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What is a bowel obstruction?

An intestinal obstruction, also known as a bowel obstruction or bowel blockage occurs when food or liquid are unable to pass through either the large or small intestine. If left untreated, life-threatening complications such as tissue death or infection, even death, can occur.

Tissue death occurs when the intestinal obstruction cuts off blood supply to a section of your intestine and causes the tissue to die. The dead tissue weakens your intestinal wall which can lead to a tear, allowing the contents of the bowel to spread throughout the abdomen, a condition called Peritonitis. This infection that occurs deep within the abdomen is life-threatening. Surgery along with direct application of antibiotics to the infected internal sites are often required to save the patient’s life.

small bowel obstruction caused by adhesions diagram

Symptoms of a bowel obstruction or bowel blockage

  • Nausea and vomiting
  • Constipation and inability to pass gas
  • Abdominal distention, which can be confused with bloating
  • Fever
  • Tachycardia, which is a heart rate that exceeds normal resting rate
  • Loss of appetite
  • Recurring abdominal pain

Causes of bowel obstruction

Adhesions: The most common cause for small bowel obstruction is intra-abdominal adhesions. Adhesions cause about 65% to 75% of all small bowel obstructions. Adhesions are scar tissue that can form after infection, radiation therapy, inflammation and most commonly, surgery. One of the reasons recurring bowel obstructions are so difficult to treat is because obstructions and blockages are often treated with surgery. Post-surgical adhesions can wrap around the intestine and squeeze it shut, similar to pinching a garden hose. In other cases, a stricture (narrowing) can occur, preventing liquids and food from passing through.

Hernias: When the intestine protrudes through an opening in the abdominal wall, it is called a hernia. Hernias can squeeze the bowel shut, making it difficult or impossible for contents to pass through the intestine. This causes impacted stool, a stricture or a blockage to occur.

Crohn’s disease: This is a chronic inflammatory bowel disease that causes inflammation in the lining of the digestive tract. The constant inflammation leads to scarring and the formation of adhesions.

Malignancy: This is defines as the presence of a malignant tumor (cancer). A tumor can obstruct the intestine, causing a blockage.

Volvulus: This is an obstruction caused by the intestine being twisted or knotted. Once the intestine is twisted or knotted, nothing can pass through. This condition can also obstruct blood flow, causing tissue death.

Diverticulitis: Similar to Crohn’s disease, diverticulitis is an inflammation or infection in the small pouches of the digestive tract that can lead to scar tissue and constipation.

Food that can cause bowel obstructions

  • Fruit – Fruits with a cellulose structure can cause, or contribute to an obstruction. One of the most common fruits reported to cause intestinal obstructions is persimmons, though a large number of cases have been reported with citrus fruits in general and other dried fruits.

Bowel obstruction prevention

  • Drink plenty of fluids – It is generally suggested that individuals drink 6 to 8 cups of water each day. Water helps food move more easily through the digestive tract.
  • Chew your food thoroughly – Not chewing food well increases the amount of work your digestive tract must do and can contribute to intestinal obstructions.
  • Clear Passage – A manual physical therapy that treats the adhesions causing recurring bowel obstructions – without surgery or drugs. By avoiding surgery, patients can often avoid repeat bowel obstructions because surgery is the primary cause of adhesions and bowel obstructions.
  • Diet change Changing your diet may help prevent future bowel obstructions.

Bowel obstruction treatment

Fasting – Allows the bowel to rest and helps reduce risk of complications during surgery, if that becomes necessary.

Nasogastric intubation – An “NG Tube” is a tube that carries food and medicine down the throat and into the stomach and also pumps out excess stomach liquids in an effort to decompress the bowel.

Surgery – surgery may be required to remove infected or necrotic (dead) tissue or to repair perforations to the bowel.

Click here to learn more about a non-surgical treatment option for bowel obstruction.

 

References

  • http://emblog.mayo.edu/2015/01/04/the-truth-about-small-bowel-obstruction/
  • http://www.sciencedirect.com/science/article/pii/0002961062903756
  • https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/symptoms-causes/syc-20351460
  • https://emedicine.medscape.com/article/774140-overview
  • https://www.livestrong.com/article/313014-bowel-blockage-diet/
  • https://www.health.qld.gov.au/__data/assets/pdf_file/0022/152473/gastro_obstruct.pdf
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