Bowel Obstruction

Overview

Bowel obstruction, or intestinal obstruction, is a medical condition where the normal flow of digested food and liquids through the gastrointestinal tract is partially or wholly blocked. This blockage can occur at various points in the digestive system, and it can be a severe medical emergency requiring prompt treatment.

Bowel obstruction is a medical condition characterized by the partial or complete blockage of the digestive tract. It can result from various causes, including adhesions, hernias, and tumours. Symptoms may include abdominal pain, distention, nausea, vomiting, and changes in bowel movements. Prompt medical evaluation and treatment are crucial, as severe cases may require surgery.

Causes

Bowel obstructions can be caused by a variety of factors, including:

• Adhesions: Scar tissue from previous abdominal surgery or injury can lead to adhesions that constrict or twist the intestines.
• Hernias: Certain types of hernias can trap a section of the intestine, leading to obstruction.
• Tumors: Benign and malignant tumours can block the intestines as they grow.
• Intussusception: This condition occurs when one section of the intestine slides into another, similar to how a telescope collapses.
• Volvulus: Volvulus is a condition where the intestine twists upon itself, causing a blockage.
• Impacted stool: Severe constipation or a large, hard stool mass can obstruct the bowel.
• Inflammatory bowel disease: Conditions like Crohn’s disease can cause inflammation and scarring that leads to obstruction.
• Strictures: Narrowing the intestine due to scarring or inflammation can result in a partial blockage.

Symptoms

The bowel obstruction symptoms can vary depending on the location and severity of the blockage. Common symptoms include:

• Abdominal pain: This is often a cramp and may come and go.
• Abdominal distention: The abdomen can become swollen and firm.
• Nausea and vomiting: As the blockage worsens, vomiting may occur.
• Inability to pass gas or have a bowel movement: Constipation or complete absence of bowel movements.
• Diarrhea: Sometimes, liquid stool may leak around the blockage.
• Bowel sounds: Increased bowel sounds may be heard initially, but they may become quiet as the obstruction progresses.

Diagnosis

To diagnose a bowel obstruction, a healthcare provider may use a combination of the following tests and assessments:

• Physical Examination: The healthcare provider will examine your abdomen for tenderness, enlargement, and bowel sounds.
• Imaging: X-rays, CT scans, or other imaging studies can help visualize the location and severity of the obstruction.
• Blood Tests: Blood tests can reveal signs of infection, dehydration, and electrolyte imbalances.
• Barium Enema: In some cases, a contrast material (barium) may be used to highlight the area of obstruction during an X-ray.

Treatment

The bowel obstruction treatment depends on its cause and severity. In mild cases, treatment may be non-surgical and involve measures like fasting, intravenous fluids, and the use of a nasogastric tube to decompress the intestine. More severe issues, especially those caused by a complete blockage, often require surgical intervention. Surgery may involve the removal of the obstruction, repair of hernias, resection of damaged bowel, or removal of tumors.

When To See A Doctor

If you experience symptoms of bowel obstruction, it is essential to seek medical attention promptly, especially if you have severe abdominal pain, vomiting, or the inability to pass gas or stool. Bowel obstructions can lead to severe complications if not treated on time. Contact your primary care physician or go to the emergency room if you suspect a bowel obstruction.

Summary 

Bowel obstruction, or intestinal obstruction, occurs when the normal movement of food and fluids through the digestive tract is partially or completely blocked. This condition can affect different parts of the intestines and requires prompt medical attention. Each year, approximately 300,000 hospital admissions in the U.S. are attributed to bowel obstructions, with about 20% of emergency abdominal surgeries related to this condition.

The causes of bowel obstruction include adhesions from previous surgeries (the most common cause, accounting for 65-75% of cases), hernias, tumors, impacted stool, and conditions like inflammatory bowel disease. Intestinal blockages can also occur due to rare conditions such as intussusception (primarily in children) and volvulus, where the intestine twists on itself.

Common symptoms of bowel obstruction include abdominal pain that often comes in waves, bloating or distention, nausea, vomiting, and an inability to pass gas or have a bowel movement. In some cases, diarrhea may occur as liquid stool leaks around the blockage. Initially, increased bowel sounds may be heard, but they may diminish as the obstruction worsens.

Diagnosis typically involves a physical examination, imaging studies such as X-rays or CT scans, and blood tests to assess dehydration or infection. In certain cases, a barium enema may be used to help visualize the blockage on an X-ray.

Treatment depends on the severity and cause of the obstruction. Non-surgical options include fasting, intravenous fluids, and the insertion of a nasogastric tube to relieve pressure in the intestines. However, 35-80% of patients may require surgery, especially if the obstruction is complete or caused by a tumor, twisted bowel, or hernia.

It is crucial to seek medical care immediately if you experience symptoms of bowel obstruction, particularly if you have severe abdominal pain, vomiting, or inability to pass gas. Untreated bowel obstruction can lead to serious complications, including bowel perforation, sepsis, and death. 

-Disclaimer-

This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about bowel obstruction or any other medical condition, please see a doctor for an accurate diagnosis and personalized treatment suggestions.