Bowel obstruction - effects on bladder and bowel after impaction cleared

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I had been feeling more unwell than usual for 10 days or so and put it down to having had a challenging month and so many flu bugs being around. But it turned out it wasn't flu. I was taken into hospital on Tuesday after some horrible symptoms I won't detial, and was found to have bowel obstruction through severe constipation. Sorry for yuck information .....

I had to have an enema and fluids and several medicines through IV. I was told it was cleared and was sent home, but after a few hours at home similar symptoms were back and I called 111, and was told I had to go straight back to hospital as they thought the obstruction had returned and I shouldn't have gone home. Thankfully it hadn't but I had to have more IVs and X-rays and anti sickness medicaitons. I'm now back home thankfully, with Movicol and Bisacodyl to use regularly, and suppositories if they are needed. 

I've been advised to avoid wheat. I don't have celiacs but people with fibromyalgia and POTS like me can have other problems with wheat, contributing to bowel problems. I've also had to stop some of my medications as they can worsen constipation and have to discuss this with the GP to find alternatives. Fortunately I have an appointment at the pain clinic due in March so will be able to get more advice there about my pain medications.

Since I've been home, my bladder and bowel are very much unsettled and I'm hoping this is temporary not going to mean my incontinence is going to be a lot worse going forward. In the first day or so, I wasn't feeling the need to pee or feeling myself peeing, but I'd suddenly feel damp and so realise I'd wet myself, not a full bladder but enough that my pad was wet.. I'd go to the toilet with only a slight urge and pee a lot. Thankfully that has now got better and I'm feeling the urge to pee again but I'm leaking after a few seconds and not always getting to the toilet before my bladder completely empties even though I'm at home.

Worse, I can't always feel when my bowel is going to empty. I go to the toilet thinking I'm just going to pee and my bowel empties as well with no warning. I have had a couple of bowel accidents, one was just a little bit but one was everything. I had a slight urge to go but knew I should go straight away. I stood up and just started pooping my pants. I didn't even feel the usual strong urge to go, I just started to poop. I managed to stop it and had to grab clean pads and clean up things to take to the bathroom as I knew my pad hadn't caught everything but I couldn't hold it and I'd completely gone in my pants before I got  back to the bathroom. I came very near another accident later on.

I don't know if this is temporary as things have been so unsettled, if it's after effects of the enema, if it's because the laxative dose is too high... I'll be talking to the GP about it this week, hope I can get an appointment but on the phone if not. I'm so relieved and thankful the horrible symptoms earlier in the week are over and the impaction was caught in time but I'm upset about how much I'm losing control at the moment.

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11 Replies

  • Posted

    Dear Ginny,

    I hope to goodness these horrible and distressing symptoms are only temporary, but of course having that is bad enough.

    Of course you're upset; anyone would be. I have slight urinary incontinence and occasional bowel 'uncertainty' due to ulcerative colitis, and sometimes I've had an unplanned bowel movement whilst having a pee, and it's not nice.

    I wish I could give you helpful advice, but other than doing what you're going to do and talking to your GP, I don't have a solution to offer. If only I did. Hopefully it'll be the medication you've been given which is causing the problem and you can sort that out with your doctor. Fingers crossed for you.

    Please accepy my very best wishes for a reduction in your symptoms, but as you say it's great that the earlier severe constipation has been dealt with. Any progress is to welcomed.

    Take care and try not to become too demoralised.

    Peter A

      

     

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    • Posted

      Thank you very much for your empathy. I'm sorry that you suffer with ulcerative collitis. I don't know much about it at all but understand it is painful. Thank you for sharing your experience.

      Things are still bad but tomorrow I see the GP and hope that should be the start of making a plan what to do and finding out if a lower dose of the laxatives I was discharged on will help, and seeing if I need any referral to find out what's caused all these problems.

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  • Posted

    Dear Ginny31,

    i can hardly imagine what you went through the last couple of days. Hope you feel a little better by now, and that this dreadful experience won't happen again.

    You say you're fortunate to have an appointment at the pain clinic in march, but i think in your situation it is a long time waiting in uncertainty. Hope your GP can give you some advice and answers soon.Till some point i can imagine your bowel is unsettled after an enema, the medication and all you went through, but losing so much control is really terrifying and hopefully just temporary.

    Don't let your illness get you down. My thoughts are with you and i wish you all the best.

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    • Posted

      Thank you very much for your support and understanding.

      I'm hoping as you say it's that it's unsettled after everything that happened and all the medication changes.

      Yes it is really scary losing control. Having only a couple of seconds warning or no sensation at all of the urgent need to go and then suddenly I'm going is just awful. I can cope with the urinary side of it now as I've had that for years, leaking throughout the day and wetting when I can't get to a toilet quickly and at night. But poop accidents are much more upsetting.

      I see the GP tomorrow so I'm hoping she can tell me what's likely to be going on and what I should do and get some idea how long it might last.

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  • Posted

    I live in the US. Well, I had a bowel constipation due to taking pain pills. It lasted 14 days. I finally saw a doctor. She tried a enema, it didn't work. I was given suppositories at the doctor's office, they didn't work. I was then told to go home and try a laxative, since none of their methods helped.

    So I thought, since they couldn't help, I thought I should go to the experts that would probably know how to deal with my problem. I went to a hospital. I told them what the doctor tried, so they told me to drink the solution you drink before a colonoscopy. It worked. I was in the hospital for about 5 hours. When I thought I was ready to go home, I dressed but then had an accident and had to re dress with hospital grab. The pain of constipation was gone. I was told if I had any additional problems with constipation I should drink Lactulose solution until the problem is fixed Then I should be on a daily stool softener and a senna product.

    I have not gothen any bowel constipation since 2014.

    However, my urine leakage has been a problem for over 30 years. Being a male, it is called post void dribbling. I never know when it happens but I have always used padding just in case of an accident. I used to carry extra underwear whenever I was away from home. Now, that I drink less water, I don't. Mainly due to haemodialysis restrictions on water intake.

    Sometimes, it happens at night, that is when I used padding on my bed so that my bed doesn't get wet.

    Most people don't like to acknowledge that they have this problem, so they don't usually seek medical help.

    I am not a doctor, so when I cannot correct a medical problem that I have, I will usually ask my doctor and he will refer me to another doctor that can help to resolve it.

    I hope you get medical advice that will help you with your medical.problems

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    • Posted

      Thank you for sharing your experience and your good wishes. Wow you had to struggle for a long time before they were able to relieve the constipation. That must have been really awful. It's good you have found a way to avoid it happening again. I was given lactulose at first but it seemed to cause stomach pain so now I have Movicol (laxative) and if needed suppositories and Bisacodyl (which is supposed to help you actually go, but things have been so erm... loose... that I haven't needed to use that).

      Do you find with needing to drink a reduced amount because of the haemodialysis you need more fibre in your diet to avoid constipation? I was advised to drink more as well as increasing fruit and veg and avoiding wheat to see if that helps.

      Like you I feel I really need the doctor's advice at this point and I'm glad I'm seeing the GP tomorrow.

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    • Posted

      And also like you, I've had urinary incontinence for some years. I was already having to use protection every day but I've had to switch to tape-on diaper-type pads whilst I'm having regular bowel accidents and heavier urinary accidents. I don't like it but it's the only way to manage and be able to be more than a couple of feet from a bathroom!

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  • Posted

    By way of update, I saw the GP. She says the bowel urgency and incontinence should be a temporary problem. She thinks it is partly things settling back down and partly as the laxative dose was too high. So I'm gradually reducing the laxatives but this does have to be done gradually otherwise there's a risk severe constipation could occur which could cause a recurrence of the obstruction.

    The worse bladder incontinence is as I thought, partly due to the fact I've had to stop my OAB medication (oxybutinin) as it can cause constipation. Hopefully I will be able to go back onto this - it's very unlikely to be the oxybutinin that caused the obstruction but whilst my bowel is recovering I have to avoid anything that could possibly cause constipation. Also, I'm having to drink more which logically means more urine. As well the fibromyalgia and autonomic nervous system issues is worse at the moment both of which worsen the bladder incontinence.

    I'm seeing the GP again next week. I may ask about seeing the continence service which needs GP referral in my area.

    At the moment, my bowel control has improved somewhat with time and with reducing the laxatives. I've had much fewer instances of going with no warning at all. It is still not good because it's as if I get the urge to go and at the same time the muscles are starting to release when what I want to do is hold on. Whether I have an accident depends on how fast I can get to the toilet and I've still had quite a few accidents though not as bad as before. My bladder control is very bad. I'm wet during the night and in the morning usually wake up desperate and wet again before I can get up. During the day the urgency is very bad or I have no warning, and I'm wetting several times a day.

    So it's still fairly horrible but not as bad as when I was having regular full bowel accidents.

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    • Posted

      Good to hear your GP is positive about a full recovery of your bowel and bladder issues. Having constipation is not only painful it’s also dangerous. I think you are doing the right thing, handling that first and then finding the best balance for medication. Hope the continence service can help you out. Where i live ( the Netherlands ) continence service ( or continence nurse ) helps finding the right continence aid, like pads, diapers, or catheters. I guess that is the advice you are seeking for, for the short term anyway.

      Although i never had constipation i totally empathize with you. Having bowel accidents affects one's life tremendous. I hope things will get better and you can find the strength stay positive.

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    • Posted

      Thank you for your encouragement. It does help to know I'm not alone. It is a difficult process getting the right level of laxatives, dietary changes, fluids, my other medications that can affect my bowels....

      I am very thankful I have an understanding GP. That's makes a difference when it's an upsetting problem I need to get help with.

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  • Posted

    I've seen the GP again and been trying to reduce the laxatives further. It is difficult because when I reduced further, things went to the other extreme of not being able to go and stomach pain and I had to increase the dose again and use a suppository on 2 occasions to prevent a return of constipation and risk of another obstruction. But I can't get the balance right because now I'm back to where I was before, my bowels starting to empty with no warning. It's horrible. I can have no sensation of a need to go, then maybe a few seconds of stomach pain or cramps if that and I'm pooping my pads. Once I've started I feel the urge and what's happening but I can't stop it even for a few seconds to try to get to the toilet. My bladder lets go as well when I poop even though I feel no need to pee. The last 3 days I haven't made it to the toilet in time once for number 2. I'm scared because it isn't always really loose - sometimes it is a little loose but not very and not every time. If it were loose like it was at first when i came out of hospital, it would explain the accidents. But this is like my muscles are letting go uncontrollably when I'm doing all I can to try to do the opposite and hold it in. I'm scared I've somehow lost all muscle control and my bowels are now doing what my bladder does and I'm going to be completely incontinent. Perhaps this isn't because of the after effects of the obstruction but a development of the fibromyalgia and hypermobility and autonomic nervous system conditions that cause my bladder incontinence. As a child and teenager / younger adult I used to have bowel urgency and regular partial accidents (til things went the other way to constipation). But except for some occasions it wasn't to the extent of completely emptying in my pants and I usually had a little warning.

    The only good things at the moment are that the obstruction is cleared so there isn't that danger, and that my bowels are emptying predictably late afternoon or evening when I'm at home so thankfully there haven't been any full accidents away from home. And that I'm getting the GP's help. I just feel so horrible and dirty when it happens and like I'll never get clean.

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