Intestinal Obstruction – Factors, Types and Treatment

Introduction

An intestinal obstruction occurs when the large or small intestines are blocked. Blockage in the intestine prevents the passing of fluids, gas, and food through your intestine in the normal way. The food, fluids, gas build up behind the blockage site. With no treatment, the blocked parts of intestine may die, causing serious problems. But, with early medical care, intestinal obstruction can often be treated successfully.

A fibrous band of tissues in the abdomen after any surgery, an inflamed intestine, colon cancer, hernia, and an infected pouch in the intestine are prominent causes of intestinal obstruction. If the intestinal obstruction is left untreated for a longer time, it can lead to serious medical complications. However, with medical care at the proper time, the intestinal obstruction can be treated successfully.

What Causes Intestinal Obstruction?

The causes of intestinal obstruction are different among adults and children. Some of the common causes of intestinal obstruction are as follows:

• Intestinal adhesions: bands of the fibrous tissue in the abdominal cavity which may form after pelvic or abdominal surgery
• Hernias: portions of intestine which protrudes into another part of the body
• Colon cancer

In children, the most common cause which leads to intestinal obstruction is intussusception, the telescoping of the intestine.

Other possible causes of intestinal obstruction include:

• Impacted feces
• Volvulus (Twisting of the colon)
• Inflammatory bowel diseases like Crohn’s disease
• Diverticulitis: It’s a condition in which diverticula (tiny, bulging pouches) in the digestive tract become infected or inflamed

What are the Types of Intestinal Obstruction?

The intestinal obstruction can be of two types: complete blockage or partial blockage. Also, you can have a pseudo-obstruction.

• Complete Blockage: Complete blockage of the intestine means no food is passed through the intestine.
• Partial Blockage: In this type, some kind of food and fluids are still able to pass through the intestine
• Pseudo-obstruction: You may have intestinal obstruction symptoms, but physically nothing is blocking food movement in the intestine. Intestinal pseudo-obstruction, also called paralytic ileus can lead to the signs and symptoms of intestinal obstruction. However, it does not involve a physical blockage. In intestinal pseudo-obstruction, nerve or muscle problems disturb the normal co-ordinated muscle contractions of intestines, stopping or slowing the movement of food and fluid through digestive system.

What are the Symptoms of Intestinal Obstruction?

The signs and symptoms of intestinal obstruction are as follows:

• Loss of appetite
• Constipation
• Vomiting
• Abdominal pain (cramp)
• Improper bowel movement
• Swelling of abdomen
• Inability to pass gas

When to See the Doctor?

Unnoticed symptoms of intestinal obstruction can lead to severe complications. Thus, you should seek immediate medical care when you notice signs of intestinal obstruction.

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What Increases the Risk of Intestinal Obstruction?

The medical conditions that would increase the risk of intestinal obstruction are:

• An abdominal or pelvic surgery that often causes adhesions
• Crohn’s disease increases the risk of the intestine’s wall to thicken and narrow the passageway
• Abdomen cancer

How is the Intestinal Obstruction Treated?

The medical practitioner would decide the line of treatment for intestinal obstruction on the cause and severity of your condition. Generally, intestinal obstruction pain requires hospitalization. 

Below mentioned are a few of the treatment options for intestinal obstruction:

• Stabilizing the patient: Firstly, the doctors will work on stabilizing you and make you ready for further treatment. This medical process would include:
  • Placing an intravenous line so that fluids can be given.
  • Inserting a nasogastric tube through the nose in the stomach to suck out air and fluid to relieve abdominal swelling.
  • Place a catheter in the bladder to drain urine.

• Treatment of Intussusception: An air enema is used for the treatment of intussusception among children

• Treatment of Partial Obstruction: To treat partial obstruction, a low fibre diet may be enough, after stabilisation. 

• Treatment of Complete Obstruction: You would need surgery to get relief from the blockage. A surgery typically removes the obstruction, as well as any section of your intestine that is damaged or has died. 

Your doctor may alternatively, suggest treating the obstruction with a self-expanding metal stent. A wire mesh tube is inserted into the intestine through an endoscope passed via the colon or mouth. It force opens the intestine to clear the obstruction.

Usually, stents are used to treat individuals suffering from colon cancer or to offer temporary relief to those for whom emergency surgery is highly risky. However, the person may still need surgery, once the condition is stable.

• Treatment for Pseudo-obstruction: Pseudo-obstruction is also called paralytic ileus; this condition can improve independently. If it does not improve, then the doctor would prescribe medications for the treatment of the same.

If the Intestinal Obstruction is Left Untreated, What Complications Can Arise?

If the intestinal obstruction is untreated for a longer time, then it can lead to serious life-threatening complications that include:

• Tissue Death: The intestinal obstruction can restrict the blood supply to a part of the intestine. The lack of supply of blood to the intestine causes it to die. Tissue death can lead to perforation (tear) in the intestinal wall, which can also cause infection in the intestine.
• Infection: In medical terms, infection in the abdominal cavity is also called peritonitis. It is a serious medical condition that would require immediate medical attention.

Conclusion

Intestinal obstruction is a blockage that limits the passage of food through the large intestine and small intestine. Some of the common causes of intestinal obstruction are a fibrous band of tissues in the abdomen after any abdominal surgery, inflamed intestine, colon cancer, hernia, and infected pouch in the intestine. If the intestinal obstruction is untreated, then it can lead to serious medical complications. However, with appropriate medical care at the proper time, intestinal obstruction can be treated successfully.

Frequently Asked Questions (FAQs)

What are the Tests Prescribed by the Doctors for the Diagnosis of Intestinal Obstruction?

The medical practitioner would first perform your physical examination. Depending on the symptoms observed and severity of your pain, they would perform a few tests such as x-ray, computerized tomography (CT), ultrasound, and barium enema.

What are the Reasons for the Occurrence of Intestinal Obstruction?

Some of the possible reasons for the occurrence of intestinal obstruction are abdominal adhesions, volvulus, hernia, scarring, inflammatory bowel disease, diverticulitis (inflammation or infection in the pouches of the digestive tract), intussusception (a severe intestine medical condition where a part of the intestine slips into another part), tumors, foreign objects, and Meckel’s diverticulum.

Is Computed Tomography Effective for the Examination of Intestinal Obstruction?

Yes, computed tomography can effectively determine the exact cause of intestinal obstruction and the presence of any serious complications among patients with high-grade intestinal obstructions.