Eating, riding, and preventing a small-bowel obstruction
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Eating, riding, and preventing a small-bowel obstruction
My husband is prone to small-bowel obstructions due to undigested (mostly, fiberous) food blocked by an adhesion (scar tissue) in his small intestine following hernia-repair surgery a few years ago. After 3 hospitalizations (including 1 surgery to repair a complete blockage), we're desperately looking for ways to prevent this from happening again. Doctors say low fiber and plenty of liquids, but how does one get a healthy does of fruits and vegetables in a low-fiber diet?!? and white flour/pasta/rice is not our way of eating as it can plug up the pipes in other ways. It seems that eating a pre-ride meal too close to a ride, without letting the meal digest, is probably one of the worst things he can do, so he has curtailed his morning group rides and long rides that include a mid-ride meal. This is very discouraging to us as riding with the group has become a major part of our life.
Does anyone have any suggestions (no horror stories, please!) to prevent this from happening again, and ideas to enable him to return to riding if at all possible?
Does anyone have any suggestions (no horror stories, please!) to prevent this from happening again, and ideas to enable him to return to riding if at all possible?
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There are yoga poses that aid digestion. My body tends to get thrown off when I travel and if I do yoga it has helped to get things back on track.
https://www.care2.com/greenliving/1-y...digestion.html
https://www.care2.com/greenliving/1-y...digestion.html
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Yup. Before and during rides, I use only liquid food. Ensure works, for example. I choose to go cheap and mix my own: 7 parts maltodextrin to 1 part flavored whey protein. I buy the malto in 50# bags from a homebrew supplier, the whey is Optimum Gold, which comes in 10# bags. 1 pt. of mixed powder in a water bottle will last a rider 3 hours.
After the ride, add more whey and some brown sugar to make a decent recovery beverage, or use chocolate milk or 1 pt. of regular milk with 5 T of sugar in it.
Otherwise smoothies, both fruit and vegetable work well. I had a dear friend who had adhesions after surgery. Though she didn't ride, this is about what she did. Kale smoothies, even. There are whole smoothie cookbooks. During the day, she'd use a sports drink for a few extra calories and hydration.
Edit: To use the Ensure, drink 1 - 1.5 for breakfast. Then put 1-2 bottles in a water bottle, depending on ride length, and fill the rest with water. Plain water in the other bottle.
There are surgeons who specialize in the laproscopic repair of adhesions. You might get an opinion from a specialist in this kind of thing.
After the ride, add more whey and some brown sugar to make a decent recovery beverage, or use chocolate milk or 1 pt. of regular milk with 5 T of sugar in it.
Otherwise smoothies, both fruit and vegetable work well. I had a dear friend who had adhesions after surgery. Though she didn't ride, this is about what she did. Kale smoothies, even. There are whole smoothie cookbooks. During the day, she'd use a sports drink for a few extra calories and hydration.
Edit: To use the Ensure, drink 1 - 1.5 for breakfast. Then put 1-2 bottles in a water bottle, depending on ride length, and fill the rest with water. Plain water in the other bottle.
There are surgeons who specialize in the laproscopic repair of adhesions. You might get an opinion from a specialist in this kind of thing.
Last edited by Carbonfiberboy; 10-24-13 at 02:13 PM.
#4
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I second the liquid food. The challenge is to find something that does well for this. I use AdvoCare's Meal Replacement Shakes. They are tremendous. I can get you information on them if you want. I use them on all of my long rides as mid-ride food (not on-bike snacks) as well as "start the day" food.
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I sympathize. I've had 2 SB obstructions, in 2005 and 2012, that required emergency surgery and weeks in the hospital. In 2012 I was off the bike for 2 months because of complications following surgery.
None of the doctors ever gave me any specific dietary advice, which is kind of weird now that I think of it. They just said I would be prone to it now because of all the adhesions from these and other prior surgeries.
I'd probably be terrible at following their advice anyway. I haven't really changed how I eat when I'm riding. It's how I eat when I'm NOT riding that is most likely the problem.
None of the doctors ever gave me any specific dietary advice, which is kind of weird now that I think of it. They just said I would be prone to it now because of all the adhesions from these and other prior surgeries.
I'd probably be terrible at following their advice anyway. I haven't really changed how I eat when I'm riding. It's how I eat when I'm NOT riding that is most likely the problem.
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Thank you all so much.
It seems that smoothies and liquid drinks are the way to go, but I believe we need to be careful with ingredients. After the first hospitalization he suggested I pick up some Ensure, but was turned off by many of the ingredients and decided it would be healthier to make them at home. We bought a NutriBullet and have used it every day since, blending yogurt with fruit and fresh greens for a tasty drink. But he doesn't want to eat smoothies all day long, and it's not practical when we are guests at someone's house, so we need to learn what whole foods he can and can't eat.
A smoothie or liquid cereal such as Cream of Wheat seems like a good option before a ride, followed by a smoothie after the ride.
Carbonfiberboy: Was your friend successful with preventing further obstructions with her diet? Haven't heard of laproscopic repair of adhesions, but we understand that anything that touches or irritates the intestinal wall can create a new adhesion, so even a repair of an adhesion can cause a new one. Imagine the horror if removing an embedded splinter in an infected finger created more splinters in its place!
JimF22003: Have you found anything that helps better than others? Doctors are trained to fix us through surgery and drugs, not by preventing something that would send us to their office to earn them more money.
We do know that every time this happened, he ate large servings of foods high in insoluble fiber in successive meals.
It seems that smoothies and liquid drinks are the way to go, but I believe we need to be careful with ingredients. After the first hospitalization he suggested I pick up some Ensure, but was turned off by many of the ingredients and decided it would be healthier to make them at home. We bought a NutriBullet and have used it every day since, blending yogurt with fruit and fresh greens for a tasty drink. But he doesn't want to eat smoothies all day long, and it's not practical when we are guests at someone's house, so we need to learn what whole foods he can and can't eat.
A smoothie or liquid cereal such as Cream of Wheat seems like a good option before a ride, followed by a smoothie after the ride.
Carbonfiberboy: Was your friend successful with preventing further obstructions with her diet? Haven't heard of laproscopic repair of adhesions, but we understand that anything that touches or irritates the intestinal wall can create a new adhesion, so even a repair of an adhesion can cause a new one. Imagine the horror if removing an embedded splinter in an infected finger created more splinters in its place!
JimF22003: Have you found anything that helps better than others? Doctors are trained to fix us through surgery and drugs, not by preventing something that would send us to their office to earn them more money.
We do know that every time this happened, he ate large servings of foods high in insoluble fiber in successive meals.
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Your husband has a medical condition and you need to seek the counsel of a sports oriented physician working with a dietitian/nutritionist, not the opinions of an internet forum on bicycling. There are many intelligent, very knowledgable people here but I don't think any of them are qualified to prescribe treatment for a serious medical condition, patient unseen, based on a one-paragraph synopsis of his medical problems. Any advice given here, no matter how well meaning, should be run past your physician.
Not all doctors treat only with surgery and drugs. My physician, a general practice MD, was a huge help in getting me off several medications through fitness and nutrition goals.
Not all doctors treat only with surgery and drugs. My physician, a general practice MD, was a huge help in getting me off several medications through fitness and nutrition goals.
Last edited by Myosmith; 10-25-13 at 12:37 PM.
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Your husband has a medical condition and you need to seek the counsel of a sports oriented physician working with a dietitian/nutritionist, not the opinions of an internet forum on bicycling. There are many intelligent, very knowledgable people here but I don't think any of them are qualified to prescribe treatment for a serious medical condition, patient unseen, based on a one-paragraph synopsis of his medical problems. Any advice given here, no matter how well meaning, should be run past your physician.
Not all doctors treat only with surgery and drugs. My physician, a general practice MD, was a huge help in getting me off several medications through fitness and nutrition goals.
Not all doctors treat only with surgery and drugs. My physician, a general practice MD, was a huge help in getting me off several medications through fitness and nutrition goals.
Ulitmately, it is up to each and every patient to learn all that they can and make the wisest and best decisions possible. Seeking second opinions and outside help does not replace what the doctor says -- but it can be a valuable supplement to it.
And, a GOOD doctor welcomes patients being open and honest and bringing their own ideas and opinions to the table to discuss them.
... As soon as I see a doctor saying "My way or the highway", I find another doctor. But that does not mean that I do not value his opinion and follow his advice. It is not only possible to do both -- it is the smart thing to do...
But, at the same time, most doctors do not like being told their business -- there is a fine line. But ultimately it is what is in the patient's best interests that matters -- not the doctor's feelings. GOOD doctors know that.
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True -- but the doctor is not in charge of your health. He is a consultant that knows a lot but not everything.
Ulitmately, it is up to each and every patient to learn all that they can and make the wisest and best decisions possible. Seeking second opinions and outside help does not replace what the doctor says -- but it can be a valuable supplement to it.
And, a GOOD doctor welcomes patients being open and honest and bringing their own ideas and opinions to the table to discuss them.
... As soon as I see a doctor saying "My way or the highway", I find another doctor. But that does not mean that I do not value his opinion and follow his advice. It is not only possible to do both -- it is the smart thing to do...
But, at the same time, most doctors do not like being told their business -- there is a fine line. But ultimately it is what is in the patient's best interests that matters -- not the doctor's feelings. GOOD doctors know that.
Ulitmately, it is up to each and every patient to learn all that they can and make the wisest and best decisions possible. Seeking second opinions and outside help does not replace what the doctor says -- but it can be a valuable supplement to it.
And, a GOOD doctor welcomes patients being open and honest and bringing their own ideas and opinions to the table to discuss them.
... As soon as I see a doctor saying "My way or the highway", I find another doctor. But that does not mean that I do not value his opinion and follow his advice. It is not only possible to do both -- it is the smart thing to do...
But, at the same time, most doctors do not like being told their business -- there is a fine line. But ultimately it is what is in the patient's best interests that matters -- not the doctor's feelings. GOOD doctors know that.
Some great online resources:
Mayo Clinic
Johns Hopkins
The American Dietetic Association
The American College of Sports Medicine
The American Medical Society for Sports Medicine
The International Organization of Sports Medicine
Food and Nutrition Board - Institute of Medicine
Journal of the International Society of Sports Nutrition
USDA Food and Nutrition Information Center
Not knocking anyone here who offers suggestions, just pointing out that even if we were medical experts, we don't have adequate knowledge of the OP's spouses condition. This is more serious than asking what energy bar is best or what sports drink causes the least stomach upset. The patient has already been hospitalized three times and had surgery once, he needs to seek the counsel of qualified professionals and recognized medical organizations.
To the OP: I hope your husband finds a solution and is able to once again enjoy the sport of cycling. Best wishes
Last edited by Myosmith; 10-25-13 at 06:07 PM.
#10
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Maybe a little often is the right way to go. It's the "proper" way to refuel on rides, anyway.
Ensure has been a reliable go-to food source for randonneurs and their ilk for ages. There is nothing wrong with it, but a lot right if you need an easily digested, high-nutrient, reasonable-tasting fuel.
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And, by the way, I agree with the above... I strongly agree.
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Smaller meals- very well chewed.
Plenty of fluid-
Don't avoid fiber-just make the servings small-
I would bias it toward water soluble fibers-fruits etc- av
Might be smart to avoid hours long rides-perhaps 1-1.5 hrs might be smart.
Low fiber-all fiber-sounds "off" since fiber tends to speed up intestinal transit.Perhaps they meant insoluble -All Bran corn etc
More smaller meals-bias toward soluble fiber-lots of fluids- keep ride duration in the 1-1.5 hr range.
It is true that digestion in general is a bit slower when exercising-so duration of exercise might be important.
MDs don't have good studies on this sort of thing-adhesions-obstructions-diets to prevent-role of exercise in etc.
His history-happened after BIG meals high in fiber(what sort of fiber) is what you need to run with.
He could certainly drink OJ pre ride- coffee milk sugar cream- get in 300 calories or so.
Do be careful with ride duration-dehydration etc
Luck
Charlie
PS- Sometimes a dietician will have a better feel than MDs but doubt they have hard numbers either-but worth asking around consulting-perhaps one who deals with athletic oldsters - post surgical adhesions and the obstructions they produce-common problem
Plenty of fluid-
Don't avoid fiber-just make the servings small-
I would bias it toward water soluble fibers-fruits etc- av
Might be smart to avoid hours long rides-perhaps 1-1.5 hrs might be smart.
Low fiber-all fiber-sounds "off" since fiber tends to speed up intestinal transit.Perhaps they meant insoluble -All Bran corn etc
More smaller meals-bias toward soluble fiber-lots of fluids- keep ride duration in the 1-1.5 hr range.
It is true that digestion in general is a bit slower when exercising-so duration of exercise might be important.
MDs don't have good studies on this sort of thing-adhesions-obstructions-diets to prevent-role of exercise in etc.
His history-happened after BIG meals high in fiber(what sort of fiber) is what you need to run with.
He could certainly drink OJ pre ride- coffee milk sugar cream- get in 300 calories or so.
Do be careful with ride duration-dehydration etc
Luck
Charlie
PS- Sometimes a dietician will have a better feel than MDs but doubt they have hard numbers either-but worth asking around consulting-perhaps one who deals with athletic oldsters - post surgical adhesions and the obstructions they produce-common problem
Last edited by phoebeisis; 10-25-13 at 07:22 PM.
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JimF22003: Have you found anything that helps better than others? Doctors are trained to fix us through surgery and drugs, not by preventing something that would send us to their office to earn them more money.
We do know that every time this happened, he ate large servings of foods high in insoluble fiber in successive meals.
We do know that every time this happened, he ate large servings of foods high in insoluble fiber in successive meals.
But as for eating on bike rides, I don't really have any problem with that. I try to stick with bananas, apples, sometimes energy bars. Towards the end of a ride when I need something, but I just can't stand the thought of solid food, I'll usually finish up with GU's or something like that.
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There are people that believe fiber is damaging to the body and should be avoided. Typically, they eat a nearly zero carb diet consisting entirely of animal products.
Here's a web site (there is also a related facebook page):
https://zeroinginonhealth.com/
I guess another alternative is to juice all your fruits and vegetables.
Here's a web site (there is also a related facebook page):
https://zeroinginonhealth.com/
I guess another alternative is to juice all your fruits and vegetables.
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Thank you all so much.
Of course he is under the care of a physician (his surgeon) who has referred him to a GI specialist and we will also see a Registered Dietitian for further guidance. I asked here only because doctors don't have ALL the answers, and I've found good information from other folks who did their own extensive research as I am doing now and found answers that worked for them. And, of course, what works for one may not work for us, but sensible measures (many of which are shared above) are a good place to start, in addition to following the advice of his doctor.
Of course he is under the care of a physician (his surgeon) who has referred him to a GI specialist and we will also see a Registered Dietitian for further guidance. I asked here only because doctors don't have ALL the answers, and I've found good information from other folks who did their own extensive research as I am doing now and found answers that worked for them. And, of course, what works for one may not work for us, but sensible measures (many of which are shared above) are a good place to start, in addition to following the advice of his doctor.
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