Intestinal Obstruction

• Intestinal obstruction refers to a blockage in the small or large intestine, impeding normal digestive flow.
• Common causes include surgical adhesions, hernias, tumors, and inflammatory conditions.
• Symptoms often involve severe abdominal pain, bloating, nausea, vomiting, and an inability to pass gas or stool.
• Diagnosis typically relies on physical examination and imaging tests such as X-rays or CT scans.
• Treatment options range from conservative management with intravenous fluids and bowel rest to surgical intervention, depending on the underlying cause and severity.

What is Intestinal Obstruction?

Intestinal Obstruction is a medical emergency defined by a partial or complete blockage that prevents the normal passage of digested food, fluids, and gas through the small or large intestine. This blockage leads to a buildup of contents behind the obstruction, causing increased pressure, distension, and potentially severe damage to the bowel wall, including perforation and infection. The condition can be life-threatening if not addressed promptly.

There are primarily two types of intestinal obstruction: mechanical and functional. Mechanical obstruction involves a physical barrier, such as scar tissue or a tumor, physically blocking the lumen of the intestine. Functional obstruction, also known as paralytic ileus, occurs when the intestinal muscles temporarily stop working properly, without a physical blockage, often due to surgery, infection, or certain medications. According to the World Journal of Emergency Surgery, adhesive small bowel obstruction (ASBO) accounts for 60–70% of all small bowel obstructions and is the most common cause of small bowel obstruction worldwide.

Causes and Symptoms of Intestinal Obstruction

The causes of intestinal obstruction are varied and crucial for diagnosis and effective treatment. They include:

• Adhesions: Bands of scar tissue from previous abdominal surgery, the most common cause of small bowel obstruction.
• Hernias: Protrusions of intestine through a weak abdominal wall spot, which can become trapped.
• Tumors: Growths (benign or malignant) within or pressing on the intestine.
• Inflammatory Bowel Diseases: Conditions like Crohn’s disease causing intestinal wall thickening and narrowing.
• Diverticulitis: Inflammation of colon pouches leading to scarring and narrowing.
• Volvulus: Twisting of the intestine, potentially cutting off blood supply.
• Intussusception: Telescoping of one intestinal segment into another, more common in children.
• Paralytic Ileus: Functional obstruction due to impaired bowel motility, often triggered by abdominal surgery, infections, or certain medications.

Intestinal obstruction symptoms typically develop rapidly and can be severe, requiring immediate medical attention. These commonly include:

• Severe, crampy abdominal pain, often intermittent.
• Nausea and vomiting, potentially bilious or feculent.
• Abdominal distension (bloating).
• Inability to pass gas or stool.
• Loss of appetite.
• Dehydration.

Intestinal Obstruction Treatment Options

Effective intestinal obstruction treatment depends on the underlying cause, location, and severity. Initial management involves hospital admission, NPO (nothing by mouth), intravenous fluids for hydration, and a nasogastric (NG) tube to decompress the stomach and relieve pressure.

Treatment approaches include conservative management and surgical intervention:

• Conservative Management: Often for partial obstructions or paralytic ileus without strangulation. This involves close monitoring, pain management, and sometimes water-soluble contrast agents (e.g., Gastrografin) to help resolve adhesive obstructions.
• Surgical Intervention: Required for complete mechanical obstructions, failed conservative measures, or signs of bowel strangulation/perforation. Procedures vary, including adhesiolysis, resection of damaged segments, or tumor excision. A temporary or permanent ostomy may be necessary in some cases.

It is important to note that any information regarding alternative or complementary therapies is supportive only and does not replace conventional medical treatment. Always consult with a qualified healthcare professional for diagnosis and treatment of intestinal obstruction.