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Intestinal Obstruction: Bowel Obstruction Causes, and Symptoms

Intestinal Obstruction (a.k.a Bowel Obstruction) is a blockage of the small or large intestine that prevents foods to pass through it. During the normal digestion process, the digested food particles travel through the intestine and are constantly in motion. But in intestinal obstruction, this process comes to a halt and the individual experience difficulty in the bowel movement.

Intestinal Obstruction

What is Intestinal Obstruction?

Intestinal obstruction is a gastro-intestinal blockage, which blocks the movement of fluids, gas and digested food. An intestinal blockage might be partial or complete.

If intestinal obstructions occur food, fluids, gas and gastric acid accumulate behind the blockage site of the intestine. When the pressure build-up the intestine ruptures, release harmful intestinal contents and bacteria into the abdominal cavity, which is a life-threatening complication.

What are the Causes of Intestinal Obstruction?

Intestinal obstruction may develop due to various reasons that include:

Mechanical Obstruction:

Mechanical obstruction can physically block the small intestine, and it can be due to:

  • An intestinal adhesion: It consists of bands of fibrous tissue in the abdominal cavity usually. develops after undergoing an abdominal or pelvic surgery or after a severe inflammation.
  • Volvulus: Volvulus is twisting or knotting of the intestine.
  • Intussusception: It is folding of a part of the intestine into another.
  • Malformation of the intestine: It is mostly seen in newborns, but is also found in children and teens.
  • Tumour: A tumor inside the small intestine also may lead to intestinal obstruction.
  • Hernia: It is an abnormal opening in the muscle or tissue that may cause intestinal obstruction.
  • Diverticulitis: Inflammation of the pouches of the large intestine can also lead to intestinal obstruction.

Non-mechanical Obstruction:

Non-mechanical obstruction occurs when there is an interruption in the coordinated movement of the small and large intestine and cause a functional intestinal obstruction. If the condition is temporary, it is known as ileus, and if the condition becomes chronic, it is referred as pseudo-obstruction.

An ileus can be caused due to:

  • An infection, such as appendicitis (inflamed appendix) or gastroenteritis (inflamed stomach and intestine)
  • Electrolyte imbalance
  • Use of opioid pain medication

Pseudo-obstruction can be caused by:

  • Nerve and muscle disorder, such as Parkinson’s disease and multiple sclerosis
  • Hirschsprung’s disease, a condition due to the lack of nerves cells in the region of the large intestine (colon)
  • Diabetes mellitus, a condition with increased sugar levels in the blood
  • Hypothyroidism, an underactive thyroid gland

Symptoms of Intestinal Obstruction:

Symptoms of intestinal obstruction depend on the location and type of the blockage. Intestinal obstruction may cause several uncomfortable symptoms, such as:

  • Severe bloating
  • Abdominal pain
  • Nausea
  • Vomiting
  • Abdominal swelling
  • Loss of appetite
  • Inability to pass gas or stool
  • Constipation
  • Severe abdominal cramps

Risk Factors for Intestinal Obstruction:

Factors that increase the risk of intestinal obstruction include:

  • Crohn’s disease is an inflammatory bowel condition that thickens walls of the intestine and narrows the passage
  • Individual who had  any surgery or radiation therapy to treat  abdominal cancer

Complications of Intestinal Obstruction:

Intestinal obstruction may prevent the blood flow into a segment of intestine and may cause several life-threatening complications if left untreated. These include:

  • Tissue death
  • Infection
  • Intestinal perforation
  • Sepsis
  • Multiple organ failure

Diagnosis of Intestinal Obstruction:

The doctor initiates diagnosis by reviewing the medical history, signs and symptoms of the individual. The doctor performs:

Physical Examination:

A physical examination is performed to detect the inflammation and tenderness of the abdomen or if there is any lump inside the abdomen. The doctor uses a stethoscope for listening to the bowel sounds, which helps in determining the obstruction.

Abdominal X-ray:

An abdominal X-ray is performed to detect the problem within the abdominal cavity, stomach and intestine. A large bowel obstruction can be seen using an abdominal X-ray, but some intestinal obstruction may not be visible in X-ray.

Computerized Tomography (CT Scan):

A CT scan is a noninvasive, painless diagnostic test that captures the cross-sectional images of the internal organs, bones and other tissues. These images show an intestinal obstruction in a detailed way than compare with a standard X-ray.

Ultrasound:

An ultrasound is performed to determine the coiling of the intestine within the intestine. It helps in differentiating mechanical and functional intestinal obstruction.

Air or Barium Enema:

A barium enema is an enhanced diagnostic procedure for detecting any changes or abnormalities in the large intestine. During this procedure, the doctor will insert liquid barium or air inside the rectum through a small tube. The barium liquid covers the lining of the colon and results in a clear silhouette of the colon.

Treatment of Intestinal obstruction:

Treatment for the intestinal obstruction is done based on the type, location and severity of the obstruction and it usually requires hospitalization. The treatment is mainly done to:

  • Prevent dehydration
  • Prevent perforation (a hole inside the intestine)
  • Maintain electrolyte balance

Treatment for partial obstruction:

In partial obstruction or ileus, the treatment is done by resting the bowels (the individual is given nothing to eat, or only clear liquids are given at a particular time). Intravenous (IV) fluids are given to treat dehydration and maintain electrolyte balance to prevent the risk of shock. A thin and flexible tube (catheter) is inserted inside the bladder for draining out the urine.

A nasogastric tube is inserted down the nose and into the throat, stomach and intestine to draw out air and fluid to relieve:

  • Pressure
  • Swelling
  • Vomiting

If the intestinal obstruction is caused due to narcotic pain medication, the doctor prescribes certain medications to reduce the effect of narcotics on the bowels.

Treatment for complete obstruction:

The individual requires surgery to clear the blockage if there is a complete obstruction of the bowel.

Surgery typically involves removal of the obstruction and also the removal of any died or damaged tissue.

A stent is a safe way of treating complete obstruction in individuals who are too sick for undergoing emergency surgery. A stent is a metal or plastic wire mesh tube placed inside the colon that forces the obstruction to get clear. In some individuals, a stent is enough to treat the condition, and some may require surgery when they become stable.

Treatment for pseudo-obstruction:

The individual is hospitalized and is monitored for two to three days to find out the cause.. Pseudo-obstruction usually gets better on its own; if the condition does not improve the doctor may prescribe certain medications that cause muscle contraction and helps to eliminate the food and fluids through the intestine.

Prevention of Intestinal Obstruction:

Intestinal obstructions can be prevented by:

  • Including a fiber-rich diet
  • Drinking plenty of water
  • Avoid lifting heavy objects

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