Bowel obstruction

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Bowel obstruction
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Abdominal pain, vomiting, bloating, constipation
Complications	Sepsis, bowel ischemia, perforation
Onset	Sudden or gradual
Duration	Variable
Types	N/A
Causes	Adhesions, hernia, tumor, intussusception, volvulus
Risks	Prior abdominal surgery, Crohn's disease, cancer
Diagnosis	Medical imaging, physical examination
Differential diagnosis	Ileus, gastroenteritis, appendicitis
Prevention	N/A
Treatment	Nasogastric tube, intravenous fluids, surgery
Medication	Analgesics, antiemetics
Prognosis	Variable, depends on cause and treatment
Frequency	Common
Deaths	N/A

Bowel obstruction, also known as intestinal obstruction, is a medical condition characterized by the partial or complete blockage of the normal flow of contents through the intestines. It can occur in the small intestine or the large intestine (colon) and can be caused by various factors, such as tumors, hernias, adhesions, or impacted feces. Bowel obstruction is a potentially serious condition that requires prompt medical attention.

Upright abdominal X-ray demonstrating a bowel obstruction

Signs and Symptoms

• The signs and symptoms of bowel obstruction can vary depending on the location and severity of the obstruction. Common symptoms include:
• Abdominal pain: Crampy, colicky pain in the abdomen is a hallmark symptom of bowel obstruction. The pain may be intermittent or constant and may worsen with eating or movement.
• Distention: The abdomen may become visibly swollen and distended due to the accumulation of gas and fluid.
• Nausea and vomiting: Nausea and vomiting are common symptoms of bowel obstruction and may occur due to the inability of the intestines to pass contents.
• Constipation or diarrhea: Depending on the location of the obstruction, patients may experience either constipation or diarrhea.
• Inability to pass gas or have a bowel movement: Bowel obstruction can lead to a complete cessation of bowel movements and the inability to pass gas.

Causes

• Bowel obstruction can have various causes, including:
• Adhesions: Scar tissue that forms after surgery or inflammation can cause the intestines to stick together, leading to a blockage.
• Hernias: Inguinal, femoral, or umbilical hernias can cause a loop of intestine to become trapped and obstructed.
• Tumors: Cancerous or benign tumors can grow in the intestines, obstructing the passage of contents.
• Intussusception: This occurs when a segment of the intestine telescopes into another segment, causing a blockage.
• Volvulus: The twisting of the intestine on itself can result in a bowel obstruction.

Diagnosis

• To diagnose bowel obstruction, a healthcare provider will perform a thorough physical examination and may order additional tests, including:
• Imaging tests: X-rays, ultrasound, CT scan, or MRI may be used to visualize the intestines and identify the location and cause of the obstruction.
• Blood tests: Blood tests can help evaluate electrolyte levels, kidney function, and signs of infection.

Treatment

• The treatment of bowel obstruction depends on the cause and severity of the obstruction. In some cases, non-surgical interventions may be sufficient, such as:
• NPO status: The patient is not allowed to eat or drink to allow the bowels to rest.
• Intravenous fluids: Fluids are administered intravenously to prevent dehydration.
• Nasogastric tube: A tube may be inserted through the nose and into the stomach to relieve pressure and remove excess gas and fluid.
• However, in cases of complete or severe obstruction, surgical intervention may be necessary. Surgery aims to remove the obstruction and repair any underlying causes, such as removing tumors, repairing hernias, or dividing adhesions.

Complications

• If left untreated, bowel obstruction can lead to serious complications, including:
• Bowel ischemia: Reduced blood flow to the affected part of the intestine can cause tissue damage or necrosis.
• Perforation: The pressure buildup in the intestines can cause them to rupture, leading to a life-threatening infection called peritonitis.

Prognosis

• The prognosis for bowel obstruction depends on various factors, including the cause, extent of the obstruction, and promptness of treatment. In cases where the obstruction is resolved promptly, the prognosis is generally good. However, complications can occur, especially if the obstruction is left untreated or if there is a delay in diagnosis.
• Early intervention and appropriate treatment significantly improve the outcomes. The majority of cases can be successfully managed with conservative measures or surgical intervention, leading to relief of symptoms and restoration of normal bowel function. However, the prognosis may be poorer in cases of extensive bowel ischemia, bowel perforation, or underlying malignancy.
• Regular follow-up with healthcare providers is essential for monitoring the condition, managing any underlying causes, and preventing the recurrence of bowel obstruction.

See also

Intestinal atresia Ileus Gastrointestinal surgery

References

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