What is Intestinal Obstruction?
Digested food particles must travel through 25 feet of intestines or more before new wastes enter your body. These wastes are constantly in motion; however, an intestinal obstruction can block the passage of fluid or digested food. An intestinal obstruction occurs when your small or large intestine is partially or totally blocked. If intestinal obstruction happens, food, fluids, gastric acids, and gas build up behind the site of the blockage. If enough pressure builds up, the intestine can rupture. This causes a leak of harmful stomach contents into your abdominal cavity.
There are many potential causes of intestinal obstruction. In many cases, this condition can’t be prevented. Early diagnosis and treatment are crucial. An untreated intestinal obstruction can be fatal.
Symptoms of Intestinal Obstruction
Intestinal obstruction causes a wide range of uncomfortable symptoms, including:
- Severe bloating
- Abdominal pain
- Decreased appetite
- Severe abdominal cramps
- Abdominal swelling
Some of the symptoms may depend on the location of the obstruction. For example, vomiting is an early sign of small intestine obstruction. This tends to happen after a longer amount of time if you have an obstruction in the large intestine. A partial obstruction can result in diarrhoea, while a complete obstruction results in constipation. Intestinal obstruction may also cause a high fever if a portion of the intestinal wall has ruptured.
Causes of Intestinal Obstruction
Intestinal obstructions are either the result of something blocking part of the intestine (mechanical obstruction) or a failure of the intestine to work properly (paralytic ileus). There are a variety of causes of intestinal obstruction:
- A strangulated hernia, which happens when part of your small intestine protrudes through your abdominal wall; 10 to 20% of small bowel obstructions are due to this and it can cause gangrene to quickly develop in the colon
- An inflammatory disease, like Crohn’s disease, in which swelling and scar tissue cause narrowing of your intestine
- Adhesions or scar tissue from previous abdominal surgery
- Colon cancer in which the tumour blocks the intestine
- Severe constipation from Parkinson’s disease, which leads to impacted bowel
- Gallstones, which can press against your intestine and block the flow of its contents
- Volvulus, which is a twist or knot in your intestine
- Intussusception, which occurs when one section of your intestine collapses into another
- Ingesting foreign objects, which is rare
- Paralytic ileus, which is a condition that often happens after abdominal surgery in which your intestine temporarily ceases contracting and moving its contents along
Intestinal Obstruction in Infants
Intestinal obstruction in infants typically arises from infections, organ diseases, and decreased blood flow to the intestines (strangulation). Some children experience the condition after having stomach flu which can cause inflammation in the intestines.
Intussusception is the most common abdominal emergency in children 2 years old and younger. This occurs when one part of the bowel collapses or slides into another part. As a result, the intestine is blocked.
Any type of intestinal obstruction is difficult to diagnose in infants because they cannot describe their symptoms. Instead, parents must observe their children for changes and symptoms that could indicate a blockage. Examples include:
- Abdominal swelling
- Child draws knees up to his or her chest
- Grunting in pain
- Passing stools that appear to have blood in them, known as a currant jelly stool
- Very loud cry
- Vomiting, particularly bile-like vomiting that is yellow-green
If you notice these symptoms or other changes in your child, seek medical attention. An intestinal obstruction is a medical emergency. Usually when a child gets treatment within 24 hours from start of symptoms, they make a full recovery.
When to see a Doctor
An intestinal obstruction is always considered a medical emergency even if hasn’t erupted, and requires prompt medical treatment. Seek emergency medical care if you have symptoms of an intestinal obstruction, especially if you have recently undergone abdominal surgery. If you experience abdominal bloating, severe constipation and a loss of appetite, seek immediate medical attention.
Diagnosis of Intestinal Obstruction
First, your doctor will ask about your medical history and perform a physical exam. He might be able to detect the obstruction by listening to your abdominal area with a stethoscope. Your doctor may also notice that your abdomen is extremely swollen or that there’s a lump in the area.
Your doctor will use CT scans and X-rays of your abdomen to locate the site of your obstruction and to determine its cause. If the obstruction is in your large intestine, your doctor may perform a colonoscopy (a flexible, lighted viewing tube) to look at your intestine. X-rays may be taken after you’ve been given an enema that uses barium or a dye called Hypaque to provide contrast. This helps to provide a clear image of your colon.
Treating Intestinal Obstruction
The appropriate treatment depends on the type of intestinal obstruction. Initially, a flexible tube may be passed through your nose or mouth to remove fluid and gas. This will relieve your abdominal swelling.
Most intestinal obstructions require surgery. You will be given fluids intravenously for as many as six to eight hours. Intravenous (IV) fluids relieve dehydration by restoring your electrolyte levels and help prevent shock during surgery. This therapy is typically given in a hospital or other certified healthcare facility.
If the tissue in the affected part of your intestine has died, your surgeon will perform a resection to remove the dead tissue and join the two healthy ends of the intestine.
While prescription medications cannot treat the obstruction itself, they can help reduce your nausea until further interventions are performed. Examples of medications your doctor may prescribe include:
- Antibiotics to reduce infection
- Anti-emetics to keep you from vomiting
- Pain relievers
You should not ignore the symptoms of an intestinal obstruction or attempt to treat an intestinal obstruction at home.
Outlook for Intestinal Obstruction
When left untreated, intestinal obstruction can cause the tissue in the affected part of your intestine to die. This can lead to a hole, or perforation, in the wall of the intestine, severe infection, and shock. Overall, the outlook of your condition depends on its cause. While most cases of intestinal obstruction are treatable, other causes, such as cancer, require long-term treatment and monitoring.