Intestinal Obstruction

What is intestinal obstruction?

During normal digestion, digested food particles travel through around 7.5 metres of your intestines. These digested waste are in constant motion. However, if intestinal obstruction occurs, your small or large intestine is blocked. The blockage may be partial or full and this prevents the passage or fluids and digested food down your digestive system. Fluids, gastric acids, food and gas build up behind the place where the blockage occurs. If the buildup causes enough pressure, there is a possibility that your intestine ruptures. Toxic contents in your intestine and bacteria leaks into your abdominal cavity and this condition is life-threatening.

In many cases, this condition cannot be prevented. An untreated intestinal obstruction may be fatal and early diagnosis and prompt treatment is crucial.

What causes intestinal obstruction?

Intestinal obstruction may be caused by mechanical causes or non-mechanical causes.

Mechanical causes of intestinal obstruction occur when a physical thing blocks your intestine.

In the small and large intestine, some causes are:

  • Scar tissue or adhesions which may occur after abdominal of pelvic surgery or severe inflammation
  • Tumour(s) in your intestine
  • Hernias
  • Inflammatory bowel disease e.g. Crohn’s disease
  • Hernias
  • Impacted stools
  • Volvulus, which means twisting of your intestines
  • Intussusception, which means telescoping of your intestines
  • Foreign substances that are swallowed
  • Diverticulitis
  • Gallstones

Non-mechanical causes of intestinal obstruction occur when there is an interruption in the coordinated system of movement in your small and large intestine. This may cause a functional intestinal obstruction. It is known as paralytic ileum or pseudo obstruction.

Some common causes are:

  • Infections such as appendicitis and gastroenteritis
  • Abdominal or pelvic surgery
  • Electrolyte imbalances
  • Use of certain medications such as opioid pain medications or narcotics
  • Muscle and nerve diseases such as Parkinson’s disease and multiple sclerosis
  • Kidney or lung diseases

What are the symptoms of intestinal obstruction?

Common signs and symptoms include:

  • Cramping and severe abdominal pain
  • Constipation and/or diarrhoea
  • Nausea and/or vomiting
  • Loss of appetite
  • Severe abdominal swelling
  • Inability to pass gas or have bowel movement

Do consult a doctor immediately should you experience any of the above symptoms.

How is intestinal obstruction diagnosed?

Your doctor will first perform a physical examination where he or she gently pushes your abdomen to examine it for bloating, tenderness or hernias. A stethoscope is used to test if there is any sound produced. Some particular types of sound may indicate a hard lump or if an obstruction is present in your system.

You may be scheduled for further tests such as blood tests to check your blood count, liver and kidney functioning and levels of electrolytes. Imaging tests such as X-ray, CT scan, barium enema and colonoscopy may be recommended. These provide a clear picture of your intestines and internal organs for your doctor to make a more accurate diagnosis and pick the best treatment option for your condition.

What are the possible complications of intestinal obstruction?

If left untreated, intestinal obstruction may lead to electrolyte imbalances, dehydration, perforation(a hole) in your intestine that leads to infection and jaundice.

If the intestinal obstruction cuts off blood supply to a segment of tissue, this may result in tissue death and infection. Tissue death occurs as the lack of blood causes your intestinal wall to die. A tear in your intestines may lead to infection in your abdominal cavity, which is known as peritonitis. Peritonitis is an emergency medical condition which often requires urgent surgical treatment.

Why surgery for intestinal obstruction?

Surgery is necessary especially in cases of complete obstruction, where no food or fluid is able to pass through your intestine. Depending on the cause of the obstruction and which part of your intestine is affected, surgery will remove the blockage and any dead tissue of your intestine. After the surgery, a colostomy or ileostomy may be required to sew the remaining portion of your intestine to an opening in the skin after the diseased portion has been removed. These may be temporary methods to collect stool in the colostomy bag. When you have recovered, the ends of your intestines are rejoined to each other and the bag is removed.

Treatment may involve inserting a metal tube through your nose and into your stomach, intestine. This will help to relieve abdominal pressure, swelling and vomiting. Volvulus of the large bowel maybe treated by passing a tube into your rectum. This forces open the rectum so that the obstruction can clear.

Surgery is highly recommended to prevent the risks and complications mentioned above, especially if the symptoms still persist after the tube has been inserted.

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