I am a 32 yo. I had a ruptured appendix at 13 and then a small bowel obstruction at 27 with no real symptoms between those times.
I was told by the general surgeon that I have a good likelihood of having additional obstruction as it was caused by scar tissue and there was abdominal surgery for both cases. First, is there anything I can do or should have followed to help prevent a future SOB? I get occasional nausia and basically have bile vomit. This is every month to 6 months. I also seem to, i guess, regurgitate some foods, to 3-4 hours after eating.
I am very active, running or gym daily for 1-1 1/2 hours and eat an OK diet. I am a bit over weight if anything so never worried about lack of absorption. I did try to see an internist once about the above concerns but e just told me that my metabolism was slowing down because I was getting older. I left his office frustrated and no answers. I would appreciate any advise or suggestions for further studies/tests.

Answered by: Maria/MDHealthForum.com Team

Small bowel obstruction means that there is a partial or complete blockage in the small intestines, as a result, the normal flow of intestinal contents is prevented. Post operative adhesion is the leading cause of small bowel obstruction, this is attributed to the scar tissue that may form in the abdomen from the surgical procedure. Appendectomy is among the surgeries that are closely linked to the development of this condition. Other causes of small bowel obstruction include: hernias, neoplasms, volvulus- abnormal twisting or the intestine, Crohn’s disease, tumors, foreign bodies and intestinal atresia- congenital closure of the lumen in the small intestine.

Signs and symptoms of SBO include abdominal pain which occurs around the belly button area, pain can be cramping in nature. If the blockage has been present for a while, the pain may decrease because the bowel ceases to contract. If the patient experiences continuous severe pain in one area, it could indicate bowel strangulation, this means that the blockage has cut the blood supply to the bowel. Strangulated bowel obstructions require immediate surgery. Small-bowel obstructions also cause elimination problems, bloating and vomiting. If the obstruction is in the upper small intestine, the vomitus is usually green in color.

Too bad that your visit to that internist didn’t go well. I hope such experience won’t discourage you from consulting other specialists. Perhaps you should try to look for gastroenterologists in your area. It is very important to confirm whether the symptoms that you have been experiencing indicate that you have recurrent small bowel obstruction. In addition to physical examination, imaging procedures such as X-rays of the abdomen, contrast enema, CT scan and ultrasound help doctors diagnose small bowel obstruction.

Vomiting bile may also be caused by peptic ulcer disease. Peptic ulcer may block the pyloric valve, because of this the stomach contents are not emptied out quickly. The stasis of food and liquids will cause increased gastric pressure, consequently leading to reflux of bile and stomach acid into the esophagus. Acid and bile reflux can cause a number of complications including heartburn, gastroesophageal reflux disease (GERD) and gastritis. Additionally, prolonged exposure of the esophagus to bile and stomach acids may lead to Barrett’s esophagus- a serious condition characterized by abnormal change in the tissue lining the lower esophagus. Bile reflux is also linked to the development of esophageal cancer. Diagnostic procedure may be requested depending on your doctor’s assessment. Endoscopy may be requested to find out whether there are ulcerations the stomach or esophagus. There are also tests to diagnose acid reflux, ambulatory acid tests, for example, identify the onset and duration of acid regurgitation into the esophagus.