A perforated bowel would cause you constant and severe stomach/lower belly pains. On examination, your belly would be extremely tender to the touch and maybe possibly be rigid, rather than soft. If you can open your bowels, which you may not be able to, then you may be passing malena stools, this is frank blood in your stools. You may also vomit fecal fluid, but not always, as this is more indicative of an obstruction.
Normally, this would require urgent hospital admission. If you were medically managed, then you may have IV fluids initiated and a large bore NG tube put down your nose and into your stomach so that any backed up fluid in your stomach can drain into a drainage bag attached to the end of the tube.
Normally however, any kind of perforation of the intestine would need surgery to repair it.
I have Crohn’s and had an operation 10 weeks ago for an abscess. When she did my surgery she couldn’t find the perforation so she drained the abscess and took my appendix out. I had a drain inserted which was draining out the leakage. The stuff coming out was bowel content. The drain fell out and now I have a fistula track. The leakage should be coming out down the track but there hasn’t been much drainage since the drain fell out. Now I am worried that whatever is coming out of my bowel is staying in and possibly causing more abscesses and complications. I was told that the perforation wouldn’t heal as long as I am eating. Has anyone experienced a similar situation?
Normally, if a perforation is medically managed, then the gut needs to rest for a certain period of time and this would probably mean having an NG tube inserted to be on free drainage and having TPN, so that you can be adequately nourished whilst resting your gut completely to allow healing to take place.
All the time your gut is working and digesting food, the less likely healing is to occur.
As I said before, it is normal for a perforation to be repaired surgically and not left for medical treatment. Also, if you have absesses in your stomach/bowels, then a drain can be re-inserted under ultrasound guidance and left to drain. It is normally one of the finebore pigtail drains that will then be strapped to your belly.