Old 03-13-2018, 09:40 AM #1 (permalink)
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Default Too Much Gas

Hey peeps, I need your collective wisdom.

We are in the hospital, day 9 post trach/vent. They have had him on a constant trickle feed with the same formula he was tolerating at home (2 cal) , and his stomach and colon are filling with gas that won't move. His stomach gets so distended that he is in agony. He's getting meds for gas, suppositories, and his Miralax. We are also putting the bed in the sitting up position.

I know the pain meds slow things down. Grrrr.

I've asked them to discontinue the constant feed and go back to periodic bolus feeding. He was tolerating 227ml at 400ml an hour every three hours at home. He was hungry by hour three, so I'm thinking every two hours (he's going to need to put some weight back on once we get through this).

He is back on the Trilogy, which is working well. Unfortunately, he is fighting and infection of some sort (getting antibiotics). His stoma keeps bleeding, so they have been unable to change the trach yet. He also has thrush which they are treating.

If we were home I'd fill him with prune juice and probiotics. Sigh. No go here.

Has anyone else not been able to tolerate the continuous feed? Might that be the problem,.

Thanks!

Becky
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Old 03-13-2018, 08:33 PM #2 (permalink)
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Default Re: Too Much Gas

Becky,

I know Matt has used Miralax but it gives me terrible gas. Can they give him a suppository to get a movement, then go to feedings more like he was used to at home? I can't understand why they won't let you give him prune juice, at least.

Is the thrush in his esophagus or only in his mouth? Did they just treat with anti-fungals or do a culture?

You must be so exhausted. I worry about you.
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Old 03-13-2018, 09:09 PM #3 (permalink)
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Default Re: Too Much Gas

"usually" the continuous feeds help the digestion a lot when it is slow, but I hope if anyone has had gas issues relating to continuous fees they can tell us.

If they stopped doing it continuous you could sneak the prunes and probiotics in easily!
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Old 03-13-2018, 09:21 PM #4 (permalink)
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Default Re: Too Much Gas

this is probably already happening, but I get great relief from burping the tube.
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Old 03-13-2018, 09:27 PM #5 (permalink)
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Default Re: Too Much Gas

Definitely tube burping works and helps a lot.
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Old 03-13-2018, 10:34 PM #6 (permalink)
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Default Re: Too Much Gas

Sorry you are going through all of this and I hope Matt is doing better tonight.
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Old 03-13-2018, 11:09 PM #7 (permalink)
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Default Re: Too Much Gas

Becky,

Continuous feed + hospital setting + diabetes could definitely be an issue. Not sure what they don't like about prune juice? Would not do probiotics with bad bugs on board since they make everything grow. But prebiotics are not a bad idea, with the bonus of insoluble fiber. Not sure about Miralax when there is probably a fluid imbalance as is. Has papaya juice been tried?

Whatever you give him in the hospital that no one wants to order is, as always, a "don't ask/don't tell" situation. You didn't sign away any caregiver rights with your admission form. Give him whatever you know he needs that is safe.

Thinking of you guys!
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Old 03-14-2018, 12:07 AM #8 (permalink)
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Default Re: Too Much Gas

One of the issues with a general anesthesia is your GI tract almost has a separate brain. It can take longer to recover from the anesthetic. That;s why they want to have you evacuate all waste before leaving the hospital even after day surgery. The GI tract can be really messed up, then add opioids and you are in a heap of trouble. It just takes time and maybe an enima. The hospital has seen this before. It is uncomfortable and sucks but it takes time. Is he on domperidone? It can help with motility issues.
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Old 03-14-2018, 09:11 AM #9 (permalink)
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Default Re: Too Much Gas

Sending good energies your way beckley and Matt!
Love you folks
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Old 03-14-2018, 08:50 PM #10 (permalink)
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Default Re: Too Much Gas

We switched back to periodic bolus feeding and it did the trick. Ha actually has a super fast digestive system, so maybe it didnít like not being able to finish the job!

Laurie, thanks for the tip on pre Vs probiotics!

Kim, you and I thought alike on this one, and it worked. The thrush was just in his mouth. Theyíve done a lot of cultures, but I donít know if the mouth was among them. They are using nystatin.

Vince, theyíve drained his stomach, done the rubber hose and suppositories. He just missed the enema. Trouble was, every time he was cleared out and rested, they resumed continuous feeds. Apparently his body does not like them (at least at 5his point). No domperidone. Iíll have to look that up.

Azgirl and Tillie, this air was stuck on his colon and belly burping wasnít working. We do a lot of that normally.

Lenore and Chally, thanks for the positive thoughts!
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Old 03-14-2018, 08:52 PM #11 (permalink)
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Default Re: Too Much Gas

I'm just so glad this worked - and yep once the gas is in the colon the stoma ain't gunna let it out...
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