Advice on how to manage narrowing of the bowel?

[JoanaPhy]

Looking for advice and tips on how to manage narrowing of the bowel during chemo before surgery; in terms of laxatives, diet and general care?

My Mum has been diagnosed with stage 3 ovarian cancer, she is in her late 60s. She has tumours on her small bowel, a large build up of ascites and a narrowing of the sigmoid colon.

She is just about to commence 3 cycles of taxol and carboplatin, then major surgery to remove the mass and repair her bowel with a (hopefully temporary) stoma, before further cycles of chemo.

As many of you know, the pain is horrendous but the narrowing of the bowel is causing awful trouble. The last few days everything is getting worse: she is in awful pain, bloated and uncomfortable, her abdomen is distended with very loud gas / gurgling sounds, bladder under pressure, she is nauseous and has lost her appetite. Passing minuscule amounts and barely passing wind at this stage. Overall she is completely exhausted and mood very low.

She is taking Tylex for the pain and Movicol as a laxative. Also trying flaxseed oil capsules with meals twice a day and 3-4 Senokot at night. We have also researched fibres (soluble and insoluble) but are bit confused by it all.

I’m sorry if this has been asked before. Any advice or positive words on how to get through this would be much appreciated. Thank you all. x

[meboo]

I don't want to give medical advice on this, but can you ask her team about whether a low fibre diet might help ? Mum had a bowel obstruction & she was told to follow this. The idea is that fibrous foods absorb water so they actually get larger /swell in your bowel. Normally this is good to keep things moving , but if there is a restriction, you don't want anything getting larger. So, for mum, it's no brown bread, v little veg, fruit without skin, no potato skin but can have the middle. Basically, puddings, pies, crumpets are fine ! It sounds like junk food heaven, but it can be a bit tricky on a practical level. However, it is working !

[JoanaPhy in reply to meboo]

Thank you Meboo, appreciate the response. I'm going to ask her to address her diet again with the team because they actually advised more fibre to keep things moving! At the time she was passing small amounts but it feels like things have changed and so should her diet.

A diet of puddings sounds wonderful to me but I'm sure it loses the appeal quickly. I'm glad to hear that it's working well for your Mum.

Thanks again, J

[Chamber]

Hi

I had a complete bowel obstruction last year. I was admitted to hospital and had a saline drip put up and wasn't allowed anything to eat or drink.

Before surgery I was put on a low fibre diet. This meant no fruit or veg. In other words nothing healthy. White bread, inside of a baked potato, cake etc.

I hope this helps and your mum feels more comfortable soon.

Best wishes

Judy x

[JoanaPhy in reply to Chamber]

Thank you Judy, really appreciate the response.

Yes it looks like low-fibre could be one answer. She's going to Oncology unit tomorrow so please God they will assess the situation and get her sorted. Good to hear from someone who has had a similar experience.

Thanks again, J

[Hidden]

I have oc stage three and ended up with a Stoma at the time I thought it was the worse thing but now I have become use to it and it has made life easier in some ways. I was put on a low fibre diet I also take docusate as well as movicol when needed. Best wishes to your Mum xx

[JoanaPhy in reply to Hidden]

Hi Granis, thanks for the reply, much appreciated. Reassuring to hear from another stage 3 woman doing well. Yes, the stoma is daunting but a necessary, anything to avoid the pain she is in. I will take note of Docusate and pass that info on. Thank you, x

[HopeP]

I haven't had a stoma, or narrowing of the bowel but during chemo have had awful constipation problems. I took laxadol which didn't help much so my oncologist eventually prescribed sodium docusate capsules which have helped enormously. Maybe you could ask if they would be appropriate for you??? Hope you get some help and a solution very soon. X

[JoanaPhy in reply to HopeP]

Thanks HopeP, appreciate your response. Another recommendation for Sodium Docusate capsules, which I'm going to pass on to Mum to discuss with her consultants. Thanks for the support and I hope you are in good spirits. x

[LorettaMEmery in reply to JoanaPhy]

I take docusate tablets too. They do help me. I had a Stoma for 14 months after my hysterectomy. After it was reversed I suffered awful constipation. I am now on a third line chemo treatment and suffer awful constipation I take syrup of figs and docusate tablets. I can still go 3 days without going - it is no fun. I think I was better off when I had the Stoma.

It had disadvantages but I was much freer and in less pain. I was so desperate to get rid of the Stoma but now realise I was better with it

All best wishes to your mum. With love x

[JoanaPhy in reply to LorettaMEmery]

Hi Loretta, thanks for the response and so sorry for the delayed response. Since I wrote this post my Mum had an emergency colostomy procedure. We hope it will be reversed in time but she is in the early stages of her treatment. It sounds like you have been through a very similar situation to Mum. Wishing you the very best, x

[Hidden]

Hi JoanaPhy, well it would seem you have got some info to take with you and your Mum. Her oncologist will advise what best diet to have as well, At least the pain seems under control though pain relief can give constipation, What I would suggest is small amounts of food more often rather than a meal, it may tempt your Mum to eat better. You will find the team will be extremely helpful and anxious to solve all the problems. Protein drinks are also another option.

[JoanaPhy in reply to Hidden]

Thank you Suzuki, appreciate that sound advice. Eating little and often sounds sensible, she tends to have three square meals a day but I think it's too much strain. Protein drinks are something we've discussed, I think she was hoping to hold out a bit longer before using them. Are there any brands you'd recommend? I saw on your profile that's you're also in Ireland.

[Hidden in reply to JoanaPhy]

Yes I am in South Munster, I am lucky to have a very good oncologist who understands me, god love him he has no other option, If your Mum is reluctant to do protein drinks then perhaps soft digestible foods. Breakthrough Cancer Research here in Cork have a cookbook with tasty recipies for chicken and rice etc. they would post it out to you I think the cost is about ten euro which goes towards research. I am not sure of the name of the protein drinks but your Mums gp would know what would suit. Also Jelly and rice you can buy ready made. I just looked for the book and cant lay my hands on it. Your Mums gynae liason nurse if she has one should be a source of information too, I do hope you have access to an Arc Cancer House near you as they are also helpful to speak to and allay your fears. The service is confidential and free. If you want to pm me please do. I am not a medic I have had problems with constipation, one suggestion was to add hot water to the mix and that worked for me. At present I am stable and having check up at the end of the month.

[JoanaPhy in reply to Hidden]

Thank you Suzuki and sorry for the delay. We've had a rollercoaster with Mum since I made this post, she now has a colostomy. A friend gave us the BCR book, which is excellent. Her diet has improved so much since November, she was so very sick at the time. Also the ARC, yes I have been in touch with them and hope to get Mum to some relaxation sessions when she is fit enough. I hope you are keeping well and thank you for your response. Xx

[Hidden in reply to JoanaPhy]

Glad to hear your Mum is over the worst and coming around, yes relaxation therapies such as reflexology is available from ARC and they are very professional and confidential and caring. I am doing okay thank you, do look after yourself too

[baxbird]

Hi,

I have a partial obstructions in my small bowel . I'm on a liquid dirt. Soup yoghurt custard etc . Liquidised food of a soup consistencey.

I take movicol daily. I have 2 x Fresubin protein drinks a day which gives you all you need in a daily intake. little and often...ie half a mug of soup.

I do have some veg soup but nothing with lumps.

My friend is making me some fruit ice cubes to suck.

All the best to you and your family.

Dawn xx

[JoanaPhy in reply to baxbird]

Hi Dawn, thank you for your reply and sorry for the late response. Great tips. I hope you are managing well atm, best wishes, x

[caf132]

Miralax works pretty good but i made my own Kefir and drank it daily and was able to get off most of my constipation meds. With all the antibiotics we are put on it messes with our flora in our gut. Have her drink a lot of water with lemon in it. Drink drink drink!!!Keep us posted!

Carol

[JoanaPhy in reply to caf132]

Belated thank you Carol, x