Intestinal Obstruction – Factors, Types and Treatment

Intestinal Obstruction

Intestinal obstruction is a partial or complete blockage in either the small or large intestine, or both, resulting in the piling up of waste materials and bacteria just before the obstruction. It is life-threatening when left untreated or if it remains undiagnosed and is commonly seen in older people.

The intestines are loops of tubes, about 25 feet long, that carry undigested food, waste products, essential and non-essential bacteria for excretion. Therefore, any obstruction in this path can cause the contents to accumulate and eventually leak out.

Types of intestinal obstruction

There are three types of intestinal obstruction:

• Partial obstruction is where some part of the intestinal contents remain stuck behind the obstruction, and some move forward.
• Complete obstruction is when the obstruction completely impedes the passage of intestinal content.
• Pseudo obstruction is the most challenging type of intestinal obstruction to treat, even though there is no physical obstruction in the intestines. Also called paralytic ileus, the muscles may go into a tensed state, causing occlusion of the intestines slowing the movement of the intestinal contents or stopping them altogether.

What are the causes of intestinal obstruction?

The causes of intestinal obstruction include the following:

Mechanical causes: Any physical obstruction in the intestines is categorized under the mechanical causes of intestinal obstruction.

• Abdominal or pelvic surgery
• Tumors/cancer of the intestines
• Twisting of the intestines, also known as volvulus
• Intestinal malformations in a newborn
• Gallstones
• Abdominal and intestinal hernia
• Impacted fecal matter

Non-mechanical causes of intestinal obstruction. Sometimes, there is no physical reason for intestinal obstruction. It is known as pseudo-obstruction.

• Long-term diabetes mellitus
• Neurological issues like multiple sclerosis and Parkinson's
• Infections such as gastroenteritis or appendicitis
• Electrolyte imbalance.

What are the intestinal obstruction symptoms?

Intestinal obstruction symptoms experienced by an individual include:

• Vomiting
• Diarrhea
• Constipation
• Abdominal pain and tenderness
• Fever due to infections
• Abdominal swelling called peritonitis
• Abdominal cramps cause severe distress
• Bloating of the stomach and intestines
• Difficulty in passing gas
• Nausea
• Reduced appetite and weight loss

How is intestinal obstruction diagnosed?

Intestinal obstruction is diagnosed with the help of certain tests:

• Physical examination: The doctor will examine the patient for abdominal tenderness, swelling and location of symptoms
• Blood tests: A blood test helps determine the blood count, electrolyte imbalance, and kidney and liver function
• Colonoscopy: Colonoscopy involves screening the intestines for obstruction or any other disease/disorder with the help of a scope (camera) and is helpful for intestinal obstruction treatment
• X-rays
• CT scan
• A contrast enema: To observe abnormalities in the intestines

What are the possible risks and complications related to intestinal obstruction?

Risks of intestinal obstruction:

• Adhesions can form in the intestines and surrounding areas due to past abdominal surgery.
• Cancer in any part of the abdomen.
• Crohn's disease can cause the walls of the intestines to narrow, causing occlusion.

Complications:

• Dehydration
• Electrolyte imbalance
• Kidney or multiple organ failure
• Intestinal perforation (leakage)
• Tissue necrosis
• Infection that can lead to a life-threatening septic infection
• Death due to multiple organ failure

What are the treatment options for intestinal obstruction?

Intestinal obstruction treatment requires hospitalization. It may be an emergency, so the individual needs to be stabilized first.

• Stabilization: The first step is to reverse dehydration with IV fluids. Any heart, lung, or other organ dysfunction is taken care of to stabilize the individual.
• Fiber-based diet: Partial obstruction is treated with a fiber-based diet after stabilization.
• Surgery: Complete obstruction and some cases of pseudo-obstruction are treated with intestinal surgery. A stent is placed in an emergency to help open up the blocked intestinal segment. The contents are then easily flushed out to ease symptoms. After this primary surgery, another surgery may be done to treat the cause of the obstruction based on the diagnosis.

When to see the doctor?

It is advisable to consult a doctor when experiencing abdominal bloating, pain and tenderness, severe vomiting and constipation, and reduced appetite.

How do you prevent intestinal obstruction?

Intestinal obstruction is a medical emergency and can lead to life-threatening infections. Therefore, prevention is vital.

• After any type of abdominal surgery, further care must be taken to prevent adhesions and ensure proper hygiene to prevent infection.
• A fiber-rich diet allows the smooth passage of waste materials within the intestines.

What is the prognosis for people who have an intestinal obstruction?

Individuals with intestinal obstruction need to monitor their diet, symptoms and any warning signs of an impending obstruction. Most cases are expected to recover, except for cancers, which require long-term rehabilitation.

Conclusion

Intestinal obstruction is the occlusion of waste materials and fluids' passage through the intestines. It is a life-threatening emergency medical condition that requires stabilization and further treatment. Prevention, including good abdominal care and a fiber-rich diet, is key to avoiding complications after abdominal surgery.

Frequently Asked Questions (FAQs)

1. How long will an intestinal obstruction last?

It usually takes between three days and three weeks for complete recovery from intestinal obstruction or longer in cases of cancers. It also depends on the types of intestinal obstruction.

2. What triggers intestinal blockage?

Previous abdominal surgery, infections and cancers may cause adhesions and mass formations in the intestinal walls that can trigger an intestinal blockage.

3. What questions should I ask my healthcare provider?

One should ask what the possible complications of intestinal obstruction treatment and surgery are and how to prevent future episodes.

4. How do you know if your bowel obstruction is cleared?

A symptom-free state and regular passage of gas and fecal matter through the intestines, outside the body with good vitals, may be prime indicators of a clear bowel.

5. How do you clear a bowel obstruction without surgery?

An enema helps flush out the intestines and pass gas and waste materials. A fiber-rich diet is of utmost importance to ensure proper bowel movements and intestinal obstruction treatment.

6. What tests are prescribed by the doctors for the diagnosis of intestinal obstruction?

The tests for diagnosing intestinal obstruction include a physical examination by the doctor, blood test, X-ray guided contrast enema, colonoscopy and CT scan.

7. What are the reasons for the occurrence of intestinal obstruction?

The primary reason is the history of abdominal surgery and cancer in the abdomen causing intestinal obstruction symptoms. It can also be due to injury or weakness of muscles and nerves of the intestines, causing the intestinal walls to shrink.

8. Is computed tomography effective for the examination of intestinal obstruction?

Yes. A computed tomography (CT) scan helps the doctor examine the intestines for any obstruction and is a guide for intestinal obstruction treatment.