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BOWEL OBSTRUCTION

Men's Health, Women's Health / By

BOWEL OBSTRUCTION

Bowel obstruction is a mechanical or functional blockage of the intestine which prevents the normal movement of the products of digestion.

  • Mechanical obstruction happens when something physically blocks the intestine and functional obstruction results from something interrupting the coordinated system of movement of the small and large intestine, slowing or stopping the movement of food through the digestive system.
  • As part of the digestive process, digested food particles must pass through 25 feet or more of the intestines.
  • These digested waste are always in motion and these movements can be stopped by a bowel obstruction.
  • When this happens, food, liquids, gastric acid builds up behind the site of the blockage. The intestine can rupture and leak harmful contents and bacteria into the abdominal cavity if enough pressure builds up at the site of blockage.
  • Either the small bowel or the large bowel can be affected and the blockage can be complete or partial
  • A complete bowel obstruction is life-threatening and often require surgery.
  • In 2015, about 3.2 million cases of bowel obstruction occurred which resulted in 264,000 deaths.
  • The obstruction can occur at any age and both sexes are equally affected.
  • If the obstruction is preventing blood from getting to a segment of the intestine, it can lead to tissue death, infection, multiple organ failure and eventually death.

Causes

There are many causes of bowel obstruction. They include:

  • Intestinal adhesion that can form after a pelvic or abdominal surgery
  • Hernias
  • Colon cancer
  • Inflammatory bowel disease such as Chron’s disease
  • Volvulus
  • Foreign bodies such as gallstones swallowed objects especially in small children
  • Intussusception most common in children
  • Diverticulitis
  • pseudoobstruction
  • Constipation
  • Fecal impaction
  • Infections such as gastroenteritis
  • Muscle and nerve disorder such as Parkinson’s disease
  • Stomach cancer
  • Some medications that affect nerve and muscles including opioid pain medications, amitriptyline, and imipramine.

SYMPTOMS

  • Stomach cramps that come and go
  • Abdominal distention or swelling
  • Constipation
  • Vomiting
  • Inability to have bowel movement or gas
  • Loss of appetite

DIAGNOSIS AND TREATMENT

The doctor will review your medical and family history and perform a physical exam. The physical exam is done to check for abdominal pain or check for lumps in the abdomen. If the abdomen is swollen or if there is a lump in the abdomen, the doctor may suspect bowel obstruction. The doctor may also listen with a stethoscope for any bowel sound.

To confirm a diagnosis, the doctor may recommend an abdominal x-ray or a CT scan.

In children, ultrasound is the preferred type of imaging

A barium enema may also be used as a diagnostic tool in certain cases.

TREATMENT

Treatment depends on the location and the severity of the obstruction.

For partial or complete obstruction, the first line of treatment is keeping the patient stabilized before further treatment is undergone. This can be achieved by:

  • Giving intravenous fluids
  • Passing a tube through the nose down into the throat, stomach, and intestine (nasogastric tube) to suck out air and relieve pressure and swelling
  • Inserting a catheter into the bladder to drain urine.

A barium enema is used both as a diagnostic procedure and treatment for intussusception. If this works, further treatment is not needed.

If your condition results from certain medications, the doctor may prescribe medication that reduces the effects of such medications.

In partial obstruction, further treatment may not be needed after the patient has been stabilized. A special low-diet that is easier for the partially blocked intestine to the process may be recommended by the doctor.

Incomplete obstruction, treatment is needed. Surgical procedure includes removing the obstruction as well as any section of the intestine that has died or is damaged.

A self-expanding stent is a safe option for people too sick to undergo emergency surgery or people with colon cancer. The stent is placed at the site of the blockage to force the bowel open allowing digestive products to pass through.