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My grandmother was admitted about 9-10 days ago with an

My grandmother was admitted...

My grandmother was admitted about 9-10 days ago with an obstruction. She had been vomiting, couldn't eat much, and hadn't had a bowel in a few days. We went to urgent care first then the ER. She as been admitted since. She has been on fluids, been getting heparin shot, and has an ng tube. She has been pumping out all the brown/green liquid. She finally had a bowel on the first but it was small and mucus filled. They started enemas on Wednesday but it only produced a little mucus. We now as of yesterday have 2 options. One getting a feeding tube, two having surgery to remove the blockage and actually 3 which the doctor didnt seem to keen on which is to continue the fats, and electrolytes thru the picc and just watch. My grandmother is 93 no other problems since. She has high blood pressure and past surgeries included lung cancer in the 90s, and a hysterectomy in her 40s. They believe the obstruction is due to scarring but cant actually tell completely. Is there anything else I can do or take her because surgery is not an option nor is the feeding tube because that wont even deal with the obstruction. She is very tired of the ng tube but I want to make the best decision. What are her chances if the surgery goes well given her age? I don't want her to die of infection, or suffer a heart attack. Please help

Doctor's Assistant: Are you keeping a personal medical record while dealing with this?

Yes

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

They have been giving beta blockers for heart fluctuations, for the past 4 days since being in the hospital. She had a few high heart rates, and bps but since has been better

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Answered in 15 minutes by:
3/9/2018
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 37,774
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
Verified

Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Surgery in her age may not be the right option.

She may be suffering with a condition called as paralytic ileus. In this, intestines cease the functions but may restore them in few days.

So expectant treatment with NG tube, IV fluids would be good. An intermittent enema regime may be needed, if she has abdominal pain, bloating and distension..

If she does not have nausea NG tube can be removed and she can be put on only liquid oral diet, which may not be more than 1000 ml per day.

Intravenous hyperalimentation (which means high calories and proteins through drip) may also help her.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Customer reply replied 1 month ago
She has been using the ng tube along with fluids since Tuesday. They removed the tube and did a clamp trial which seemed to go well. Then they gave her sips of drink, coffee, and jello. She unfortunately was unable to keep it down and vomited again the same stuff that is suctioned out via the ng tube. So they gave it one more day and the same occurred and they just most recently put the tube back in yesterday. She is in no pain other than the throat. She is now on a picc and getting fats, and things from that now. My question is what more can be done. Should we continue to wait it out, since I have researched the mortality rate in regards ***** ***** and its not looking good at all. She also does not want the tube through the stomach as a feeding tube for the rest of her life either. She had enemas and they proved unsuccessful as I explained before it only produced mucus. No bowel since the first of march. I read about giving Coca Cola as that would help mimic the stomach acid and help move the bowels along IS There any other options other than the ones he gave?? its been 10 days in the hospital she is growing tired of it all

Unfortunately there is nothing much can be done, additional to it. As a matter of fact there should not be more done, and a wait and watch policy at this point of time would be far better for quality of life.

Coca cola test may be done once, but usually is not helpful.

Enema is only beneicial if there is significant distension of the abdomen.

Paralytic ileus usually does not cause significant bloating / distension.

But the intestinal motility may return back to some extent in due course of time, if not completely.

That may help in nausea and vomiting resolving.

It is privilege assisting you.

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Customer reply replied 1 month ago
Can a patient with the NG tube for a long period of time clear the obstruction if they can have a constant bowel with the help of the ng tube? What I mean is if we keep her on it for the next 4 days and say she produces a bowel. Will the problem be solved?

NG tube keeps the small intestines decompressed and give them time to restore the functions.

So yes, in next 4 days, she may improve.

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Please read about paralytic ileus;

https://www.medicinenet.com/script/main/art.asp?articlekey=7886

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Customer reply replied 1 month ago
if in the off chance she has this paralytic ileus what is the remedy for that? the same ng tube and fluids or something else ?

The treatment is expectant;

1) Nasogastric tube.

2) Intravenous hyperalimentation.

3) Medications like Metoclopramide for intestinal stimulation.

4) Small amount of laxative through NG tube may be considered.

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Customer reply replied 1 month ago
Last question.
Do you think magnesium oxide, acidophilus laxative and simethicone would help the condition if given?
and also for the metoclopramide how long should she be on that

Metoclopramide is usually tried for 3-5 days.

Magnesium oxide, acidophilus laxative and simethicone may help and no harm in employing them.

Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 37,774
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
Verified
Dr. Arun Phophalia and 87 other Medical Specialists are ready to help you
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Customer reply replied 1 month ago
OK thanks very much

You are very welcome.

Wishing a speedy recovery for your grandma.

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