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twisted bowel image on photo of man's belly

What Is Twisted Bowel and How Can a Bowel Adhesion Diet Help?

April 9, 2022 //  by Joanna//  8 Comments

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So, it happened again. A day of increasing abdominal pain, nausea, trip to the ER, twisted bowel diagnosis, hospital admission for bowel rest. It is almost with exact regularity that I get these.

The last one was exactly seven months ago to the day. The previous one was between six and seven months earlier. So frustrating!

hospital rotated
My most recent admission

If you’ve been struggling with repeated SBO (small bowel obstruction) aka twisted bowel, you might have tried a bowel adhesion diet already.

I have not, because none of my surgeons ever committed to the answer that my repeated hospital visits are due to what I eat. In fact, this last time, my discharge papers recommend an immediate return to a full-fiber diet.

Still, I might try a different approach for a while and see if it helps or not. Here is what I researched and learned about the bowel adhesion diet.

CONTENTS
  • What Is SBO or Twisted Bowel?
  • What Are the Symptoms Of a Twisted Bowel?
  • How Dangerous Is An Intestinal Obstruction?
  • How Is a Twisted Bowel Treated?
  • Can This Vicious Cycle Be Prevented?
  • What Are Adhesions?
  • Can Anything Be Done to Prevent Twisted Bowel From Adhesions?
  • The Bowel Adhesions Diet
  • The Main Principles Of the Bowel Adhesions Diet
  • Final Thoughts
xray of twisted bowel
Inflammed intestines due to obstruction

What Is SBO or Twisted Bowel?

Small bowel obstruction is a condition that happens often to those who underwent abdominal surgeries in the past.

Intestinal obstruction is a blockage that keeps food or liquid from passing through your small intestine or large intestine.

The Mayo Clinic

Some of the causes of small bowel obstruction include:

  • fibrous bands of scar tissue (adhesions) in the abdomen that form after surgery
  • hernias (also often a result of surgery)
  • strictures from an inflamed intestine (often with Crohn’s disease or diverticulitis)
  • some medications

Small bowel obstruction can be caused by many pathologic processes, but the leading cause in the developed world is intra-abdominal adhesions.

Small bowel obstructions can be partial or complete and can be non-strangulated or strangulated

National Institutes fo Health Publication

In my case, the cause is certainly adhesions.

If you follow my blog, you know that I was diagnosed with colorectal cancer in 2014, underwent chemo and radiation treatments to the pelvic area (which weakened the tissues in that area), and then had two abdominal surgeries.

Part of my treatment was a temporal ileostomy, which was reversed several months later.

At the specific place where my intestine was reconnected after the ileostomy was removed, there is a band of adhesion now, clearly visible on the CT, every time I get my bowel obstruction.

In other words, this is exactly the spot, where stuff gets stuck and won’t budge.

belly ache
Excruciating pain is the best indicator

What Are the Symptoms Of a Twisted Bowel?

When this happens, I experience the following symptoms which increase with time:

  • Sense of fullness in the bowel
  • Bloating that becomes painful with time (it feels like my abdomen is going to explode there seems to be so much trapped gas in there)
  • No bathroom trips for BM or gas (everything is blocked from the point of blockage downward)
  • At first, a dull belly ache, like with indigestion, but then it changes into very painful cramps
  • Nausea and burping
  • Sometimes, vomiting
  • Chills and sweats

How Dangerous Is An Intestinal Obstruction?

I’ve been lucky so far and all my obstructions (too many to count, at least 15) have resolved either on their own at home or after a short stay at the hospital.

No surgical intervention was required.

However, if unrecognized and untreated, a twisted bowel can be a life-threatening condition for two reasons.

Tissue death

If the obstruction cuts off blood supply to a part of the intestine, that part might die and has to be surgically removed.

Infection

If the intestinal wall breaks due to obstruction or as a result of tissue death, the contents of the intestine can leak into the abdominal cavity and cause a life-threatening infection.

1 2
CT scan is the most often used modality to diagnose SBO

How Is a Twisted Bowel Treated?

In my case – since I am such a veteran – I can pretty much recognize the signs of an incoming obstruction pretty fast.

I know that the most important part is to stop any intake of food and drink as soon as possible.

Basically, what has to happen, is that the bowel gets needed rest so that the pressure on the blockage point is relieved and the bowel can untangle itself.

In order to provide that rest, you have to stop putting things into the bowel.

This includes water, just because of the need to stop adding more volume to the already present stuff in the gut when the obstruction happens.

A few times, I managed to ward off a trip to the ER by following these steps:

  • Stop intake of food and drink
  • Rest with a heating pad on the belly
  • Apply castor oil pack to the abdomen

Probably depending on how severe the obstruction is, taking these steps resulted in unblocking within 10-12 hours.

Other times, the pain kept increasing and I was forced to visit the doctor or ER and was admitted every time with a partial bowel obstruction.

You can read about my experiences during the treatment in the hospital here.

It’s not pretty, but still better than going under the knife or having any of these life-threatening possibilities occur like tissue death or infection.

2 2
I am usually out after two or three days of bowel rest in the hospital

Can This Vicious Cycle Be Prevented?

I’m laughing at the term “veteran” but it’s not a laughing matter. I am literally sick of it.

In the last six years since the initial cancer surgery and five years since my reconnection, I’ve been admitted to the hospital at least ten times for SBO.

The nurses recognize me. The doctors wring their hands and feel sorry for me. And I keep asking, what can I do to prevent this from happening?

What Are Adhesions?

So, we know, that my obstructions are caused by adhesions. What are they?

Most simply put, adhesions are fibrous bands of tissue that connect two parts of the body that normally would not be connected. I like to think of them as two-sided tape or Velcro, only there is no way to open them up easily.

An adhesion develops when the body’s repair mechanisms respond to any tissue disturbance, such as surgery, infection, trauma, or radiation, resulting in inflammation.

Although adhesions can occur anywhere, the most common locations are within the abdominal cavity, the pelvis, and the heart.

Adhesions, General and After Surgery

Checks out for me. Surgery, check. Radiation, check. Abdominal cavity, check. No wonder, twisted bowel is my “new normal.”

Turns out that adhesions are really rather common.

According to WebMD, “abdominal adhesions are a common complication of surgery, occurring in up to 93% of people who undergo abdominal or pelvic surgery.”

While most adhesions are painless and won’t be even noticed, those that cause trouble are responsible for over 60% of small bowel obstructions in adults.

Can Anything Be Done to Prevent Twisted Bowel From Adhesions?

Apparently, the only approved method to deal with adhesions is another surgery to remove them.

However, it is almost certain that new adhesions will be formed as a result of adhesion-removing surgery. Crazy, right?

I discussed this option with my surgeon whom I trust with my life (he saved it once after all).

He advises against the surgery. And I agree.

The problem is that the obstructions I get now are partial, there has never been a high danger of tissue necrosis or spillage of the intestine contents.

What if the new adhesions would form in a more dangerous spot and a complete blockage would be more likely?

bowel adhesion diet
Welcome baby food

The Bowel Adhesions Diet

Now, to start with – none of my medical team, not the surgeon, not the GI doctor, or any of the attending doctors during my obstructions said that changing a diet would result in fewer chances of getting an obstruction.

Basically, the thinking goes, you might be adhering to the bowel adhesion diet 99% of the time, and you slip up once or twice and an obstruction could happen.

This is the most annoying thing about the whole situation. It’s a crapshoot whether and when it will happen or not.

Sometimes I get them after eating a soup, other times after eating a handful of nuts. Sometimes it’s mashed potatoes, other times it is corn kernels. So, go figure!

Still, here is what I found out about the dietary approach.

I’m going to give it a try for a while. As long as I can stand it.

fiber foods
Most of these have to be out or modified to not cause trouble

The Main Principles Of the Bowel Adhesions Diet

Because obstruction happens when food cannot pass through the stricture in the bowel, it makes sense that large chunks of undigested food should be avoided.

Chew your food really, really well.

Avoid eating raw food.

Avoid any stringy food (celery, mango, pineapple)

All insoluble fiber should be avoided (stalks of veggies, dried fruit, nuts, seeds).

Skins and seeds of fruits and vegetables are to be avoided.

It’s better to eat more often but in small portions and always chase with copious amounts of liquid.

Whenever possible, food should be pureed or blended.

Basically, baby food for adults. As a foody who loves food experiences, I will not be happy about this.

Here is a link to a comprehensive brochure with allowed foods and foods to be avoided on the bowel adhesions diet.

It is in PDF format and comes from a trusted source (an Australian governmental agency).

It also provides a suggested meal plan which might be useful if you struggle with meal planning.

peeled apple
Always peel your fruits and veggies

Final Thoughts

I’ll be honest. I will not be happy about eating this type of diet. I’m in my early 50s, and I do not want to eat baby or geriatric food before my time.

Food means more to me than nutrition. Food is also company and fun. I love to experience different flavors and textures of food also while traveling. I find joy in learning about different cultures through their food practices.

But I also do not want to find myself with a twisted bowel searching for an ER somewhere overseas during my summer vacation in Europe and go through what I just went through again.

So, I might as well just jump in and try this diet and see where it takes me.

I’ll keep you posted.

What Is Twisted Bowel and How Can a Bowel Adhesion Diet Help?What Is Twisted Bowel and How Can a Bowel Adhesion Diet Help?What Is Twisted Bowel and How Can a Bowel Adhesion Diet Help?

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Comments

  1. Lisa

    April 13, 2022 at 11:50 am

    I’m so sorry this keeps happening to you. Thank you for sharing your knowledge about SBO and offering ideas about preventing an obstructed bowel. I hope you find a diet that is helpful.

    Reply
    • Joanna

      April 13, 2022 at 8:47 pm

      Thank you Lisa! Hope springs eternal. At least it’s worth a try.

      Reply
  2. Mike

    April 13, 2022 at 4:21 pm

    Twisted bowel doesn’t sound like fun at all. I hope the diet works for you.

    Reply
    • Joanna

      April 13, 2022 at 8:47 pm

      Thank you! I hope so too.

      Reply
  3. Hadassah Treu

    April 14, 2022 at 4:41 am

    I am so sorry that you struggle with SBO! But it is great that you wrote this article to help others who struggle with a twisted bowel. I hope the diet will work and alleviate the symptoms.

    Reply
    • Joanna

      April 16, 2022 at 8:51 pm

      Thank you so much! It is really frustrating, but if that is the price I am to pay for being alive after cancer, I take it.

      Reply
  4. Caroline

    July 10, 2022 at 5:35 pm

    Thank you for all of your thoughts and experiences. I had surgery in 2020 to remove a tumor. The tumor was discovered after 5 visits to the ER for SBO. Since the surgery, I’ve been okay (and I underwent chemo too). However, this last month I have been experiencing the symptoms of an SBO and was admitted to the ER again. The paramedic who came to get me even said “hey, I think I took you to the hospital before”…yes, he did. I will give the Bowel Adhesion Diet a look through and check back here to see how you are doing. I hope it works!

    Reply
    • Joanna

      July 30, 2022 at 4:42 pm

      Thank you for sharing your journey. And please forgive my tardy reply, I’ve been traveling to Europe to visit my family and was off the blog for a few weeks. Wow, it took them five SBO occurrences to notice the tumor? I wonder if it is more difficult to notice tumors when the organ is so inflamed.Because they did take CT-scans every time, right? Sorry to hear you had another one again. Give the diet a try and let’s hope it will work for you. I had another one two months after the post was published, and am in fact scheduled for a surgery in a few days to remove adhesions from my bowel. My surgeon decided that with such high numbers of SBO instances it makes sense to the surgical route a try. No guarantees but I am willing to give it a shot.

      Reply

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About Joanna

Joanna is a committed researcher and educator, passionate about health and wellness for herself - a cancer thriver - and her family. She is an avid clean cook and baker, a gardener, and an inquisitive formulator of gentle and effective organic skincare products. When not blogging, Joanna teaches college in the field of German Studies. She lives with her family in Los Angeles, California.

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JOANNA 🌺 | Blogger
Traveling abroad is so much fun. New cultures, cui Traveling abroad is so much fun. New cultures, cuisines, people you encounter, architecture and history you discover. But did you know that traveling the world is also good for you? The benefits go well beyond de-stressing. 

Read my new blog, link in the bio ⬆️✈️🧳

#travelthroughtheworld #healthylifehappylife #beyou❤️ #midlifewoman #enjoyeurope #worldatmyfeet #amalficoastitaly #beautyofnature🍃 #travelitalia #healthyyou #timeforselfcare  #healthylivinginsideandout #healthandwellnessjourney #healthychanges #healthcoachlife #midlifeconfidence #midlifematters #midlifewisdom #midlifewellness #midlifeadventures
Only now when I’m going through my photos I real Only now when I’m going through my photos I realize how much beauty I’ve got to immerse myself in these past few weeks. From the ancient ruins through the masterpieces of the Florentine renaissance to the unsurpassed baroque sculptures in Rome. Here is a little sampling in a photo dump. 

#artlover🎨 #travelinspirations #romanholiday #europeanvacation #traveleducation #arteducationmatters  #seizethemoment #photodump📸 #italyvacation
What can I say, I love me some wine. 🍷 Who’s What can I say, I love me some wine. 🍷 Who’s with me in this? (Content intended for 21+ peeps) Wine, to me, is the best alcoholic beverage as it can really help bring out the flavors of a meal. Or, it is perfect on its own in so many occasions. Recently, during my vacation, I got to try many wines in Italy and Spain but when at home in California, I’m mostly reaching for Californian wines. 

I have been gifted a few of iconic wines from Gary Farrell Vineyard and Wineries and let me tell you, their wines are really worth trying! 

Take this 2018 Chardonnay. It is bright and fresh, bursting with white flowers and apricot aromas, not too oaky or too tiny, just perfectly balanced and expressive of the terroir of the southwestern foothills of the Sonoma Valley. No wonder it received a whooping 95 points from the Wine Enthusiast! Additionally, @garyfarrellwinery is committed to sustainable business and sustainable farming methodologies and committed to diversity and inclusion efforts. Great tasting wine while supporting good causes? Count me in. 

Double tap if you’re a #winelover like me. Which ones are your favorite varieties? Let me know in the comments 🍷🍾

#russianrivervalley #garyfarrellwinery @apexdropofficial #chardonnayday #invinoveritas #californiawine #californiawinery #homeisbest #cozydinner #whitewinelover
This really resonated with me today. During my thr This really resonated with me today. During my three-week-long sojourn in Europe, I forgot all notions of watchful and time-restricted eating, and just enjoyed everything that caught my eye: fatty cheeses, meats, real butter, sumptuous deserts, copious amounts of local wines and spirits if desired. Chances are that most of what I ate was healthy anyways because this is what kind of food I am generally drawn to, and secondly because food is much better regulated over there and the chance of getting junk in the disguise of food is distinctly smaller than back home. 

Balanced with socializing, walking miles on end, dancing, and swimming, I still got home a few pounds lighter. Not only on the scale but also in spirit. No stress, less baggage, relaxed, at peace.

Happy weekend everyone! 😚 

#ballance #healthylivinginsideandout #healthandwellnessjourney #healthychanges #healthcoachlife #betterhealth #midlifewisdom #midlifewellness #midlifetribe #midlifewomenrock #midlifemagic #midlifemotivation #lifestylechoice #yourhealthisyourwealth #behealthybehappy #healthyaging
Life is so good right now. I’m surrounded by lov Life is so good right now. I’m surrounded by love, the beauty of nature, and art. Learning about new cultures, meeting people who live half the world away, trying new cuisines. The only missing part is our kids. Just a few more days…
#summerineurope #lifeisgood❤️ #rockingmidlife #midlifewomen #happyandblessed #barcelonaspain #joanmiro
So much fun! Picking organic cherries with my dad So much fun! Picking organic cherries with my dad in my hometown. Five in the bucket, two in my belly. Yum! 

#eatplantbased #cherryseason #inpoland #summervacation2022 #fruitarian
This motto: carpe diem. Living by it every single This motto: carpe diem. Living by it every single day @amalficoast_italy 🍋❤️🇮🇹 #carpediem_italy #liveyourbestlife♥️ #happinessismade #behappy😊 #livingthebestlife
Beauty is in the eye of the beholder. Sometimes. O Beauty is in the eye of the beholder. Sometimes. Other times it is just there. Look at this amazing sculpture by Bernini, The Rape of Persephone. So amazing! Check out the way he manages to show the figures in motion, how he makes the stone come alive. Is this still marble or is it flesh come alive? Just wanted to share. #bernini #villaborghese #baroqueart #beautyofart #romeitaly
It’s time for my summer break. I’ll be enjoyin It’s time for my summer break. I’ll be enjoying la dolce vita in Rome for a while, then sailing the Mediterranean, visiting my family in Poland and finally digging into Gaudi’s and Miro’s art in Barcelona. I might be posting sporadically but mostly I will enjoy the time away from screens of any kind. 
Enjoy the video with the sounds from a random church in Rome. I’m hearing it all the time while walking. Wonderfully meditative!
Have a great July and see you here back in August 😘❤️🇮🇹🇬🇷🇵🇱🇪🇸
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