Intestinal (Bowel) Obstruction

Intestinal Obstruction is a very discomforting disease marked by abdominal bloating and severe stomach cramps. Read on to know about the causes, symptoms, diagnosis and treatment as well as the various types of Intestinal Obstruction.

What is Intestinal Obstruction?

As the name suggests, it is a condition that is characterized by a functional or mechanical obstruction of the intestine (or bowel). This leads to failure of the normal passage of digested products through the intestine.

Picture 1 – Bowel Obstruction Picture
Source – wikimedia.org

This condition is also known by other names like :

  • Bowel Obstruction
  • Ileus
  • Intestinal Pseudo-Obstruction
  • Colonic Ileus
  • Intestinal Volvulus
  • Paralytic Ileus

Chronic Intestinal Pseudo-Obstruction

It is a rare condition of Gastrointestinal movement that is characterized by chronic or continuing signs of intestinal blockage even in the absence of a persisting lesion. It arises due to inefficient or altered Peristalsis (wavelike muscular contractions of the alimentary tract). The condition is mainly treated by antibiotics and nutritional support.

Chronic Idiopathic Intestinal Pseudo-Obstruction

This is a condition in which there is ineffective Gastrointestinal movement due to a rare, primary disease of enteric muscle or nerve. In acute intestinal obstruction of this type, the diagnosis is carried out with the aid of exploratory laparatomy. Treatment is mainly aimed at managing the discomforting symptoms. Hydration as well as nutritional support, along with pain relievers, is used to treat primary cases of this disorder which has no other cure.

Small Intestine Obstruction

A blockage of the small intestine is a very discomforting condition that results in proximal dilation of the bowel due to swallowed air and accumulation of GI secretions. This disorder mainly arises due to post-surgical adhesions followed by malignancy. It is corrected by operative procedures like Appendectomy, Upper Gastrointestinal Surgery and Colorectal Surgery.

Distal Intestinal Obstruction Syndrome

It is an intestinal blockage occurring due to thickened feces (stool) and is generally seen in individuals who are suffering from cystic fibrosis. It is also seen in older people experiencing Pancreatic Insufficiency. People with this disease may be inclined towards constipation. The condition is characterized by vomiting, abdominal pain and a tangible lump in the abdomen. It is cured by laxatives, restriction of oral intake, enemas and abdominal decompression with the aid of Nasogastric tube.

Large Intestinal Obstruction

It is a blockage of the large intestine occurring due to factors like constipation, adhesion, Endometriosis and presence of hernias and benign strictures. The complication is mainly cured with the aid of surgery.

Intestinal Obstruction Symptoms

Some of the main symptoms of Intestinal Obstruction are

  • Severe pain and/or cramps in the abdomen
  • Abdominal bloating and flatulence
  • Diarrhea
  • Vomiting
  • Bad breath
  • Inflammation of the abdomen
  • Constipation
  • Loud bowel sounds
  • Inability to expel intestinal gases through the anal passage

This disorder is marked by a partial or complete blockage (obstruction) of the intestine.

Intestinal Obstruction Causes

This condition may occur due to a number of factors. Some of the main causes of Intestinal Obstruction are

Mechanical Obstruction

This occurs due to the presence of any solid, foreign material that is in the intestine and acting as a cause of obstruction. Other mechanical causes of bowel obstruction can be abnormal growth of tissues, Intussusceptions, Volvulus or twisted intestine, Adhesions or post-surgical development of scar tissues, impacted stool and presence of hernias, gallstones or tumors.

Ileus

The bowel (intestine) fails to act properly in this disorder, despite the absence of any structural disorder. Intestinal Obstruction is itself referred to as Ileus.

Intestinal Pseudo-Obstruction Syndrome

This is one of the major causes of intestinal obstruction in children as well as infants. Also known as Paralytic Ileus, it arises due to various health abnormalities like

  • Trauma (injury) to the blood supply of the abdomen
  • Mesentric Artery Ischemia or reduced supply of blood to the abdominal region
  • Infection within the abdomen (Intra-abdomen infection)
  • Lung or kidney ailment
  • Use of some medicines, particularly narcotics
  • Abnormalities in the level of electrolytes, minerals and chemicals within the body, such as reduced level of potassium

In older kids, Paralytic Ileus may arise due to viral or bacterial infection. It may also occur as a result of Gastroenteritis (food poisoning) that is sometimes related with Appendicitis and Secondary Peritonitis.

Intestinal Obstruction Diagnosis

Intestinal obstructions can be diagnosed with the help of imaging tests like X-Rays and CT scan of the abdomen. Upper GI and small bowel series as well as Barium enema can also be used for diagnosing the condition. The early stages of Mechanical Obstruction can be diagnosed by using a stethoscope to listen to the abdominal sounds. High-pitched sounds in the bowel can be an indication of this condition.

However, bowel sounds can reduce and ultimately become silent in the event of significant bowel damage or a long-standing obstruction of the intestine. Early Paralytic Ileus is characterized by reduction or absence of bowel sounds.

Intestinal Obstruction Treatment

Treatment is completely dependant on the cause of the blockage of the bowel. Normal cases of intestinal blockage can be treated by inserting a Nasogastric (NG) tube into the stomach through the nasal passage. This helps provide relief from vomiting sensations and abdominal distention. In some cases, catheter is also introduced into the bladder for carrying out Intestinal Decompression.

Patients suffering from a mechanical obstruction and not showing a good response to non-operative treatment may require surgical cure. In case of an Intestinal Obstruction surgery helps remove the blockage and restore intestinal function.

Intestinal Obstruction Complications

If left untreated, this condition may give rise to acute, life-threatening complications like

  • Kidney failure
  • Necrosis
  • Peritonitis
  • Jaundice
  • Infection
  • Electrolyte imbalance
  • Intestinal perforation

In newborn infants, Paralytic Ileus is related with Nectrotizing Enterocolitis or destruction of the bowel wall. It is a life-threatening condition that may give rise to lung and blood infections.

Intestinal Obstruction Prognosis

The outcome of this disease varies with the causative factor. Cure should differ according to the cause of the disorder. Proper method of treatment for an appropriate underlying factor can correctly cure the condition in a few days.

If you are suffering from inability to pass gas or stool, contact a professional healthcare provider immediately. Early treatment will prevent future complications and help you achieve a faster recovery from this discomforting condition.

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