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When a normal digestive process occurs, the digested food particles must travel through 762 centimeters or more of the intestines.
These digested wastes are kept in constant motion during the usual digestion process. However, intestinal obstruction can interrupt this process.
This occurs when your small or large intestine is blocked and prevents the passage of liquids and digested foods and may occur wholly or partially.
If an intestinal obstruction occurs, food, liquids, gastric acids, and gases accumulate behind the site of the blockage.
The pressure accumulated in this section can result in the waste and bacteria found in the abdominal cavity rupturing the intestinal membrane or leakage, causing a complication that could be fatal.
There are many potential causes of intestinal obstruction. Often, this condition can not be prevented. Early diagnosis and treatment are decisive since an untreated intestinal obstruction can be fatal.
symptom
Intestinal obstruction can manifest itself through the following symptoms:
• Abdominal pain
• Decreased appetite
• Nausea
• Vomiting
• Impossibility of bowel movements or evacuation of gas
• Constipation
• Diarrhea
• Severe abdominal cramps
• Abdominal swelling
Some of these symptoms will depend on the location and time of the obstruction. For example, vomiting is an early sign of small bowel obstruction.
A partial obstruction can cause diarrhea, while a complete block can cause the inability to expel gas or feces.
Intestinal obstruction can also cause infection and inflammation of the abdominal cavity, better known as Peritonitis.
This occurs when a part of the intestine has ruptured, presenting fever and an increase in abdominal pain.
This condition is life-threatening and requires emergency surgery.
Causes of intestinal obstruction
Mechanical obstructions:
When they occur in the small intestine, it can be due to:
• Adhesions, which consist of the development of fibrous tissue due to any abdominal or pelvic surgery or after a severe inflammation
• Volvulus due to torsion of the intestines
• Intussusception, an intussusception of a segment of the intestine in the next section
• Malformations of the intestine, often in newborns, but can also occur in children and adolescents
• Tumors within your small intestine
• Gallstones, although they rarely cause obstructions
• Ingested objects, especially in children
• Hernias
• Inflammatory bowel disease, such as Crohn’s disease
Although uncommon, mechanical obstructions can also block the colon or large intestine and can be caused by:
• Impacted stools
• Adhesions of pelvic infections or surgeries
• Ovarian
cancer • Colon cancer
• Obstruction due to abnormally dense and adherent meconium
• Volvulus and intussusception
• Diverticulitis due to inflammation or infection of bowel bags or diverticula
• Intestinal stenosis, narrowing in the colon caused by scars or inflammation
Non-mechanical obstruction
Your bowels usually work as a coordinated system of movement.
If something interrupts these coordinated contractions, it can cause a functional bowel obstruction, generally known as a non-mechanical obstruction.
If it is a temporary condition, it is known as ileus and can be caused by:
• Abdominal or pelvic surgery
• Infections, such as gastroenteritis or appendicitis
• Effects of some medications, including opioid analgesics
• Electrolyte imbalances
If it is permanent, it is known as intestinal pseudo-obstruction and can be caused by:
• Parkinson’s disease, multiple sclerosis, and other nervous and muscular disorders
• Hirschsprung’s disease, a disorder in which nerves are absent in sections of the large intestine
• Disorders that cause nerve damage, such as diabetes mellitus
• Hypothyroidism, the underactive gland thyroid
Bowel obstruction in babies
Intestinal obstruction in babies typically arises from infections, organic diseases, and decreased blood flow to the intestines (strangulation).
Intussusception is common in children two years old and younger. This occurs when a part of the intestine collapses or slips to another position.
As a result, intestinal blockage occurs.
Any intestinal obstruction is challenging to diagnose for babies because they can not describe their symptoms.
So parents should watch their children for changes and symptoms that could indicate the presence of a blockage, such as:
• Abdominal swelling
• Bringing the knees to your chest
• Somnolence
• Fever
• Grunting of pain
• Stools that appear to have blood in them, known as currant jelly feces
• Very loud
crying • Vomiting, particularly yellow-greenish bile vomiting
• Show Signs of weakness
If you notice these symptoms or other changes in your child, seek immediate medical attention.
How is intestinal obstruction diagnosed?
First, the doctor presses the abdomen to feel or discard the presence of a lump. Then with the help of a stethoscope, he listens to the particular sounds to determine if there is an obstruction.
And finally, perform other tests to perform your diagnosis, such as:
• Blood tests for blood counts, liver and kidney function, and electrolyte levels
• X-rays
• Tomography
• Colonoscopy: scan performed through a flexible tube with a camera inserted through the large intestine
• Enema with contrast
Possible complications
Without proper treatment, complications such as:
• Dehydration
• Electrolyte imbalances
• Perforation, or a hole that forms in your intestines, which leads to infections
• Kidney failure
On the other hand, if the obstruction prevents the blood from reaching a segment of the intestine, this may trigger:
• Infection
• Tissue death
• Intestinal perforation
• Sepsis, a life-threatening blood infection
• Multiple organ failure
• Death
Treatment of intestinal obstruction
The treatment for intestinal obstruction depends on the location and severity.
Do not try to treat the problem at home; the doctor will indicate the appropriate treatment, depending on the type of intestinal obstruction.
For partial obstructions or an ileus, it can be treated simply by resting the intestines and administering intravenous fluids; feeding it will correct any electrolyte imbalance.
In the case of a chronic obstruction due to stenosis or narrowing of the intestine, the doctor can use a procedure without surgery and place a metallic stent, which is nothing more than a wire mesh that expands inside the intestine with the help of an endoscope.
In case of a severe complication of intestinal obstruction and permanent damage to your bowel, it is required that a surgeon perform a surgical procedure to remove the section of dead tissue.
Usually, your doctor will suggest treatment to reduce discomfort, such as nausea, pain, and antibiotics to fight the infection.
Key points
• The most common obstruction causes are adhesions, hernias, and tumors; A small bowel obstruction, without previous surgery or the presence of hernias, presents the most probable cause of the existence of cancer.
• Prolonged obstruction can cause intestinal ischemia, infarction, and perforation.
• When it comes to infants, you should see the doctor immediately when observing the first symptoms.
• Consider the risk of self-medication because of the seriousness of the complications that can lead to death.
Consequences of intestinal obstruction
In general, the perspective of your condition depends on the cause that originates it. Most cases of intestinal obstruction are curable with proper treatment.
However, other causes, such as cancer, are a symptom of another disease and require long-term treatment and monitoring.
When the proper treatment is not given, the intestinal obstruction can cause the death of the tissue in the affected part of your intestine.
It can also cause a hole or perforation in the bowel wall, causing severe infection and shock.
Pathophysiology
When it is a simple mechanical obstruction, the blockage occurs without vascular compromise.
The liquid and the food in the intestines, the digestive secretions, and the gas accumulate above the obstruction.
The proximal bowel distends, and the distal segment collapses. The mucous membranes’ secretory and absorption functions are depressed, and the intestinal wall becomes edematous and congested.
Severe intestinal distention is self-perpetuating and growing, and peristaltic and secretory disorders intensify, increasing the risks of dehydration and increased choking obstruction.
Strangulation obstruction, where blood flow is compromised, occurs in approximately 25% of patients with small bowel obstruction.
Its cause is generally associated with a hernia, volvulus, and intestinal intussusception. Strangulating obstruction can progress to infarction and gangrene in just 6 hours.
First, venous obstruction occurs, followed by arterial occlusion, which gives rise to rapid ischemia of the intestinal walls.
The ischemic bowel becomes edematous, and infarct ensues, which causes gangrene and finally perforation.
In obstruction of the large intestine, strangulation is not common, except that caused by volvulus.
Perforation can occur in an ischemic segment (usually in the small intestine) or when marked dilation occurs.
