Digestive System Disorders: Bowel Obstruction

Bowel Obstruction:

What Happens in Bowel Obstructions?

A bowel obstruction, also known as Pseudo-obstruction - intestinal, Ileus, Paralytic ileus or Intestinal volvulus can be either mechanical or functional. This disorder prevents the normal transit of wastes through the digestive tract and in severe cases, the blood supply to the bowels is cut off due to the obstruction. When the blood supply is cut off, this is called bowel strangulation or ischemic bowel and requires emergency treatment, otherwise it can be fatal.



What Causes A bowel Obstruction?

A bowel obstruction can take place in either the small intestine or the large intestine. The causes of such an obstruction may differ.



Obstruction in the small intestine might include:

• Complications of Crohns Disease that cause adhesions or inflammatory strictures


• Abnormal proliferation of cells in the bowel that is either benign or malignant


• Abnormal twisting of the intestine which causes the obstruction


• Hernias which contain the bowel


• Previous abdominal surgery that result in adhesions


• Ischemic strictures


• Foreign object that have been swallowed or gallstones in gallstone ileus


• A malformation where the there is a narrowing or absence of a portion of the intestine.


• Carcinoid rare, preferred location: ileum
  
  

Obstructions in the large intestines might include:

• Complications of Inflammatory Bowel Disease


• Hernias


• Diverticular Disease


• Abnormal proliferation of cells in the bowel


• Abnormal twisting of the intestine that includes the sigmoid, caecal or transverse colon


• A malformation where the there is a narrowing or absence of a portion of the intestine


• Fecal impacting
  
  

What Are The Symptoms Of A Bowel Obstruction?

Symptoms of a bowel obstruction include

• Constipation


• A history of rectal bleeding if a colon tumor is the cause of the problem, a bloated abdomen, abdominal pain varying in either vague and mild, or sharp and severe, depending on the cause of the obstruction


• Vomiting or fecal vomiting.
  
  

Obstruction may be complicated by respiratory compromise from pressure on the diaphragm by a distended abdomen, electrolyte abnormalities and dehydration due to vomiting, perforation from prolonged distension or pressure from a foreign body.



How Is Bowel Obstruction Diagnosed?

At the onset of mechanical obstruction, the physician will listen to the abdomen with a stethoscope and may hear high-pitched bowel sounds. Bowel sounds decrease and eventually becoming silent when the obstruction has persisted for too long or the bowel has been significantly damaged. A colonoscopy, barium enema, abdominal CT scan, abdominal film, and upper GI and small bowel series are also diagnostic tools in finding bowel obstructions.



How Is Bowel Obstructions Treated?

Hospitalization with correction of dehydration and electrolyte abnormalities, an insertion of a nasal gastric (NG) tube as well as treating the cause of the obstruction is often the treatment. Often, surgery is required to repair the bowel and is the best option. Bowel resections are used in this case where injured sections are removed and the healthy ends of the bowel are stitched together. If resection is not possible, ostomy surgery would be the best option.


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