Dealing with Ostomy Blockages (w/ video)

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Blockages and partial blockages are a concern for ostomates, especially ileostomates, but there are several ways to both prevent and treat minor blockages.

In this article, I’ll go over some tips that I’ve found to be helpful in my own experience, but these tips shouldn’t replace the advice of your care provider.

Blockages are no joke, and I’ve been sent to the hospital because of one. If you feel that you might have anything more than a partial blockage, you should visit your local ER just in case.

Video

Causes of Blockages (Also Called a Bowel Obstruction)

Blockages can be caused by a number of reasons, but not all causes are in our control.

Some ostomates, for example, have strictures or motility issues that increase the chance of blockages. These people should work with their doctor to find solutions that help prevent blockages, including surgery.

Pregnancy, especially in the second and third trimesters, is a risk factor for bowel obstructions as well. If you are pregnant, it’s best to work with both a stoma nurse and an obstetrician to make sure that things go smoothly and you can plan what for what happens if any complications arise.

But for the majority of ostomates, blockages have to do with what and how we are eating.

A small group of ostomates may also experience blockages because their appliance is being put on too tight, and this can be especially problematic in the weeks following surgery when the stoma is more swollen than normal.

Preventing blockages

If your blockages are being caused by digestive issues, including structures, then it’s important that you’re following up with your GI or surgeon.  The tips below may or may not help if you’ve got problems that are unrelated to your stoma.

What you eat / How you Eat

I’m willing to bet that the majority of blockages are caused by what, or more importantly, HOW we eat.  This is actually good news since it means that we’re in control most of the time.

Typically, ileostomates are told to avoid certain foods, especially in the weeks following their surgery. I do have a more complete list of these foods HERE, but for the most part, they include:

  • Raw fruits and vegetables.
  • Whole nuts and seeds.
  • Beans and legumes (especially when dried & cooked).
  • Mushrooms.
  • Whole corn kernels
  • Other, similar foods.

I’ll be honest, I’m not the type of person who avoids foods, especially healthy foods, in order to prevent a blockage.  Instead, I make sure that I focus on how I’m eating those foods.

Here are my tips for avoiding food-related blockages:

  • Take your time. Eating should be something to do mindfully, and when you rush, you aren’t giving your body the time to chew, digest and assimilate your meals properly.
  • Chew!! Perhaps the most important thing you can do is to chew your food until it’s nearly liquid!  This is especially important when eating something like mushrooms, which don’t break down in your stomach or gut.
  • Go easy on your portion sizes! I tend to eat a few meals throughout the day, but my meals are often huge.  This can be problematic, even you’re eating mindfully and pacing yourself. Certain foods are easier to digest than others in large quantities, but if you’re able to eat less food at a time, you’ll be doing yourself a favor.
  • Drink with your meals. Drinking before, during and after a meal will help to move things along and prevent your output from becoming too thick and slow.
  • Experiment with new foods slowly. This is crucial in the first month or so after your surgery, and you should try small portions of new foods to see how it affects you before using it in a full meal.
  • Keep a food diary. You may find that certain foods are more problematic than others, so it might be helpful to keep a food diary until you feel comfortable with the food you regularly eat.

Signs of a blockage

If you’re unfortunate enough to have a blockage, there are symptoms that seem to be common among ostomates.

NG Tube
Wait too long and you’ll end up with an NG Tube, like I did! :(

Keep in mind that these may still vary from person to person, but I’ve experienced the following symptoms myself:

  • Decreased or no output over a prolonged period of time.
  • Unexpected liquid output that’s out of the norm.
  • Pain and/or pressure behind my stoma.
  • My stoma will retract.
  • Nausea.
  • Vomiting (this is a very bad sign!! Get to an ER if your blockage has lead to vomiting!).

I find that certain symptoms, like pain and pressure, can come on suddenly, while nausea and vomiting tend to happen much later (like 12+ hours after the blockage started). Again, this may differ from person to person.

Things I Do When I’m Experiencing a Blockage

When I feel that I’m experiencing a partial blockage, I tend to do the following:

  • Drink warm water or tea. This not only helps to flush my digestive system, but I find that warm fluid also help me relax (which is important to do in a situation like this).
  • I apply gentle pressure around my stoma and massage my abdomen. I’ve been told that many blockages are just behind the stoma, so massaging the area may help to loosen things up and get things moving again. You may find that some areas around your stoma are tender, so be gentle!
  • I’ll bend forwards, backward, sideways, and twist;  I may also try to bring my knees to my chest (either while laying down or standing). I find that these movements can also help to push things along.
  • I may remove my appliance to give my stoma more space to open up. If your appliance is too tight around your stoma, it could cause the flow of your output to be slowed down.  This will help when you’re using the massage technique, but I’d suggest hanging a “kitchen catcher” bag off your pant waist so it will catch any output.  You might also find that removing your appliance and massaging while under a warm shower can be quite effective.

Other suggestions

  • Some people like to take a warm bath when they feel a partial blockage coming on. If you do decide to have a bath, keep your appliance on.
  • A heating pad may also work as an alternative to having a warm bath.

Things NOT to do

  • Do not take laxatives. Taking a laxative if you are partially or completely blocked may cause some serious complications. I would also suggest not drinking liquids (like prune juice) if you have a complete blockage.
  • Do not eat until the blockage is resolved. As with laxatives, you don’t want to eat when you’re experiencing a blockage. When was the last time you unclogged a toilet by flushing paper towels down the drain? Same situation here.
  • Do not stick anything into your stoma unless a healthcare provider has given you specific instructions. Some ostomates who experience frequent blockages may be given a Foley catheter along with instructions on how to use it on themselves, but this should not be attempted without the OK from your doctor, surgeon or stoma nurse.
  • Do not ignore pain or vomiting! If you’ve got enough pain that you’re wincing or have vomited, then you should have been at your doctor’s office or ER a half hour ago! Seriously, don’t ignore these signs.
It may help to keep a special card to keep on you when visiting your ER. This card is available from the UOAA and can be downloaded and printed HERE.

Further Reading

You might enjoy some of my past articles detailing my experiences with partial and full blockages.  Please, learn from my mistakes!

Question: Have you experienced a blockage? What helps you?
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dogtalkerer
5 days ago

Sorry vegan, I shoulld have explained in more detail.  the guy was doing more of a colonoscopy prep.   he used milk of magnesia.    as far as function, a better solution to irrigation. but I wonder if its really healthy for a once a week routine? 
I looked into irrigation, not as wonderful as first thought.   it takes time and requires more or less a 2 piece bag and other gear-a long drain bag.   as I recall about 1/2hr to 45minutes a day or every other day.  for me, thats too much time wasted.  apparently its not an easy process for I have read about peoples problems in trying to irrrigate. the stoma caps really are not much smaller than a bag. I first assumed they were only maybe 2inches wide. a little bottle cap thing.
i also wonder if constant irrigation is good for the body? hard to think that the lower section of the large intestine only serves as a holding tank.  with 10inches of mine gone, I seem to drink a lot more water.   
 
 
 

dogtalkerer
12 days ago

stella and LL, from your bio’s, sounds like you both have colostomys. from everything I’ve read, blockages seem to be very rare in colostomys.  after 12yrs, I have never had a problem nor have I changed my eating patterns.  I have found grapefruit seeds in the bag.  a rare kernel of corn.   I eat lots of raw veggies and stuff.  I did once find a rather long piece of grass in the bag, along with the stringy stuff from corn on the cobb.
from your description, I’d say your system is/was working as normal.   if you get flushed out and go to eating light, you are not going to have much output.  what goes up, comes down, and,  what goes in, comes out.   little in, little out.   there is a guy over at UOAA that routinely does a colon flush so he can go several days with no output.   I’ve had what you described happen to me, Taco Bell I think. 
A question for the Ileo’s, have you ever had a blockage with no pain? this seemed to be the important point that was missed?
Vegan, you should try to set up this site with a little icon which indicates if people have an ileo, or colo.  from my experience, they are very different in operation and troubles.

LLNorth
12 days ago
Reply to  dogtalkerer

@dogtalkerer That is a good idea, identifying the type of ostomy one has – I have just put this information (Colostomy 4/30/2018) on my “signature” line on my profile, so it will show below everything I post.
 
ps – I tend to “baby” my stoma, I know!

sjlovestosing
13 days ago

Hi Mimi,
I am so sorry that you went through all of this.
Eating soups that have been cooked a while and soft or pureed foods may help ease you back. I started with broth, then crackers, then soup. I ate lightly for several days and tried not to eat raw veggies until things started to move. It took me about a week before I was back on track. 
Regarding bananas, rice and applesauce, though they are soft, they tend to bind as well. These were the foods that my children’s pediatric nurse told me to give them when they had a bout of diarrhea. I hope this helps. Get well soon.
My prayers are with you,
Stella

ChrisandBagpus
15 days ago

Mimi
To help keep output soft the only thing I know that helps are apple sauce and bananas also others have mentioned marshmallows, I know that the marshmallow plant is soothing as is marigold. So I would drink marigold ( calendula) tea, try linseed finely ground not whole seeds with plenty of liquid and also if you can get proper marshmallow leaf as a tea. these will help to sooth and soften. Question is it scar tissue or is it spasms especially as you had okay output for a while?
I can’t see any reason how any these can make it worse and may calm things down.
LLM
Chris

SqueakyandLiza
15 days ago

I second what LL said about eating peels. Anything that is too much of a hassle to peel, I just don’t eat any more (grapes, blueberries, cherries). But a lot of thing are worth the trouble (apples, peaches, tomatoes, cucumber, etc). 
I’m sure it will take a little time to maybe revise how you can eat certain things, if your doctor cannot help with the scar tissue. 

LLNorth
15 days ago

Mimi, I am so sorry to learn of your ordeal. I wish I had a sure-fire solution for you – I have had to pretty much forego uncooked vegetables, myself, and don’t eat peelings (potato skins, peach skins, grape skins, etc.). Even peppers – red, yellow, or orange – I leave the skin on but cut them very, very small and cook them. This has been adjustment. Please don’t think I am saying “just do this and your problem will be taken care of” – it is only my experience. I have not had a blockage like yours or narrowing caused by scar tissue. I hope that you are feeling better. LL

john68
16 days ago

Hi Mimi, You poor pup. I can’t comment on the scar tissue but for myself if I have been sick and of my food or have had to fast it takes my system a few days to get normal again. Just a thought but medication can disrupt output. For a time maybe try over cooking food like veg or blending vegetables into soup so you still getting vitamins. I hope the discomfort passes soon 👍

SqueakyandLiza
16 days ago

Mimi,
That sounds like a horrible experience. I am so sorry that you had to go through it. It must be frustrating that you had done everything you were supposed to and still had this happen. 
I don’t have firsthand knowledge about blockages, but my opinion would be to keep things as simple as possible to start-maybe smoothies and as you feel more comfortable work you way up to other foods, and focus on chewing things up as much as you can. And see your regular doctor to follow up with what the hospital told you. 
Good Luck Mimi. 

Mimi
16 days ago

Hello fellow ostomates
I am seeking guidance.
I ended up in A&E at the beginning of the week. I had woken up with no output and a swollen stoma. I did not have any pain. I drank loads, massaged by tum, had a warm bath and called the stoma nurse. She said I had done all the right things, and to watch and wait at home for a few more hours.
Mid-morning I decided to go to A&E. I was there for most of the rest of the day, I took off my bag, and my poor stoma was very swollen and only pushing out small rat-poos every 15-30 minutes or so. I had a CT scan and was examined by about 5 different doctors. I was then transferred to hospital where I spent an uncomfortable and worrying night.
In the morning I was seen by a surgeon who carried out an intervention and inserted some enemas . . . it was all very sore and painful. But the stoma started working and I had a good gush of output mid-morning, then nothing again until about 5.00pm. By this time I had not eaten anything for three days. The surgeon said that the blockage was caused by scar tissue narrowing the entrance to the stoma, and that there was nothing I had done to cause the blockage. Which makes me wonder, what can I do to prevent another blockage?
The following day when I was discharged, I was told to eat sloppy food – like ice-cream and soup. I don’t have much of an appetite, still feeling sore and tender from the intervention, and am eating very small amounts of soup and porridge, and consequently there are very small amounts of output. I have asked for more guidance on what I can do, but I thought I would ask here, in case anyone has had a similar experience.
I am having a tough time anyway with the cancer and trying to cope with that. Having a functioning stoma and being able to eat a healthy vegan diet was one positive for me, and I am now feeling really upset with the blockage being caused by scar tissue narrowing the entrance to the stoma. Can the scar tissue soften?
Any thoughts? Or has anyone had a similar experience?
With best wishes and thanks.
 

john68
18 days ago

Hi Stella, you’re symptoms certainly sounds like a blockage, and you have done everything correctly and maybe over it. Also try a warm bath and a good walk can help. Maybe even consider taking off the appliance and letting the stoma move more. Hope you back to normal soon 👍

sjlovestosing
17 days ago
Reply to  john68

@john68
Thank you, John for responding. Things are just beginning to move again. I don’t know if having diarrhea knocked my intestines for a loop and has caused them to take longer to get back on track or what. It’s been an experience. I did do yoga and walked up and down my 600 foot, steep driveway a couple of times. (I also prayed a lot!) :lol: 
God bless!
Stella

SqueakyandLiza
17 days ago
Reply to  sjlovestosing

@sjlovestosing
Stella, I’m glad things are working themself out and you didn’t need to go to the hospital. I haven’t had a blockage but heard they can be pretty painful. 
Also a sort of random question- with the ostomy, how do you know if you have diarrhea?  I’ve had doctors ask me that and always say no because I wasn’t sure. 😂

sjlovestosing
17 days ago
Reply to  SqueakyandLiza

@SqueakyandLiza
Hi Liza,
I guess it’s easier for someone with a colostomy to be able to tell the difference, because our output hasn’t changed much in looks. It may be a little looser, but not much. Also, my bag filled very quickly each time I had an attack. Things are still a little slow in getting back to normal, but the output looks about the same – just less of it. I think I have to get all the beneficial flora back in the old gut, so I’ve been having yogurt smoothies with other nutrients mixed in for good measure. Thanks for your post!
God bless,
Stella

shauna
shauna
9 months ago

I use a very thin closed pouch. it does well. but do I need to give myself an enama to clean myself out?

john68
1 year ago

A whole devoted website to every thing ostomy, it doesn’t get much better than this

LK
1 year ago

Wow, so many newbies or near newbies here. Welcome to you all. I found that Eric has provided so much valuable information here that this is the only place I go and keep coming back to. If you have questions or need to discuss something, you can go to the top of the page  click on “Forum” and “new topics” area to start a forum. Foods can be tricky sometimes and if you keep a food journal for about the first six months you will be able to better identify what works for your guts. Drink plenty of fluids with/between meals to help aide in digestion. If you, like most of us, enjoy a meal with pasta/rice or something similar, try and eat a salad and slightly softer cooked veggies with it to balance the hard/ soft, digestion issues. Fruits like honeydew, cantelope, and watermelon, back up a meal that is likely to thicken things up.  I find on occasion I have to relearn what I can and cannot eat.  John Dickin…On holiday yet, not fun at all. So sorry it had to be a bad experience for you. Heal well and take short walks to help move things along when you can. Stay hydrated.Liz Krohn…Fruit peels and skins can be hard to digest and fall under the insoluble fibers. Be careful with how much of it you eat. Skins around orange segments can have their say to.Awc19…Alice, rest assured that not everyone gets blockages or further tummy troubles. What brought you here after a 9 year stoma? I know that I needed people with a stoma in my life when I found this site. And am so glad I did. Eric always adds new things to educate us.Rachel…how sweet to take care of your grandma the way you do. Tell us a bit about her if you want and how and when she became an ostomate. How is that you get to help along her journey with her stoma? Is anyone else pitching In to help you? Daniel, Rachel and Finbar and anyone new reading this forum…Please do not try the suggestions of rubbing and pushing around your stoma and tummy too soon after surgery.  This can cause other issues with deeper stitches and scar tissue that have not healed yet. I asked my doctor to show me how my guts were laid out inside me after surgery. This can open the door to ask him about trouble shooting blockages and bad gas. Ask when and how, you should go to to ER if you have pain of any kind. A good lot of us have had years of experience and have healed well inside and out so these things can work for us, but you are all still healing and need the time to complete the task. If I feel too full a feeling in my belly and cramping I will lay down and rest, turning from side to side every ten min. or so. This helps to move gas around without the pushing on your tummy too soon after surgery. Certainly if the pain is bad, do not hesitate to make see your doctor, stoma nurse or ER department. Better safe, then sorry right? Down the road when things have healed more manipulating your gut may work for you, but give it at least a year just to be safe and always check with the doctor or stoma nurse. All the best to you all and most of all…be well.  

LizKrohn
1 year ago

Watch out for apple skins. Rather peel!

Awc19
1 year ago

Thanks, Rachel. I use YL products and have Digize which I have used for stomach aches and constipation. I am a newbie here and still gathering helpful tips. This is one I am not looking forward to having to try but will remember it when and if I need it.Alice 

LizKrohn
1 year ago
Reply to  Awc19

We need special facebook or other platforms so us veterans can help newbies AND I learn something new each time. I had a skin problem and it was a newbie that helped me change my whole skin protection method. No more skin problems!!!

Rachel
Rachel
1 year ago

When my grandma has a blockage, I rub some YL Digize oil on her belly. Normally within 2 hours everything starts rushing out.

Daniel Shaw
Daniel Shaw
1 year ago

I really found a lot of this information helpful. However being that I have been dealing with this for a very long time and dealt with most of the stuff that you have discussed. There is 1 things that has worked for me that has not been mentioned being that I’ve had this condition for quite a while I have noticed that you can internally plush as if you are trying to go to the bathroom! If you have a blockage at the same time gently apply pressure and push in around you’re stoma and your blockage might shoot loose. I find it best to do this without a bag in the shower you would be amazed at what will come out I’ve had whole slices of mushrooms yes at that time I did not know not to eat mushrooms. Also my GI gave me the worst advice possible I had choked on a piece of me and after looking at my throat decided that it was Scar from acid reflux. So it was decided to do a surgery on my throat. All that was fine but Mighty I told me not to eat meat which dissolves quite fine in my stomach when I said well what should I eat he told me pasta. Then I G I told me to take antacid every single morning. So following my GI instruction taking my antacid every morning I had a bowl of mac and cheese which dissolved in my stomach and became a complete hard blockage in my intestines swallowing my whole stomach up to the point of me squeezing my intestines and all it was very painful. It’s been a week now I’m mostly cleared out but still have some blockage. I think I’m close to getting it all out but the last thing I want to do is go to the hospital have never had a pleasant experience there. LOL

lynn
lynn
21 days ago
Reply to  VeganOstomy

thanks…I wonder how much is OK to “Push”?

John Dickin
John Dickin
2 years ago

Thanks for your help.Illiostomy 9years. It decided to block now while motohoming in Portugal. Three weeks in Faro General . Two with tube up nose into stomach. Out now thee days in and a few twinges. Decided to recover here in Portugal, as weather is great here compared to U.K. Eating little and often, water only, no salad very week at the moment due to hospitalization. But like a flat battery. but I will get there. Good Luck. John.

Finbarr Griffin
2 years ago

Fantastic article, and really informative. Your information on all aspects of having an ostomy is educating me.
Thank you.

lynn
lynn
22 days ago
Reply to  VeganOstomy

SOOOO useful…saved me trip to the hospital which is not where I need to be for other reasons. I am still very sore but things are “,osing” again. I threw up 1.5 gallons and I am soooooo sore but you advice to move around and someone else suggested to cut flange larger Really helped almost immediately

sjlovestosing
18 days ago
Reply to  VeganOstomy

@VeganOstomy
Hi Eric,
I have a question. Last Sunday, I had my first bout with diarrhea since my operation 2 years ago. I drank like crazy that day. On Monday, I had no movement, which I expected, (and kept up the fluids) but then on Tues. at 3 a.m. in the morning I finally had a normal looking, but small amount of feces- I am guessing about 1/4 of the bag. Anyway, I didn’t have a movement again until Wednesday afternoon, and that came out in little soft pellets. Today, I still am not doing much. This morning, I started to stop eating for the day. Again, I am drinking plenty of fluids – mostly warm herbal teas and water. My stool seems to be coming and is soft, but not in large amounts. I feel no discomfort, have been active all day, and have been massaging the area. Do you think I may have a partial blockage? I called my ostomy nurse, but have not heard from her yet.
Thanks for your response.
Stella

lynn
lynn
21 days ago

I agee totally best way to learn about this ostomy stuff is from one another. There are some doctors who seem to not really know about things like new appliances and advice you can find on forums like there. Amazes me!