Intestinal Obstruction

Types of Intestinal Obstruction:

1. Mechanical Obstruction: A physical blockage in the intestine.

   • Adhesions: Bands of scar tissue that form after surgery, causing the intestines to stick together.
   • Hernias: When a part of the intestine bulges through a weakened area in the abdominal wall.
   • Tumors: Cancerous or benign growths that block the intestines.
   • Volvulus: Twisting of a loop of the intestine, cutting off its blood supply.
   • Intussusception: When one part of the intestine slides into an adjacent part, more common in children.

2. Non-mechanical Obstruction (Paralytic Ileus): Occurs when the muscles of the intestine stop functioning correctly, preventing movement of food and waste through the intestines.

   • Paralytic Ileus: Often seen after surgery, certain medications, or infections.

Symptoms of Intestinal Obstruction:

• Severe abdominal pain: Cramping or colicky pain that may come and go.
• Bloating and abdominal distension: The abdomen may appear swollen or feel full.
• Nausea and vomiting: Often occurs, with vomiting sometimes containing bile or fecal material.
• Inability to pass gas or have a bowel movement: This may indicate a complete blockage.
• Constipation: Lack of bowel movements due to the obstruction.
• Fever: May occur if there is an infection or inflammation.

Causes of Intestinal Obstruction:

• Post-surgical adhesions: The most common cause, especially after abdominal surgeries.
• Hernias: Strangulated hernias can obstruct blood flow to parts of the intestines.
• Tumors: In both the small and large intestines.
• Inflammatory conditions: Such as Crohn’s disease or diverticulitis.
• Foreign objects: Swallowed objects or hard masses (e.g., gallstones, bezoars) can cause blockages.
• Infections: Such as gastroenteritis, can temporarily halt intestinal function.

Diagnosis of Intestinal Obstruction:

1. Physical Examination: Doctors may feel for distension, tenderness, and abnormal bowel sounds (either high-pitched or absent).
2. Imaging Tests:
   • X-ray: Can reveal dilated loops of bowel and gas accumulation.
   • CT scan: Provides more detailed images to determine the location, cause, and severity of the obstruction.
   • Ultrasound: Often used in children, particularly for diagnosing intussusception.
3. Blood Tests: To check for signs of infection, electrolyte imbalances, and kidney function.

Treatment of Intestinal Obstruction:

1. Non-surgical Treatment (for partial or functional obstructions):

   • Nasogastric Tube: A tube may be placed through the nose into the stomach to relieve pressure from gas and fluid buildup.
   • IV Fluids: To prevent dehydration and stabilize the patient.
   • Bowel Rest: No oral intake (food or fluids) to allow the bowel to decompress.
   • Medications: Drugs to stimulate bowel movement or manage pain may be administered.

2. Surgical Treatment (for complete or severe mechanical obstructions):

   • Removing the blockage: Surgery may be necessary to remove the cause of the obstruction, such as adhesions, tumors, or hernias.
   • Bowel Resection: In cases where part of the intestine has become damaged or necrotic (dead tissue), that portion may need to be surgically removed.
   • Colostomy or Ileostomy: If a large portion of the bowel is removed, the surgeon may create a stoma (an opening in the abdomen) to allow waste to leave the body through a bag temporarily or permanently.

Complications of Intestinal Obstruction:

• Strangulation: If the blood supply to part of the intestine is cut off, the tissue may die, leading to a medical emergency.
• Peritonitis: If the intestine ruptures, contents from the bowel can leak into the abdominal cavity, causing a severe infection known as peritonitis.
• Sepsis: A life-threatening condition caused by the body’s response to a severe infection.

Prevention:

• Manage hernias promptly: Seek early treatment for hernias to avoid complications.
• Post-surgical care: Proper follow-up care after abdominal surgery to monitor for signs of adhesions.
• Healthy lifestyle: A diet rich in fiber, regular exercise, and staying hydrated can help prevent certain types of obstructions like constipation-related blockages.

When to Seek Medical Attention:

Seek immediate medical attention if you experience symptoms of an intestinal obstruction, especially if you have severe abdominal pain, bloating, vomiting, or an inability to pass gas or stool. Early diagnosis and treatment are critical in preventing serious complications.

Conclusion:

Intestinal obstruction is a serious medical condition that can become life-threatening without prompt intervention. While some cases can be managed with non-surgical treatments, others may require surgery to remove the obstruction. If you suspect an obstruction, it’s important to seek medical care immediately to avoid complications like tissue death or infection.