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Bowel Obstruction: Symptoms, Causes & Treatment

What are the symptoms of bowel obstruction?

The symptoms of a bowel obstruction can vary depending on the type and location of the obstruction, but some common symptoms include:

  1. Severe abdominal pain – This is often one of the first and most prominent symptoms. The pain may come in waves and can be cramping or colicky.
  2. Vomiting – Persistent vomiting, especially if it becomes green or fecal-smelling, can indicate a complete obstruction.
  3. Inability to pass gas – An obstructed bowel prevents the passage of flatus (gas) as well as stool.
  4. Constipation – There is difficulty having a bowel movement or no bowel movements at all when the obstruction is complete.
  5. Bloating and abdominal distension – As gas and fluids accumulate, the abdomen becomes swollen and distended.
  6. Loss of appetite – Due to the bowel obstruction and vomiting.
  7. Dehydration – From persistent vomiting and inability to consume liquids.

Other potential symptoms:

  • Nausea
  • Loud bowel sounds initially, then absence of bowel sounds
  • Fever (indicating perforation or peritonitis)
  • Passing little amounts of diarrhea initially (partial obstruction)

The severity depends on whether it’s a partial or complete obstruction. Prompt medical attention is necessary, as a complete bowel obstruction cuts off blood supply and can lead to tissue death, tears, and life-threatening complications if not relieved.

What are the causes of bowel obstruction?

There are several potential causes of bowel obstruction, which can occur in the small or large intestine. Some of the main causes include:

1. Adhesions or scar tissue – Adhesions from previous abdominal or pelvic surgery can cause the intestines to become kinked or twisted, obstructing the passage of contents.

2. Hernias – Intestinal hernias, such as inguinal, femoral or incisional hernias, can become strangulated and obstruct the bowel.

3. Inflammatory bowel diseases – Conditions like Crohn’s disease or diverticulitis can cause inflammation and narrowing of the intestines.

4. Intestinal tumors or cancers – Growths in the intestines can physically block the lumen.

5. Impacted feces or intestinal strictures – A narrowing of the intestine from scarring or impacted stool can prevent contents from passing through.

6. Intussusception – This is when one part of the intestine prolapses into another section, typically more common in children.

7. Volvulus – A twisted loop of intestine causing an obstruction, often involving the sigmoid colon.

8. Gallstones – Large gallstones can occasionally block the intestines after passing through a bile duct abnormality.

9. Foreign bodies – Ingested objects or masses like bezoars can mechanically obstruct intestinal flow.

10. Paralytic ileus – Lack of normal intestinal muscle contractions, sometimes after surgery or due to medications.

The obstruction can be mechanical (physical blockage) or functional (lack of normal peristalsis). The location, whether partial or complete, and the underlying cause determine the symptoms and treatment approach.

What is the treatment for bowel obstruction?

The treatment for a bowel obstruction depends on the location, cause, and severity of the obstruction. Some common treatment approaches include:

Non-Surgical Treatments:

  • Nasogastric tube decompression – A tube inserted through the nose into the stomach to remove air and fluids, relieving pressure.
  • Enemas – For some partial lower intestinal obstructions, enemas may help dislodge impacted stool or gas.
  • Medication – Intravenous fluids, antibiotics, and medications to reduce inflammation or smooth muscle spasms.
  • Observation – For partial obstructions, a period of non-operative treatment with bowel rest may be tried first.

Surgical Treatments:

  • Manual reduction of hernias – For obstructions caused by hernias, gentle manual pressure may allow the hernia contents to go back into the abdomen.
  • Adhesiolysis – Cutting adhesions or scar tissue bands causing the obstruction.
  • Resection and anastomosis – Removing the obstructed portion of intestine and reconnecting the healthy segments.
  • Stent placement – Expandable metal or plastic tubes that reopen an obstructed area.
  • Ostomy surgery – Creating an opening in the abdomen (colostomy or ileostomy) to allow intestinal contents to divert out of the body.

Surgery is generally required for complete intestinal obstructions that do not resolve with non-operative management. The type of procedure depends on the cause, location, and viability of the obstructed intestine.

Timely intervention is crucial, as delays raise the risk of complications like intestinal perforation, peritonitis, or loss of intestinal blood supply requiring more extensive surgeries.

Prevention through adhering to dietary recommendations after intestinal surgery may reduce future obstruction risks.

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About the Author: John Scott

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