Intestinal Obstruction

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Intestinal obstruction, also known as bowel obstruction, is a severe condition that is caused due to blockage in the intestine (small or large intestine), which results in severe impairment in the passage of food particles, liquids, and gas through the intestine. Read More

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Intestinal Obstruction

What is intestinal obstruction?

Intestinal obstruction, also known as bowel obstruction, is a severe condition that is caused due to blockage in the intestine (small or large intestine), which results in severe impairment in the passage of food particles, liquids, and gas through the intestine. 

Intestinal Obstruction
Picture Courtesy: geni.com

What are the types of intestinal obstructions?

Types of bowel obstruction can be classified in two ways; the type that involves, which the intestine is affected, and the types by its effects.

By Effects:

  • Partial Obstruction

A situation where the bowels are partially obstructed causes severe pain in the abdomen when their digested materials need to pass through the spectrum. After a long strain and painful episodes, digested materials pass through, but some may still be held back.

  • Complete Obstruction

The passageway is completely blocked in this situation, and no digestive materials can be passed out. It creates a lot of inconveniences, nausea, abdominal pains, and difficulty in excreting the waste products out of the system.

By Intestine:

  • Small Intestinal Obstruction

The small intestine is partially or entirely blocked from passing out waste products in this situation. 

  • Large Intestinal Obstruction

This occurs when the large intestine is partially or completely blocked from excreting digested materials due to certain problematic obstructions.

Causes

The causes of bowel obstruction can be due to physical barriers in or outside the bowels causing obstructions in the spectrum or ileus, which causes pseudo-obstruction.

What are the risk factors associated with intestinal obstruction?

Physical factors include:

  • Inflammatory bowel diseases such as Crohn’s disease
  • Intussusception
  • Malignancy
  • Cancerous tumors in the abdomen
  • Adhesion is a result of scar tissues from abdominal or pelvic surgeries.
  • Hernia
  • Gallstones
  • Colorectal cancer
  • Diverticular disease
  • Volvulus is a twisted colon 
  • Impacted feces, etc.

Pseudo-obstruction factors may include:

  • Infection
  • Disorders of the nerve or muscles such as Parkinson’s disease
  • Medications such as tricyclic antidepressants and opioid drugs that affect the nerves and muscles.
  • Diabetes
  • When nerves are missing from the bowels and causing Hirschsprung’s disease.
  • Abdominal, ovarian, or pelvic surgeries.

Symptoms

symptoms of intestinal obstruction
Picture Courtesy: gastrocare

The signs that accompany bowel obstruction may include:

  • Severe abdominal pains and cramps are often around the belly button.
  • Lack of bowel movements and the inability to pass out gas.
  • Hard and swollen stomach
  • Constipation.
  • Bloodstained feces when there is partial obstruction.
  • Diarrhea in partial obstruction.
  • Nausea feelings that lead to vomiting.

How are intestinal obstructions diagnosed?

Once the patient notices constipation that has lasted for a week or more, the patient should consult a doctor immediately.

To diagnose the disease, the doctor first goes through the medical history to find out if there’s any record of ailment that can lead to bowel obstruction. A stethoscope is further used to examine the bowel’s activities (bowel sound) for movement. Where there’s no sense of movement and a compact stomach, there is likely an obstruction in the intestine.

The following can then be used to figure it out:

  1. Blood tests to find out the electrolytic level of the blood and if the liver and kidney are still functional.
  2. Imaging tests to view the stomach and intestine for obstructions. A special liquid called barium enema is often injected into the rectum and spreads into the bowels to brighten the area when imaging is carried out. Imaging tests include:
  • X-rays
  • CT scans of the abdomen
  • Endoscopy

3. Colonoscopy; During this procedure, a small flexible tube and a camera are inserted through the spectrum to check if the colon is twisted. It can also be used to untwist the colon.

How is intestinal obstruction treated?

An intestinal obstruction causes a lot of inconveniences added with the consistent pain in the abdomen. And with the complications that can cause more discomfort, it is advisable that once the patient is diagnosed with an obstruction, then the patient should be treated immediately. 

The following ways are recommended to cure the ailment:

  • Special Diets

For most partial obstructions, the patient can be placed under observation because these blockages can be relieved after a few days. During the observation period, the patient is being placed on special diets such as soft meals and fluids that can soften the activities in the bowels. Solid meals are avoided to prevent further buildup.

  • Medications

Drugs such as pain relievers to ease pain, laxatives and stool softeners to help the patient defecate easily, anti-nausea drugs to stop nausea and vomiting, and antibiotics to combat infections can be used to ease the discomfort. They can be given in the form of fluid through intravenous lines.

  • Nasogastric (NG) Tube

A thin tube is inserted through the patient’s nose and passed into the abdomen. This aids in relieving some pressure from the intestine by helping the patient release gas and fluid.

  • Enemas

Fluid or air can be injected into the bowels to cause reactive pressures in the stomach and relieve the compaction. 

  • Stent

A mesh tube is pushed into the bowels to open forcefully for any disease-induced closures.

  • Surgery

For a blocked bowel, surgery is the best option for treatment. Tumors, malignant adhesions, hernias, etc., can be operated on and taken out. The damaged tissues and parts of the intestine can be removed. Twisted colons can also be untwisted.

Complications in surgery such as paralytic bowel, nerve damage, adhesions, and short bowel syndrome, where the part of the intestine is taken out of the bowel, bring a loss of some functions.

What are the possible complications of intestinal obstruction?

If the blockage is not addressed on time, severe complications may arise. These health issues can become so critical and out of control. They include:

  • Nausea
  • Dehydration
  • Imbalance in electrolytes
  • Fever, infections 
  • Severe pain in the abdomen
  • Constipation 
  • Abdominal abscesses
  • Death of Intestinal Tissues

Due to the obstruction, the intestinal walls begin to decay and die off with no flow in the blood to the intestine.

Perforation of Intestinal Walls.

As a result of dead tissues, holes (perforation) can be formed in spots far too weakened.

  • Infection; holes (perforation) and wounds in the bowels can become infected. Infections such as peritonitis and sepsis are also likely to occur.
  • Liver and kidney failure

Can intestinal obstruction be prevented?

The preventive measures against intestinal obstruction are often related to diet and lifestyle. As the person grows older, our digestive system functions slowly, thereby increasing the risk of bowel obstructions.

To prevent such from happening, keep to these guidelines:

  • Eat a lot of balanced diets. However, consume a lot more vegetables and fruits than we consume fat and carbohydrate. The ratio should be 70:30.
  • Avoid rough and high-fiber foods like nuts, wholegrain cereals, dried meat, popcorn, etc. Eat more soft, moist dishes like soups, sauces, etc.
  • Cook until it softens. Hard foods have a higher chance of causing a buildup.
  • Cut food into little chunks while eating and make sure to chew them properly before we swallow.
  • Please take off the peels of fruits and vegetables before eating them to aid in easier digestion.
  • Cut down on the caffeine to avoid irritating and inflaming the bowels.
  • Avoid carrying heavy materials to prevent the formation of a hernia.
  • Quit smoking and any addictive drug usage.
  • Lessen or avoid the intake of alcohol.
  • Stay hydrated
  • Exercise regularly.
  • Limit the stress level.
  • Take stool softeners whenever you have problems with bowel movements.

FAQ

Can a bowel obstruction correct itself?

When the obstruction is partial, it can heal better on its own. Avoid tough, stringy foods; instead, taking a lot of fluid can help the situation. Unlike totally blocked bowels, which at a higher rate require surgery, partially blocked bowels can heal fast with simple nasogastric tubes and enemas.

Can a person pass stools with an obstruction?

In partial obstruction, passing stools is possible but often comes in the form of diarrhea. Meanwhile, in a complete obstruction, the person finds it impossible to pass out gas (flatus) or feces. Instead, it can result in vomiting. 

Can bowel obstruction cause back pain?

When there is an obstruction in the bowel or colon, the resulting pains can spread from the abdomen to the back, causing lower backaches.

What are the mechanical causes of intestinal obstruction?

The mechanical causes are also referred to as the physical causes blocking the bowels. They include; scar tissues, tumors, hernia, intussusception, etc.

What is the difference between an ileus and a bowel obstruction?

Both have similarities as they stop digested food from passing through the spectrum. However, ileus results from muscle and nerve problems that stop food from going through the digestive tract also called ‘pseudo-obstruction.’ In comparison, bowel obstruction results from physical barriers in the digestive tract.