Obstruction of bowel (intestinal obstruction)

Abdomen | Gastroenterology | Obstruction of bowel (intestinal obstruction) (Disease)


Description

An intestinal obstruction is a partial or complete blockage of the small or large intestine that results in failure of intestinal contents to pass normally through the bowel. It can occur anywhere in the intestinal tract and can be mechanical or nonmechanical. A mechanical cause physically blocks the movement of material through the intestines.

Depending on the level of obstruction, bowel obstruction can present with abdominal pain, abdominal distension, vomiting, fecal vomiting, and constipation.

Causes and Risk factors

Mechanical blockage may be caused by scar tissue from prior surgery (adhesions), benign or malign tumors(e. g. , lipomas, large polyps, colorectal cancer), weakness in the abdominal wall that may trap a portion of small intestine (abdominal hernia), a swallowed foreign body, a gallstone (that migrated into the intestine), a bolus of undigested food, telescoping of the intestines (intussusception), twisting of the intestines (volvulus), narrowing of a portion of the intestines (stricture), or small, balloon-shaped pouches on the intestinal wall (diverticula). Nonmechanical causes stem from certain intestinal conditions, such as a disruption of the normal propelling motion (peristalsis) of muscles of the intestinal wall (dysmotility syndrome or pseudo-obstruction) or paralysis of the bowel wall (paralytic ileus).

Bowel obstruction may be complicated by dehydration and electrolyte abnormalities due to vomiting; respiratory compromise from pressure on the diaphragm by a distended abdomen, or aspiration of vomitus; bowel ischaemia or perforation from prolonged distension or pressure from a foreign body.

Diagnosis and Treatment

Your doctor will ask you questions about your symptoms and other digestive problems youve had. He or she will check your belly for tenderness and bloating.

An abdominal X-ray, which can find blockages in the small and large intestines. A CT scan of the belly, which helps your doctor see whether the blockage is partial or complete.

Most bowel obstructions are treated in the hospital.

In the hospital, your doctor will give you medicine and fluids through a vein (IV). To help you stay comfortable, your doctor may place a tiny tube called a nasogastric (NG) tube through your nose and down into your stomach. The tube removes fluids and gas and helps relieve pain and pressure. You will not be given anything to eat or drink.

Most bowel obstructions are partial blockages that get better on their own. Some people may need more treatment. These treatments include using liquids or air (enemas) or small mesh tubes (stents) to open up the blockage.

Surgery is almost always needed when the intestine is completely blocked or when the blood supply is cut off. You may need a colostomy or an ileostomy after surgery. The diseased part of the intestine is removed, and the remaining...