Saturday, March 15, 2014

Diary of a Crohn's Flare: Imuran & Partial Small Bowel Obstruction

I began having pain in my abdomen Wednesday of this week around lunch time.  The pain didn't feel like other pains I've had with Crohn's Disease and my various medications.  Anti-cramping meds only provided minimal relief.

The pain, bloating, discomfort, and full feeling severely suppressed my appetite and over the course of Wednesday afternoon through Thursday at bedtime, I ate the equivalent of 1 - 1.5 full meals.  Towards the end of this period of time, the pain began to feel like a radiating pain in my upper left quadrant and a mild burning sensation there too.

I called the doctor's answering serviced and they advised me to stop taking the Imuran / azathioprine (there's concern about it causing pancreatitus).

The pain continued through Friday but had lessened.  I felt a little better and managed to eat a bit of food (1 pancake).  By noon I didn't feel any pain and felt very famished, so I ate 2 bagels with cream cheese and ham.  After eating this food I began to hurt again and experienced the other sensations (feeling full, bloating, etc.).

The feeling of fullness continued through dinner, where I was only able to eat 1/2 or less of the food on my plate.  I went to sleep normally but the pain woke me by 2 am and it was powerful enough to prevent me from going back to sleep.  At this point I knew the problem was what I call an "episode" but medically it's called a partial small bowel obstruction.  Since I had the abscess last December, I've decided it will be prudent for me to monitor my temperature.  So far, I've had no temperature spike.

I suspect that I've had a partial small bowel obstruction since lunch on Wednesday.  I'm not sure why I had the different sensations for this one.

If my temperature spikes, the pain spikes, or the partial small bowel obstruction doesn't resolve by sometime tomorrow afternoon, I'll check myself into the hospital.

In the meantime, I'm only permitting myself to drink water and coffee.

The pain remains pretty high and I'm must take a 1/2 - 1 Norco tablet every 4 - 6 hours to remain comfortable.  I'm also forcing myself to reduce my activity and have spent most of this (Saturday) morning in bed.

This will interfere with my planned business trip next week.

The difference between a partial small bowel obstruction and a complete bowel obstructions is that with a partial small bowel obstruction some food / stool can pass through the obstruction.  With a (complete) bowel obstruction nothing can get past the obstruction.  Until last night I continued to pass stool (albeit at a much lower frequency and quantity than normal).  Since early this morning, I've not been able to pass any stool.

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