Intestinal Obstruction

Overview

Intestinal obstruction is a blockage that prevents food or liquid from passing through the small intestine or large intestine (colon). This can occur due to various factors such as fibrous bands of tissue (adhesions), hernias, colon cancer, medications, or inflamed intestines caused by conditions such as Crohn's disease or diverticulitis. Intestinal obstruction can lead to serious complications if left untreated, but prompt medical care can often successfully treat it. Symptoms include crampy abdominal pain, loss of appetite, constipation, vomiting, inability to have a bowel movement or pass gas, and swelling of the abdomen.

Understanding the disease

Symptoms

The symptoms of intestinal obstruction include crampy abdominal pain that comes and goes, loss of appetite, constipation, vomiting, inability to have a bowel movement or pass gas, and swelling of the abdomen. If you experience these symptoms, it's essential to seek immediate medical care.

Risk Factors

The risk factors for developing intestinal obstruction include:

1. Age: Children, especially those between 6 months and 3 years old, are more likely to develop intussusception, a common cause of intestinal obstruction in children.
2. Sex: Intussusception is more common in boys.
3. Intestinal malrotation: This is a condition where the intestine does not develop or rotate correctly, increasing the risk of intussusception.
4. Certain conditions: Some disorders can increase the risk of intussusception, including cystic fibrosis, Henoch-Schonlein purpura (IgA vasculitis), Crohn's disease, and celiac disease. For adults, the most common causes of intestinal obstruction are intestinal adhesions (fibrous bands of tissue in the abdomen), hernias, and colon cancer. Other possible causes include inflammatory bowel diseases such as Crohn's disease and diverticulitis, an infection or inflammation of diverticula in the digestive tract.

Development

Intestinal obstruction develops when there is a blockage that prevents food or liquid from passing through the small intestine or large intestine. There are several possible causes, including:

1. Fibrous bands of tissue (adhesions): These can form after surgery, causing a blockage.
2. Hernias: A part of the intestine can protrude through a weak spot in the abdominal wall, causing an obstruction.
3. Colon cancer: A blockage can occur due to a tumor in the colon.
4. Certain medications: Some medications, such as opioids, can affect muscle and nerve function, leading to paralytic ileus.
5. Strictures: Narrowing of the intestine due to inflammation caused by conditions like Crohn's disease or diverticulitis.
6. Intestinal pseudo-obstruction: In this case, muscle or nerve problems disrupt the normal contractions of the intestines, causing a blockage without a physical obstruction. Intussusception is another type of intestinal obstruction that occurs when one segment of the intestine slides into another, forming a telescope-like structure. This is more common in children and can be caused by various factors, including irregular intestinal formation at birth, certain conditions like cystic fibrosis or Crohn's disease, and infections.

Assessment and Diagnosis

Triage

Seek immediate medical care if you have severe abdominal pain or other symptoms of intestinal obstruction. Intestinal obstruction can lead to serious complications if left untreated, so prompt medical attention is crucial.

Diagnosis

Intestinal obstruction can be diagnosed using a combination of physical examination, imaging tests, and occasionally, diagnostic procedures. For a physical examination, the doctor will ask about your medical history and symptoms, perform an abdominal examination, and may listen for bowel sounds with a stethoscope. Imaging tests such as abdominal X-rays, computed tomography (CT) scans, and ultrasound can help confirm a diagnosis of intestinal obstruction. In children, ultrasound is often preferred. Air or barium enemas may also be performed for enhanced imaging of the colon. In some cases, a barium or air enema may be used as a diagnostic and treatment procedure for children with intussusception.

Management and Treatment

Complications

The potential complications of intestinal obstruction include tissue death, infection, and peritonitis. Untreated, intestinal obstruction can cause the blocked parts of the intestine to die due to lack of blood supply, leading to a tear in the intestinal wall and infection. Peritonitis, a life-threatening condition, refers to infection in the abdominal cavity and requires immediate medical attention, often involving surgical intervention.

Home Remedies

It is important to seek prompt medical care if you are experiencing symptoms of intestinal obstruction as it can lead to serious complications. Home remedies are not recommended for this condition, as it requires professional medical attention to properly diagnose and treat the underlying cause.

Treatment

Treatment for intestinal obstruction depends on the underlying cause and severity of the blockage. Prompt medical care is crucial to prevent serious complications. Here are some common treatment options for intestinal obstruction:

1. Surgery: In many cases, surgery is necessary to remove the blockage and restore normal intestinal function. The type of surgery performed depends on the cause of the obstruction, as well as the location and severity of the blockage.
2. Fluid and Electrolyte Management: In some cases, intestinal obstruction may cause dehydration due to inability to pass fluids. In such cases, intravenous (IV) fluids may be given to prevent dehydration and maintain electrolyte balance.
3. Medications: Certain medications may be prescribed to alleviate symptoms, manage pain, or treat underlying conditions causing the obstruction. For example, antibiotics may be given to treat infections associated with the obstruction.
4. Nasogastric or Nasoduodenal Tube Insertion: In some cases, a tube may be inserted through the nose or mouth into the stomach or small intestine to relieve obstruction-related symptoms, such as nausea, vomiting, or abdominal distension.
5. Bowel Rest: In some cases, medical professionals may recommend bowel rest to allow the intestine to recover from the obstruction. This may involve not eating or drinking anything for a period of time, typically under medical supervision. It is important to note that the specific treatment approach may vary depending on the individual case and underlying causes. Consult a healthcare professional for personalized advice and treatment recommendations.

Preparing for medical consultation

Preparing for an appointment for intestinal obstruction is similar to preparing for appointments related to other digestive conditions. Here are some steps you can take to prepare for the appointment:

1. Make an appointment with your primary health care provider or a specialist, such as a gastroenterologist, who specializes in treating digestive conditions.
2. Gather information about your symptoms, including when they started, their severity, and any related symptoms.
3. Prepare a list of personal information, such as major stresses, recent life changes, family medical history, and any known liver disease in your family.
4. Bring a family member or friend along for support and to help remember the information provided during the appointment.
5. Avoid consuming foods that may worsen your symptoms, such as spicy, fatty, or fried foods. Remember to ask any questions you may have during the appointment, and don't hesitate to discuss any concerns or fears you may have regarding your condition.