intestinal obstruction: Is it Life Threatning

Intestinal Obstruction: Is It Life Threatening?

Last week I had a talk with one of my friends who is an ER doctor. He told me about this patient, a 54-year-old male, who had chronic constipation and was referred to him by his general physician for ‘not being able to open bowels for 2 weeks; yes you read it right, TWO WEEKS!

After further diagnosis, the doctors came to conclusion that he had been suffering from Crohn’s disease! The patient was immediately taken to OT for bowel resection and the damaged portion of the intestine was removed through colectomy. He revealed that had he not removed the damaged intestine, it could have become a life-threatening situation.

This made me think of all those times when I didn’t take any notice of my bowel health, eating junks and drinking like a retired sailor! I started researching everything about intestinal obstruction, its causes, signs, symptoms and risk factors and what I came to know might shock you all.

A study conducted in 2015 by Disease And Injury Incidence and Prevalence Collaborators found 3.2 million cases of intestinal obstruction, among which 2,64,000 patients died of the condition! Now it’s clear that not being able to take a dump for days IS a big deal and can also be a symptom of serious illnesses like cancer, hernias, endometriosis, tuberculosis, appendicitis and so on.

This takes us to one big question:

What Exactly Is Intestinal Obstruction And How Does It Occur?

Intestinal Obstruction, also known as bowel obstruction is a disorder caused due to blockage of the normal flow of intestinal contents, disrupting the normal digestion. Some of the common signs and symptoms include vomiting, bloating, constipation, abdominal pain, fecal vomiting, swollen abdomen and so on.

Obstruction might occur due to several reasons. Mechanical obstruction can occur if there’s presence of:

  • Hernias
  • Adhesions
  • Tumor
  • Volvulus: twisting of bowel upon itself usually at least full 180 degree
  • Intussusception: prolapse of one part of intestine into lumen
  • Crohn’s disease
  • Ischemic strictures
  • foreign bodies like gall stones
  • Intestinal atresia
  • ovarian cancer
  • colon cancer
  • meconium plug in newborns
  • Other causes: fecal impaction, gallstones, inflammatory bowel disease

Large bowel obstruction might occur due  to:

  • Colon atresia
  • Fecaloma
  • Endometriosis
  • Diverticulitis/Diverticulosis
  • Neoplasms/Cancer

Signs and Symptoms

Intestinal obstruction causes a wide range of uncomfortable symptoms, including:

  • severe bloating
  • abdominal pain
  • decreased appetite
  • nausea
  • vomiting
  • inability to pass gas or stool
  • constipation
  • diarrhea
  • severe abdominal cramps
  • abdominal swelling

How Is It Diagnosed?

The main methods for diagnosis include blood tests, CT scanning, endoscopy, colonoscopy and X-rays of the abdomen and ultrasound. Under the identification of a mass, biopsy is suggested to identify the nature of the mass. Diagnosis helps to know whether the obstruction is partial or complete.

When to See a Doctor?

When the complications start to become severe like dehydration, electrolyte imbalance, kidney failure, excruciating abdominal pain, kidney failure, constipation, then it’s essential to go  and see a doctor immediately.

Treatment

Medical management

  • Treatment is directed towards decompression of intestine by removal of gas and fluid, correction, and maintenance of fluid and electrolyte balance.
  • NG- tube insertion for drawing fluid from abdomen
  • Keep patient nil per orally
  • Analgesic and antispasmodic drugs used to relieve pain and to provide comfort
  • Antibiotic drugs to treat and prevent infection
  • Administration of fluid and electrolytes by IV infusion
  • A rectal tube may be used to decompress an area that is lower in bowel

Surgical management

Surgery will be performed to relieve the mechanical obstruction, if conservative efforts are failed. The operative procedure will be varied with the condition of the patient. It depends on an underlying condition such as:

  • Resection of bowel is done for obstructing lesion or strangulated bowel; along with end to end anastomosis
  • Cutting of Ladd’s band and lengthening of roots of the mesentery if malrotation of gut
  • Enterotomy is performed to remove foreign body from the intestine

After further research I came to know that intestinal obstruction is also common in infants as the infection can arise inside the womb through diseases and condition like decreased blood flow inside the intestines and so on. Some even experience this condition after stomach flu. However, any type of bowel obstruction is difficult to diagnose in infants because symptoms can go unnoticed as young ones can describe the  symptoms.

To sum up, intestinal obstruction is a serious form of digestive disorder and it can be a major sign of other possible deadly diseases that might need immediate medical attention.

Also Read: Bowel Incontinence: Causes, Symptoms, Diagnosis, Prevention and Treatment

For more detailed information, see the full video below:

 

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