mom to ask for the doctors phone number. After dropping SD off with a bottle of laxatives she had to go get drunk at a concert. She will probably be asleep until 1ish.

No hostility. None. I swear.

I am so sorry. Your poor SD. She is so lucky you are caring enough to research this and be sensitive about it . Honestly, I'm very wtf about her bm here . I have had a step mom since I was 6 (dad is now divorced from her but I maintain a close relationship) and I truly love her like a second mom and have the utmost respect for her, but I cannot imagine being 11 and having this go on and NOT have my mom.
Maybe I've missed back story here and SD is better off with you guys for the week, but a blockage is a big deal, it's so far from just being constipated, she needs the doctor or something more than a laxative it seems to me.
I'd be super hesitant to do anything I didn't personally hear from her doctor.
If "going out to get drunk" was more important than her dd's health , I wouldn't trust her instructions. I'd want to talk to or have your dh talk to her doctor first .
I am so sorry. This is a lot to put on you, since you guys are more removed from the situation, as in haven't spoken to her doctor and stuff.
This is freaking me out I'm worried.

Good luck curly and curly's SD.

The things the doctor said were:
Laxatives
Enema
No dairy
As few carbs as possible
As many liquids as possible (as in it would be great to do all liquid for 24 hours)

DH has a juicer and looked up recipes for juices.

Still no response to texts/voice mails. I asked SD if she remembered her doctors name. She said no but she has an accent and was going on a month long vacation out of the country so....this is just great.

[CurlyQ284]

She is reporting a lot less pain and more poops today. She said she feels a lot better and no nausea. She says she would rather have an enema than do what the docs will do if it doesn't clear.

I will feel like a badass (haha) if I can clear this thing.

[kristinschmistin]

Honestly the BM sounds like a powertool. I'm glad your DSD has you and your H to look out for her. I hope everything goes well w the enema.


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[bcv513]

Honestly I would take her to a local ER. Has she had X-rays or anything to confirm a blockage? I would think an eleven year old with a blockage would be admitted. I feel like the mom is leaving something out or didn't get the whole story.

[CurlyQ284]

Jul 12, 2014 11:05:07 GMT -5 kristinschmistin said:

Honestly the BM sounds like a powertool. I'm glad your DSD has you and your H to look out for her. I hope everything goes well w the enema.


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She is not my favorite. I normally don't harbor any anger towards her. If she wants to go out all the time, that's hardly a CPS offense since they are with their grandmother. Since there's nothing we can do about it, we just let it go. We get them as much as possible. This is part of why weve been trying to move here. We are still about 2 hours away though. We are hoping to move even closer but that'll take time.

Its only times like this that piss me off.

[nursewife]

Usually when I see blockages, I'm sending them to the hospital to be admitted. It's not something thats managed as out patient. I'd take her to a local ER. They will likely to do a flat plate of the abdomen and see what is going on. If it is just constipation, it can be treated at home (although for something like that, I'd want to be following a doctor's advice to the letter).

[kristinschmistin]

Also, her father should have just as much access to her healthcare providers as her BM. For these reasons- so he can get information as often as he wants/needs to help provide the best care for your DSD.

My ex husband has equal access to all healthcare (and school) related matters. Not that he needs it, or would ever use it, but if he wanted to he could contact them as I do. It's part of co-parenting and usually part of most parenting plans/separation agreements.


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