How Will My Lifestyle Change with Small Bowel Obstructions?

We understand that many new patients experience very uncomfortable symptoms in the time that passes between the first phone call and the initial treatment with Clear Passage® Physical Therapy. Below, we will share suggestions from various sources that our bowel obstruction patients have found beneficial. These resources are intended to:

• Help prospective patients avoid exacerbating problems.
• Temporarily manage bowel obstruction symptoms at home.
• Help you avoid future bowel obstructions.

Proper nutrition, exercise, and self-treatment can play an important role in overall health and function during an obstruction and after treatment. 

You Can Choose Some Natural Tools

Various physical therapy tools can aid in self-care to avoid recurring bowel obstructions caused by adhesions (internal scarring); however, using the wrong tools or improperly using tools can result in injury or even death. Clear Passage® will only recommend self-treatment tools after a complete review of your medical history and a thorough physical evaluation.

Because adhesions in one area can spread to other body areas, Clear Passage® requires prospective patients to provide the full lifetime history of their body’s healing events. 

For example, if you fell onto your bottom at age ten or had knee surgery at age fifteen, you’ll need to let us know. Those events may or may not be related to your present condition and goals – but we need to know about them. This will help us “connect the dots” to help determine the cause of your current complaint(s) and how best to unravel them. 

Vitamins, Herbal Supplements, and Probiotics

Many online resources recommend probiotics, vitamins, herbal supplements, and special diets for bowel obstruction. You can use these trustworthy resources to research various products on the market.

• Visit our Vitamin Intake page for the recommended daily intake ranges for the most common vitamin and mineral supplements. These values are established by the U.S. government, based upon scientific data and disseminated by both the NIH and USDA.
• The National Institutes of Health provides scientifically analyzed information about herbal supplements, their efficacy for various conditions, and associated cautions and interactions. 

We do not recommend one probiotic brand over another when it comes to probiotics. However, we feel that probiotics should contain a minimum of 10 bacterial species and 10 million CFU per dose. Consider a probiotic that does not have fungus or yeast species, including Candida and Saccharomyces. 

Nutritional Guide

People with bowel obstructions and other digestive disorders do not have the luxury of eating just any foods. It can be tricky to figure out which foods to eat or avoid when one’s digestive system functions differently from one day to the next. In addition, some people can tolerate certain foods that others cannot.

Clear Passage® Physical Therapy has taken the guesswork out of eating by creating a free, downloadable Digestive Health Guide that provides a comprehensive summary of health and nutrition guidelines for people who experience recurring bowel obstructions. It can assist with diet as well as lifestyle choices. As with any diet, please consult your doctor and/or dietician before starting a new diet.

The following is a synopsis of the information you will find in the Digestive Health Guide.

General Guidelines

When preventing obstructions, consider that you want to avoid creating a cork that stops food from passing through the bowel. If your symptoms are mild, a low-fiber diet (aka a restricted-fiber or low-residue diet) may be appropriate. Severe cases may need to stay on a low-fiber diet for an extended period. 

Check with your doctor about the duration of your diet and whether you should take a multivitamin supplement. People with severe symptoms may be able to switch to a minimal fiber or even a liquid diet. You can slowly adjust your diet from day to day according to your condition and symptoms. As your symptoms improve, bring a greater variety of foods back into your diet one at a time and in small amounts. This will help you to identify any foods that you cannot tolerate.

Here are some quick tips:

• Eat several small meals a day instead of three large meals. 
• Drink plenty of fluids. Health professionals suggest drinking up to 64 ounces of water per day.
• Eat as many different low-fiber foods as you can so that your body gets sufficient nutrients. 
• Eat only as much as you are comfortable consuming.
• Limit fatty and greasy foods.
• Chew all solid foods well; relax and enjoy what you eat.
• Keep a food journal.
  • Write down which foods may make you nauseous, bloated, or give you cramps. 
  • Discontinue any foods that make your symptoms worse.
• Forego gas-forming foods such as:
  • Gassy vegetables (e.g., beans, broccoli, cauliflower)
  • Carbonated drinks
  • Chewing gum.

Low-Fiber Diet Essentials

To avoid stopping up your bowel:

1. Peel skins and remove seeds from vegetables and fruit. 
2. In general, you will want to reduce the amount of fiber you ingest.
3. Do not eat dried foods or raw vegetables. 
4. Cook vegetables to reduce the amount of gas they produce during digestion. 
5. Meat, dairy and eggs do not have fiber and are good protein sources.
   1. However, skip lactose-containing drinks if you have problems with milk products. 

What can you eat if you have a small bowel obstruction? (Remember, no skins or seeds!)

People with mild or only rare symptoms are generally OK with foods from this list:

• Vegetables that are canned or well-cooked and soft
• Applesauce, apricots (very ripe), bananas, cantaloupe, grapefruit, honeydew, mangos, nectarines, papayas, pears, peaches, plums, and watermelon 
• Canned apricots, mandarin oranges, peaches, and pears
• Baked goods made from refined flours (white flour) such as bagels, biscuits, bread, buns, crackers, croissants, muffins, pancakes, rolls, and waffles
• Low-fiber, cooked and prepared cereals, such as Cheerios®, Corn Flakes®, Cream of Wheat®, Oatmeal, Plain Puffs®, Rice Krispies®, and Special K®
• Grains and Pasta (fresh or dried), such as amaranth, barley, couscous, fettuccine, macaroni, millet, quinoa, spaghetti, and white rice
• Cooked, tender, soft lean beef, lamb, fish, shellfish, and poultry
• Eggs
• Hummus (well pureed)
• Peanut butter and other smooth nut butters
• Smooth tofu
• Fats, coconut or olive oils, butter, mayonnaise, sesame butter (tahini), and vinegar 
• Smooth/seedless dressings, sauces, jelly, syrup, and condiments
• Mild herbs and spices
• Almond milk, coconut milk, and rice milk
• Cheese (hard)
• Fruit popsicles (made with recommended ingredients)
• Puddings made with coconut milk, homemade yogurt, or goat yogurt
• Angel food cake
• Hard candy
• Flavored gelatin

What should you avoid eating?

• Bamboo shoots, bean sprouts, bok choy, broccoli, Brussel sprouts, cabbage, cauliflower, celery, coleslaw, corn, lettuce, lima beans, okra, onions, peas, peppers, sauerkraut, swiss chard, and tomatoes
• Coarse whole-grain breads that contain fruit, nuts, or seeds, such as barley, bran, and breads, as well as cereals made with whole grain, cornmeal, cracked wheat, and pumpernickel flour
• Breads, cereals, and muffins containing dried fruit, granola mix, nuts, and seeds
• Brown or wild rice
• Whole wheat pastas
• Popcorn
• Meats that are chewy or contain gristle
• Beans: kidney, lima, and navy
• Peas: chickpeas, lentils, and split peas
• Processed meats with casings or skins like bologna, hot dogs, salami, and sausage
• Nuts
• Seeds
• Chunky peanut butter or other chunky nut butters
• Very spicy foods and dressings
• Chunky pickles and relishes, chutney, hot peppers/sauce, and marmalade with peel
• Olives and pickles
• Chocolate with fruit or nuts
• Cheese with seeds
• Yogurt mixed with fruits that have seeds, tough skins or membranes (blueberry, cherry, raspberry, strawberry)
• Yogurt mixed with granola
• Milkshakes made with berries

Minimal Fiber or Soft Diet Essentials

A minimal-fiber or soft diet requires limiting more foods than a low-fiber diet. This diet may be required if your symptoms occur more frequently or worsen while on the low-fiber diet. If you continue to have abdominal or stomach pain and intestinal cramping with this diet, you may need to work with your health care team to lower your residue intake. They may suggest a liquid diet. If you find that your symptoms improve, you can gradually begin switching back to a low-fiber diet.

What can you eat?

• White flour breads
• Plain noodles
• White potato (no skin)
• White rice
• Cream of rice
• Grits
• Strained oatmeal
• Quinoa
• Cooked, tender, soft lean beef and lamb, fish and shellfish, and poultry (no skins)
• Eggs (poached or soft scrambled)
• Angel food cake
• Hard candy
• Flavored gelatin
• Jelly
• Popsicles
• Syrup

What can you drink?

• Almond milk, coconut milk, and rice milk
• Bouillon
• Black coffee
• Clear broth
• Fruit-flavored drinks
• Strained fruit juice
• Tea
• Tomato juice
• Vegetable juice

What should you avoid eating?

• ALL raw fruits and vegetables (some juices are allowed)
• Dairy (although dairy does not contain fiber, it adds bulk to stool)

Liquid Diet Essentials

Suppose your symptoms are severe, such as occasional vomiting after eating solid foods. In that case, you will need to avoid all solid food and maintain a strict liquid diet until your symptoms improve. Fluids are essential for keeping your skin, eyes, and mouth lining moist. An all-liquid diet has little to no residue and can be a poor source of nutrients. Consult your doctor about finding the right nutritional supplements. 

What can you drink?

• Fruit juices
• Fruit flavored drinks
• Jell-O®
• Popsicles (Fruit)
• Clear broth/ soups
• Bouillon/consomme
• Coffee/herbal tea
• Almond, coconut or rice milk
• Homemade plain yogurt or flavored goat yogurt
• Ovaltine®
• Eggnog
• Fruit nectars
• V-8® juice, tomato juice
• Ensure® or other protein-rich liquid supplement drinks

What should you avoid?

• Avoid all solid foods when on a liquid diet
• Juices that do not say “100% juice” or contain added sugar
• Carbonated fruit drinks (they may be tolerated better after they go flat)

Download and print our Digestive Health Guide to keep in your kitchen to have a comprehensive summary of health and nutrition guidelines for people with digestive disorders, including sample recipes and menus.

Stool Softeners

Stool softeners can be taken in the form of a capsule, tablet, liquid or syrup. Take stool softeners precisely as directed, following the directions on the package or your prescription label. Contact your doctor immediately if you develop a skin rash (hives), difficulty breathing or swallowing, fever, vomiting or stomach pain. Do not take stool softeners that contain a stimulant.

There are also natural ways to soften stools. Increasing fat intake will increase colon motility. Probiotics will increase the good bacteria in your digestive system, resulting in softer and more frequent stools. In addition, slowly drinking warm water in the morning stimulates gastrocolic reflex.

Exercise

Walking and gentle yoga are the safest and best exercises you can do while experiencing a bowel obstruction. Consult your health care provider or a Clear Passage® therapist for further suggestions. The needs of each individual will vary from one to the next, depending on the nature and severity of abdominal adhesions.

Stretching

When it comes to stretching, the most important thing you can do is listen to your body. Stretches can be uncomfortable, but the discomfort should decrease as you hold the stretch, not increase. If you experience pain that increases as you stretch, you are pushing yourself too hard, or your form is incorrect. Hold stretches anywhere from two to ten minutes, as needed. You can deepen the stretch as you feel your tissues lengthen or soften.  

Your Clear Passage® therapist can educate you on which stretches are most appropriate for you and exactly how to perform your stretches for maximized benefit. If you have any changes in medical status or become pregnant after your treatment with us, consult with your physician. You may need to modify or discontinue stretching exercises for a while. 

Here are some body areas our patients find helpful to stretch:

• Calves 
• Iliopsoas – front of thighs
• Quadratus lumborum – posterior abdominal wall
• Abductors – inner thighs
• Iliotibial band – outside of the thigh
• Hamstrings
• Piriformis – buttocks/top of hip joints
• Quadriceps – front and side of thighs
• Hips and lower back
• Pelvis 
• Anterior trunk – the front of the torso, the hip, belly, and rib area

Specialized Self-Treatment Instructions

You do not have to live in fear of additional bowel obstructions. You can learn how to manage your own symptoms through diet, exercise, and self-administered physical therapy. During a five-day treatment program, Clear Passage® therapists instruct you in self-treatment techniques to maintain the gains from treatment and to keep new adhesions from forming, so you can inhibit future obstructions.

If you have experienced recurring, adhesion-related bowel obstructions and a future surgery seems inevitable, it will be worth your while to look into this natural, surgery-free alternative treatment. The Wurn Technique, administered by Clear Passage® Physical Therapy, is not medical quackery. It has an impressive history of success. 

The following information is not a substitute for the advice of your physician, dietician or nutritionist or self-treatment education provided by a Clear Passage® physical therapist. Contact your doctor immediately if you experience changes in bowel movements, such as constipation, nausea, vomiting, or pain.

Consult with your healthcare provider right away if you are experiencing fever or other severe symptoms. If your life is not in immediate danger, use the helpful suggestions in this article to find relief of symptoms at home, and contact us to learn more about how you can avoid surgery and improve the quality of your life.