Bowel Obstruction

What is a bowel obstruction? Bowel obstruction is a stumbling block that stops food or liquid from passing through the small or large intestine. This could be as a result of adhesions (fibrous bands of tissue) in the abdomen that formed after surgery, Crohn’s disease (an inflamed intestine), diverticulitis (infected pouches in the intestine), hernia, or colon cancer. If left untreated, the blocked parts of the intestine can die, leading to severe problems. With prompt medical care, however, bowel obstruction can, often, be treated successfully. Types of bowel obstruction Bowel obstruction can be, mainly, of two types – partial bowel obstruction or complete bowel obstruction. There can also be a third type known as pseudo-obstruction.  In a pseudo-obstruction, there is the presence of bowel obstruction symptoms but no physical blockage. It can be a result of problems with the gastrointestinal muscles or with the nerves that control them. Intestinal obstruction is a blockage that keeps food or liquid from passing through your small intestine or large intestine (colon). Causes of intestinal obstruction may include fibrous bands of tissue (adhesions) in the abdomen that form after surgery, an inflamed intestine (Crohn’s disease), infected pouches in your intestine (diverticulitis), hernias and colon cancer. Without treatment, the blocked parts of the intestine can die, leading to serious problems. However, with prompt medical care, intestinal obstruction often can be successfully treated. Diagnosis of bowel obstruction Bowel obstruction diagnosis is carried with series of investigation, such as;

• Physical examination of the abdomen, which is usually the first step taken.
• Assessment of medical history.
• Stethoscopical assessment of bowel activity.
• Blood tests; such as, liver function test, complete blood count, estimation of electrolytes level, and kidney function test.
• Endoscopy, in which a doctor uses a special camera to look inside the gut.
• CT scan.
• X-rays.
• Colonoscopy; the use of a flexible lighted tube to look at the large intestine.
• Enema with contrast.

Bowel obstruction treatment The choice of bowel obstruction treatment depends on the cause and the severity of the blockage. For complete bowel obstruction, this may require a surgery. Bowel obstruction treatment include;

• Medication: such as, laxatives, stool softeners, anti-nausea drugs (to prevent vomiting), pain relief, and antibiotics (to fight bacterial infection).
• Observation: for pseudo obstruction which often resolves with time, doctors may just observe and provide fluid intravenously to prevent dehydration.
• Nasogastric tube: A narrow tube passed through the nose to the stomach to remove fluids and gas trapped in the stomach. This helps relieve pressure, and eases pain and vomiting.
• Bowel obstruction surgery: Surgical removal of blocked or damaged sections of the bowel.
• Therapeutic enema.

Symptoms

Bowel obstruction symptoms can be any of the following;

• Cramps-like abdominal pain, which comes and goes.
• Loss of appetite.
• Constipation.
• Inability to make bowel movement or pass gas.
• Swelling of the abdomen.
• Nausea or vomiting.
• Severe bloating.

Causes

The agents that causes bowel obstruction can be grouped into two – 

• Mechanical obstruction, which are responsible for partial bowel obstruction and complete bowel obstruction. 
• Non mechanical bowel obstruction, which are responsible for pseudo obstruction.

Mechanical obstruction: This means there are physical barriers that prevent or restrict the flow of matter through the bowel. These barriers include;

• Adhesions, or tissues that develop after an abdominal or a pelvic surgery.
• Diverticulitis.
• Foreign object, when swallowed.
• Gallstones, on rare occasions.
• Hernia.
• Impacted stools.
• Infection.
• Inflammatory bowel diseases, like Crohn’s disease
• Intussusception: That is, when a segment of the bowel pushes into another segment; thereby making it collapse.
• Meconium plug; the first stool of new-borns.
• Tumours.
• Twisted bowel. 
• Malformation of the intestine.

Non mechanical bowel obstruction: This means there has been a disruption to the coordinated working style of the entire digestive system. Root cause of non-mechanical bowel obstructions consist of:

• An abdominal or a pelvic surgery.
• Diabetes.
• Electrolyte imbalances.
• Hypothyroidism.
• Hirschsprung’s disease; this is a condition where nerve cells are absent from the end of the bowel.
• Infections; for instance gastroenteritis or appendicitis.
• Nerve and muscle disorders, for instance Parkinson’s disease and diabetes mellitus.
• Opioid medication.

• Intestinal adhesions bands of fibrous tissue in the abdominal cavity that can form after abdominal or pelvic surgery
• Colon cancer
• In children, the most common cause of intestinal obstruction is telescoping of the intestine (intussusception).

Other possible causes of intestinal obstruction include:

• Hernias portions of intestine that protrude into another part of your body
• Inflammatory bowel diseases, such as Crohn's disease
• Diverticulitis a condition in which small, bulging pouches (diverticula) in the digestive tract become inflamed or infected
• Twisting of the colon (volvulus)
• Impacted feces

FAQ

What are the probable risk factors for bowel obstruction?

Yes, there are a couple of them. These include;

• Cancer, particular in the abdominal area.
• Inflammatory bowel diseases, which may thicken the walls of the intestines.
• History of an abdominal or a pelvic surgery, which is likely to increase the risk of adhesion formation.
• Radiation therapy.
• Improper development of the intestine. 

Are there any complications that may arise from bowel obstruction? 

If left untreated or not promptly treated, bowel obstruction can lead to serious, life-threatening complications, such as;

• Tissue death. 
• Infection.
• Dehydration.
• Electrolyte imbalances.
• Perforation of the intestines. 
• Abscess within the abdomen.
• Pulmonary aspiration, wherein a person inhales solids such as vomit.

In situations whereby blood is prevented from getting to a segment of intestine, the following complications can arise;

• Sepsis, a mortal blood infection.
• Multiple organ failure, such as kidney failure
• Death.

For those who had bowel obstruction surgery as a treatment means, the following complications can arise;

• Bowel paralysis.
• Nerve damage.
• Short bowel syndrome, a condition where part of the bowel is lost or does not function properly.
• Wound reopening.

How to prevent bowel obstruction.

• Healthful lifestyle choices.
• Regular exercise.
• Soft fruits; for instance figs and peaches are good natural alternatives.
• Act fast once you start experiencing difficulty passing stools or gas. Prompt treatment helps lower the risk of the occurrence of a bowel obstruction.

Are there any lifestyle changes that can help with easing bowel obstruction?

There are numerous lifestyle changes that can help boost the health of the digestive system. Some of these are;

• Regular and further exercising.
• Always staying hydrated.
• Limit stress as much as possible.
• Quit smoking and consumption of alcohol.

Are there any diets that can help with easing bowel obstruction?

Here are some suggested changes to diet;

• Consume smaller portions more regularly.
• Thorough food chewing.
• Avoiding large amounts of high-fibre foods.
• Cut down on caffeine; it can irritate the bowel.
• Avoid tough or stringy foods.
• Peel fruits and vegetables to enable easier digestion.
• Thorough food cooking, until it softens.