Serious wind pain - merendino interposition.

[medway]

18 months post op, I am still getting, in some cases, quite serious wind pain which I cannot tie down to any particular food as sometimes I can eat something and other times not. I have had a couple of cases of extreme pain for half an hour or so, which definitely is very sudden build up of an extraordinary amount of wind. The pain gradually goes and I can burp 8-10 times in quick succession with more from the other end later.

Does anybody else have this pain issue? My surgeon cannot explain it and my local doctor does not understand it as he does not know anything about my merendino interposition 'new plumbing'. He has suggested constipation?

[Hidden]

I think this is probably a gastroenterological issue. Some people use gripe water - which sounds odd until you think that babies also get pain until the wind gets released.

Sometimes, more generally, I suspect that it might be something to do with the bacteria in your gut, fomentation of what you have eaten, and how things flow through (hence the significance of constipation). It is also possible that there may be some bacterial issue that might need antibiotics, but these things are often quite complicated to resolve - often there are quite a lot of things going on at the same time. There is a leaflet about bloating / wind on the CORE website corecharity.org.uk/conditio... but you have to be selective and careful about these because they are not tailor-made for your situation.

So I think that the answer is that it is quite common, but difficult to pin down exactly what is due to the after-effects of the surgery and what might be common factors with other digestion issues. I am conscious that this probably does not help much!

[medway]

Thanks Alan. I told my doctor it was a difficult one. I'm going down the Movicol route first to see if its constipation. If its no better I'm going to ask to see a dietician who will know more about digestion. The only strange thing is that it always happens later in the day and I'm fine in the mornings which suggests a build up problem. It could also be due to activity as I'm able with the merendino and no reflux to lead a normal life actionwise if not digestively.

I'm also wondering if its because i do not burp immediately after eating but some time later which again can be build up. I do find i have to clear wind after a few mouthfuls which suggests permanent wind in the system and perhaps not releasing it due to the type of op. I have 10cm of closed jejunum and absolutely no reflux I can feel, so I'm wondering if 10cm is too much stopping me burping early. I'll discuss this with my surgeon next time. I think the standard length of jejunum is 10cm. I'll ask if he has done an op with less.

I asked him how many merendino's are around. He said quite a few but there do not seem to be any on here OR people dont know what they have had done. Surgeons do many different things. I have noted comments about partial stomach removal which suggests merendino.

[Hidden]

I do not know about the surgical technicalities, but a few inches here or there probably won't make as much difference as the general shape and new speed of food running through the first bits of your digestive tract?

We do swallow air when we eat, and sometimes the more air we take in, the more wind gets created, so perhaps eating slowly and chewing well might feasibly be a factor. That sometimes leads to outrageously anti-social flatulence as well.

Position and posture might be relevant to releasing wind, and perhaps giving yourself enough time relaxing after eating? (think babies and colic!)

I am speculating with most of this - it is probably a matter of systematically trying things out until you find better relief.

[jay2908]

Sometimes buscapan or windeeze can help. You may find the movicol does the trick as it will often help flush out any bacterial overgrowth. Also try a simple diet for a few days and avoid typical wind producing foods such as beans and greens. Try having a warm drink 20 mins before you eat to help relax your gut and clear out the previous meal. I hope you find a solution.

Jay

[medway]

Thanks for the above comments and suggestions. I've been taking actimel or yakult for a couple of weeks which in theory is putting the right bacteria back, but no change. I've also with my surgeons approval stopped taking omeprazole, the theory being that producing acid may return the digestive system to some sort of normaility, but again no change. I dont think swollowing air is the answer as the amount I expel is very large and its there all the time as when I eat I burp after just a few mouthfuls, the food entry opening my jejunum.

I'm wondering if I could have some sort of infection but would have thought that it would show in other ways. Also alcohol? My surgeon says I'm ok to drink it in moderation - a glass of white wine 4/5 nights a week. I'll try no wine for a few weeks.

No doubt I will find a solution some time but after 18 months I haven't found it. I used to get these painful attacks in the first few months post op and then i seemed to be ok for nearly a year and now they have come back. My activity has increased dramatically as I have moved and have a large garden to tend with more physical use on my body. If i improve in the winter with less activity I will learn something.

It would be good if i could compare notes with others who have had the merendino, but from requests on here it sounds like I'm the only one.

I have been using Kolanticon which is supposed to stop wind. I'll check into buscapan.

The search continues

[gutlesswonder]

Seek and ye shall find !

I have been granted half-a-dozen patents for bio-engineering so I know a bit about reactors,fermentation,bacteria etc etc.Your gut is just a bio-reactor,albeit a pretty marvelous one.

The contents of our intestines include many billions of organisms comprised of many hundreds of different species - each one inhabiting a different niche and doing a different 'job' .

Think livestock and ranching.

Every change in you,including the food at every meal ,results in a commensurate change for your

internal co-inhabitants.

If you experiment with an alteration in diet or medication you need to maintain that new steady state unchanged for 8-12 weeks minimum in order to give the rest of the gang a chance to get used to the new state of affairs.Only then can you decide if the change was permanent and beneficial or otherwise.

Pretty slow and tedious but that's evolution for you .At body temperature the majority of bacteria will produce a new generation every 20-30 minutes.

Taking antibiotics is obviously highly disruptive and it can take months to re-establish equilibrium with a fresh population throughout the whole 8 metres.

It has taken me many years (22 years post-op) to get to a situation where ,with confidence ,I can know that if I do X the outcome will be Y.

In all honesty I just don't think it is worth the effort.I prefer to live as normally as possible and suffer the consequences.

However it would be mad not to take a few basic precautions.So in my case (Ivor Lewis ) I know that the majority of my wind is swallowed;as the bolus (food ball ) is passed by peristalsis (muscular contraction) down the narrow lumen (internal diameter) of the stomach tube.

By lying down prone at an angle of about 15 degrees I can burp up sufficient to avoid pain during the night. During this manoeuvre it is quite difficult to avoid serious reflux.

I also depend on a balance of dietary fibre (Muesli for breakfast),fruit and live yoghurt to keep things moving smoothly but not too swiftly.

With this regime I can even cope with the occasional Mexican bean stew !