Bowel obstruction

An Overview

In a bowel obstruction (intestinal obstruction), a blockage prevents the contents of the intestines from passing normally through the digestive tract. The problem causing the blockage can be inside or outside the intestine. Inside the intestine, a tumor or swelling can fill and block the inside passageway of the intestine. Outside the intestine, it is possible for an adjacent organ or area of tissue to pinch, compress or twist a segment of bowel. A bowel obstruction is a serious problem that happens when something blocks your bowels, either your large or small intestine. It’s also known as an intestinal obstruction.

If your digestive system comes to a grinding halt, you can’t have a bowel movement or pass gas. You might also notice stomach pain and a swollen belly. A complete bowel obstruction can be a dangerous condition that can lead to dehydration, kidney failure tears in the intestinal walls, which can cause abdominal infections, and death of parts of the intestines.

Symptoms for Bowel obstruction

Signs of an intestinal blockage will depend on how severe the obstruction is. But it almost always comes with belly pain, usually around your belly button, and cramping. Other signs include:

  • Constipation.
  • Cramping abdominal pain, generally coming in intense waves that strike at intervals of five to 15 minutes and sometimes center either on the navel or between the navel and rib cage (Pain that becomes constant may be a symptom of bowel strangulation).
  • Can’t pass gas.
  • Cramping.
  • Decreased appetite.
  • Lack of appetite.
  • Rumbling bowel noises (borborygmus).
  • Abdominal tenderness/belly pain.
  • Severe pain.
  • Swollen belly.
  • No gas passing through the rectum.
  • A bloated abdomen, sometimes with abdominal tenderness.
  • Rapid pulse and rapid breathing during episodes of cramps.
  • Nausea or vomiting.
  • A hard, swollen belly.
  • Diarrhea (with a partial blockage).
  • Feeling unwell (malaise).
  • Inability to have a complete bowel movement.
  • Cramps and pain in the lower abdomen especially on the left side.
  • Lower abdominal distention

Vomiting and diarrhea are early signs of bowel obstruction. Recognizing these symptoms means that a person can seek treatment before the condition progresses.

Causes of Bowel Obstruction

There are many possible causes of bowel obstruction. The different causes are either mechanical or non-mechanical. Mechanical obstructions are physical barriers that prevent or restrict the flow of matter through the bowels. These include:

  • Adhesion or tissue that can develop after abdominal or pelvic surgery.
  • Abnormal intestinal physiology.
  • Prior abdominal surgery.
  • Scar tissue or a hernia could make your bowel too narrow for anything to pass through.
  • impacted stools.
  • infection.
  • Congenital Tiresias (a birth defect that involves absence or narrowing of parts of intestines).
  • Pyloric steno sis (narrowing of the opening from the stomach into the intestine that prevents food from entering the intestine).
  • Sigmoid volvulus.
  • Fecal impaction from chronic constipation.
  • Twisting of the colon, called volvulus (often seen in infants and toddlers).
  • A swallowed foreign object.
  • Ogilvie’s Syndrome.
  • Gallstone ileus.
  • Paralytic ileus doesn’t involve a physical blockage but can cause signs and symptoms similar to obstruction.
  • Hirschsprung’s disease (a birth defect in which a nerve cells are missing from parts of the intestines).
  • A  tumor or other type of growth inside your bowel could block it.
  • Inflammatory bowel diseases (IBDs).
  • Damaged blood vessels leading to the bowel can cause some bowel tissue to die.
  • A foreign object, if swallowed.
  • Gall stones though this is a rarer cause of obstruction.
  • Hernias.
  • Part of your bowel may get twisted, which can close it off and keep anything from passing through.
  • It can get inflamed and swell up.
  • Intussusception, which is when a segment of the bowel pushes into the next segment, making it collapse.
  • Meconium plug, which is the first stool that newborns pass.
  • Tumors.
  • A twisted bowel.

Diagnosis

Diagnosis tends to begin with a physical examination. An obstruction can cause a hard lump in the abdomen, which a doctor may be able to feel. The doctor will also ask questions and look at a person’s medical history.

Depending on individual cases, a doctor may recommend further tests. These can include:

  • Blood tests to check levels of electrolytes, liver and kidney function, and blood counts.
  • Endoscopy in which a doctor uses a special camera to look inside the gut.
  • CT scan.
  • X-rays.
  • Give you a barium enema. They’ll put a special liquid that contains barium (a whitish-silver metal) into your rectum. It will spread into your bowels and show on an X-ray as a bright area. If there’s a blockage, the barium may show it.
  • Urine test.

Prevention

  • To help prevent colorectal cancer, eat a balanced diet low in fat with plenty of vegetables and fruits, don’t smoke, and see your doctor for colorectal cancer screening once a year after age 50.
  • To help prevent hernias, avoid heavy lifting, which increases pressure inside the abdomen and may force a section of intestine to protrude through a vulnerable area of your abdominal wall. If you develop an
  • Abnormal lump under the skin of your abdomen, especially near your groin or near a surgical scar, contact your doctor.
  • Eating smaller portions more often.
  • Chewing food well.
  • Avoiding large amounts of high-fiber foods, such as wholegrain cereals and nuts.
  • Putting down on caffeine, which can irritate the bowel.
  • Nasogastric tube. This is a narrow tube that goes up the nose and into the stomach. It removes fluid and gas trapped in the stomach, relieving pressure. This eases pain and vomiting.
  • Surgery. Surgeons can remove blocked or damaged sections of the bowel. In cases of IBDs, a strictureplasty may be necessary. Here, a surgeon will widen a narrowed section of bowel by cutting and sewing. A mesh tube called a stent is a safe option for people who are too sick for surgery.

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