What is intestinal obstruction? Why does it happen? What are the symptoms? Is it a serious disease? How is it diagnosed and treated? Does it kill? What should you do? You can find the answers to all these questions and much more below.

What is intestinal obstruction?

Intestinal obstruction is a condition of obstruction that prevents the passage of food or liquid from the small intestine or large intestine (colon). Causes of intestinal obstruction include bands of fibrous tissue (adhesions) in the abdomen that form after surgery, inflammatory bowel disease ( Crohn’s disease and ulcerative colitis ), infected bags in the intestine (diverticulitis), hernias, and bowel cancer .

If intestinal obstruction is not treated, the blocked parts of the intestine can die over time and cause serious problems. However, most of the time, intestinal obstruction can be successfully treated with immediate medical attention.

Types and causes of intestinal obstruction

Here we basically need to differentiate between mechanical, functional and pseudo-intestinal obstruction.

Mechanical intestinal obstruction

In mechanical intestinal obstruction, intestinal passage is blocked from the outside. This is possible due to adhesions in the abdomen after previous operations or tumors pressing on the intestines. The blockage can also be caused by diseases in the gut.

Causes of this include, for example, tumors in the intestine with increasing age, congenital narrowing, narrowing due to inflammation (such as inflammatory bowel diseases), narrowing due to poor blood supply, or foreign bodies in the intestine. Trapped bowel within the groin/belly or scar fracture can also lead to mechanical bowel obstruction.

functional bowel obstruction

The most common clinical picture in this category is intestinal paralysis or reflex intestinal arrest after surgery on the abdomen or spine, as well as after taking certain medications (opioid-containing pain relievers). Any form of inflammation in the abdomen (intestinal inflammation, gallbladder inflammation, appendicitis, pancreatitis, inflammation of the peritoneum) can lead to reflexive, temporary intestinal obstruction.

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pseudo-intestinal obstruction

Pseudo-intestinal obstruction can also cause the same symptoms but do not involve a physical obstruction. In the case of pseudo-intestinal obstruction, muscle or nerve problems disrupt the normal coordinated muscle contractions of the intestines, slowing or stopping the movement of food and liquid through the digestive tract.

Pseudo-intestinal obstruction can affect any part of the intestine. Causes may include:

  • Abdominal or pelvic surgery
  • Infection
  • Certain medications that affect the muscles and nerves, including tricyclic antidepressants such as amitriptyline and imipramine, and opioid pain medications containing hydrocodone and oxycodone
  • Muscle and nerve disorders such as Parkinson’s disease

Who is at risk?

Diseases and conditions that can increase the risk of bowel obstruction include:

  • Abdominal or pelvic surgery that often causes adhesions
  • Crohn’s disease, which can cause thickening of the intestinal walls
  • Cancer in the abdomen (especially if you have a history of surgery to remove an abdominal tumor or radiation therapy)

Bowel obstruction symptoms

Symptoms of intestinal obstruction include:

  • Cramp-like abdominal pain that comes and goes
  • Loss of appetite
  • Constipation
  • Vomiting
  • Inability to defecate or pass gas
  • blood in stool
  • abdominal swelling

When should you see a doctor?

Because of serious complications from intestinal obstruction, medical attention should be sought immediately if severe abdominal pain or other symptoms of intestinal obstruction are present.

Diagnosis of intestinal obstruction

Tests and procedures used to diagnose bowel obstruction include:

  • Physical examination: The doctor will ask about medical history and symptoms. He or she will also perform a physical examination to assess the condition. A bowel obstruction may be suspected if the abdomen is swollen and tender, or if there is a lump in the abdomen. He can listen to bowel sounds with a stethoscope.
  • X-ray: The doctor may recommend an abdominal X-ray to confirm the diagnosis of intestinal obstruction . However, some intestinal blockages cannot be seen using standard x-rays.
  • Computed tomography: Computed tomography scanning combines a series of X-ray images taken from different angles to produce cross-sectional images. These images are more detailed than a standard X-ray and are more likely to show intestinal obstruction.
  • Ultrasound: When bowel obstruction occurs in children and teenagers, ultrasound is usually the preferred type of imaging.
  • Air or barium enema: An air or barium enema is basically advanced imaging of the colon that can be done for some suspected cause of obstruction. During the procedure, the doctor inserts air or liquid barium into the colon through the rectum. An air or barium enema can actually correct the problem most of the time and no further treatment is needed.
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Intestinal obstruction treatment

Treatment for bowel obstruction depends on the cause of the condition, but usually requires hospitalization.

Hospitalization to stabilize the condition

Upon arrival at the hospital, doctors will first work to treat and stabilize the person concerned. These processes may include:

  • Inserting intravenously into a vein in the arm so that fluids can be given
  • Putting a nasogastric tube from the nose to the stomach to absorb air and fluid, relieve abdominal swelling
  • inserting a thin, flexible tube (catheter) into the bladder to drain the urine and collect it for testing

Invagination treatment

A barium or air enema is used both for diagnosis and as a treatment for some children. If this procedure works well, no further treatment is usually necessary.

Partial congestion treatment

If there is an obstruction (partial obstruction) that some food and liquids can still pass through, further treatment may not be needed after stabilization. The doctor may recommend a special low-fiber diet that is easier to process for partially blocked bowel. If the blockage does not resolve on its own, surgery may be needed to remove the blockage.

Complete blockage treatment

If nothing can pass through the bowel, surgery is usually required to remove the blockage. Which procedure will depend on what is causing the blockage and what part of the bowel is affected. Surgery usually involves removing the blockage as well as any dead or damaged part of the bowel.

Alternatively, the doctor may recommend treating the obstruction with a self-expanding metal stent. Wire mesh tubing is inserted into the colon through the mouth or through an endoscope through the colon. It forces the colon to open so that the obstruction can be removed.

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Stents are often used to treat people with colon cancer or to provide temporary relief in people for whom emergency surgery is too risky. Surgery may still be required after the condition is stabilized.

pseudo-intestinal obstruction treatment

If the doctor determines that the symptoms are caused by pseudo-intestinal obstruction, he or she can monitor the condition in the hospital for a day or two and treat it if the cause is known. False bowel obstruction can also go away on its own. Meanwhile, food is given, possibly through a nasal tube or intravenously, to prevent malnutrition.

If the pseudo-intestinal obstruction does not resolve on its own, the doctor may prescribe medications that cause muscle contractions that can help move food and liquids through the intestines. If this condition is caused by a disease or drug, the doctor aims to treat the underlying disease or stops the drug. Rarely, surgery may be needed to remove part of the intestine.

In cases where the colon is enlarged, a treatment called decompression may provide relief. Decompression can be done with colonoscopy, a procedure in which a thin tube is inserted into the anus and guided into the colon. Decompression can also be done surgically.

Can intestinal obstruction be prevented?

Intestinal obstruction can only be prevented to a limited extent. It is important to pay attention to regular bowel movements and avoid foods that are difficult to digest.

Intestinal obstructions are common, especially after abdominal surgeries. In such a case, there is talk of intestinal obstruction after surgery. After such an operation, special attention should be paid to possible signs of intestinal obstruction, and if symptoms occur (such as abdominal pain, inability to defecate or vomiting), a doctor should be consulted immediately.

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