Bowel Obstruction? Let's talk about this!

Have you ever had a severe stomach ache, a feeling of fullness, or a feeling of being sick? Do you feel like you can't eat, and you feel like you're going to vomit? Sometimes these can be a sign of something serious. That's a blockage in the intestines, or what doctors call a bowel obstruction . Time is of the essence in this case. So today, let's talk about this in detail, but very simply.

What is a bowel obstruction?

Simply put, a bowel obstruction is a blockage in either your small intestine or large intestine , either partially or completely. You know, the food we eat travels through the intestines after the stomach, where it absorbs the nutrients the body needs, and finally the waste products are eliminated as feces. So, when this intestinal tract becomes blocked, food and waste stop moving and get stuck in one place.

Imagine that when a water pipe gets stuck in the middle, the water fills up in one place instead of flowing out. This is what happens here too.

When waste, air, and digestive juices get trapped in this way, the intestinal tissue in that area can be damaged. This can stop the normal functioning of the intestines and even cause dangerous complications. That's why it's important to see a doctor immediately if you have these symptoms.

What are the types of intestinal obstruction?

Doctors classify these intestinal blockages mainly based on where the blockage is located:

• Small Bowel Obstruction: Most of the time, about 80% of blockages occur in the small intestine. The small intestine is the part that connects the stomach and the large intestine. As food passes through the large intestine, it is digested and nutrients and water are absorbed into the body.
• Large Bowel Obstruction: The large intestine includes your colon and rectum . The absorption of nutrients that begins in the small intestine continues here. It also processes food and water into stool. About 20% of all obstructions occur in the large intestine.

It can also be classified according to the nature of the blockage:

• Complete Obstruction: The affected section of the intestine is completely blocked. Nothing can pass through.
• Partial Obstruction: Only part of the intestine is blocked or narrowed. Some things can pass through.
• Pseudo-obstruction: This is a bit of a strange one. It causes symptoms of a blockage without actually having one. Scientists think it's caused by a malfunction in the nervous system of the intestine. But more research is needed on this.

How common are intestinal blockages?

Small bowel obstruction is a common reason people visit emergency departments (EDs). Colonic obstruction is not as common in the general population. However, it is more common in people with colon cancer. About 40% of people with colon cancer are diagnosed with the disease when they present to the emergency department with symptoms of bowel obstruction caused by a tumor.

What are the symptoms of a small bowel obstruction?

You may experience a sudden, severe stomach ache that subsides and then comes back (like a wave). The pain may persist for a while. You may also have one or more of these symptoms:

• Stomach pain , bloating, or feeling full .
• Nausea and vomiting .
• Food is tasteless .
• Malaise - This means a general feeling of illness.
• Diarrhea (this is often a sign of partial obstruction).
• Signs of dehydration, such as a rapid heartbeat and dark urine.
• Severe constipation (in case of complete obstruction, there is no passage of air or stool).

How are the little children?

Babies and children have the same symptoms as adults. However, it is not possible to tell where a baby is in pain. They may pull their legs up to their stomach and cry. In addition, young children may have symptoms such as:

• Fever.
• Rectal bleeding.
• Greenish-yellow vomit.
• Lethargy.
• Stomach feels swollen and tight.

What does a bowel obstruction feel like?

How it feels can vary depending on whether the blockage is in the small intestine or the large intestine, and what is happening inside the stomach. In general, a bowel obstruction feels like a sharp pain in the stomach. In a small intestine obstruction, the pain comes on gradually, every few minutes. The pain can also be felt in more than one place. In a large intestine obstruction, the pain can be continuous. The pain may also feel like it is spreading throughout the stomach. However, if you have severe abdominal pain along with symptoms such as bloating, nausea, and vomiting, you should definitely seek medical advice immediately.

Can you pass stool when you have a bowel obstruction?

Yes. It depends on where the blockage is and how severe it is. For example, a partial blockage may make it a little difficult to pass stool, but a complete blockage may make it impossible to pass stool or pass air.

What are the causes of intestinal obstruction?

There are several main causes of intestinal obstruction:

• Abdominal Adhesions: If you have had previous abdominal or pelvic surgery, you may develop scar tissue inside your abdomen after that surgery. These can act like sticky tape and stick parts of your intestines together, causing a blockage. This is the leading risk factor for small bowel obstruction in countries like the United States.
• Hernias: A part of the intestine can protrude through a weak spot in the abdominal wall. If the protruding part of the intestine becomes stuck, or if it becomes too tight, it can cause a blockage in the intestine. Hernias are the second most common cause of small bowel obstruction.
• Cancerous Tumors: Cancerous tumors can develop in the colon itself, or cancer from elsewhere can spread to the colon (metastatic cancer) . These tumors can cause partial or complete obstruction of the colon. The main cause of colon obstruction is colon cancer.

There are other reasons too:

• Inflammatory Bowel Disease (IBD): IBD conditions, such as Crohn's Disease, can cause scar tissue to form in the walls of the intestine. This scar tissue can build up and narrow the intestine (strictures) .
• Diverticulitis: This is when small pouches (diverticula) in the colon develop and become inflamed. This swelling can cause the colon to narrow. As with IBD, scarring can occur, narrowing the colon.
• Intussusception: This is the leading cause of intestinal obstruction in children under 3 years of age. This occurs when one part of the intestine becomes trapped inside another, like a telescope being rolled inward. This can cause the intestine to become blocked and blood flow can be blocked.
• Volvulus: Some babies are born with malrotation of their intestines. This can cause their intestines to twist (volvulus) , which can cause a blockage. Adults can also have intestinal torsion, but it is very rare.
• Radiation therapy to the abdomen, pelvis, or rectum: Radiation enteritis can occur as a side effect of radiation therapy. This is when the radiation causes scarring of healthy tissue. This scarring can cause the intestines to narrow and become blocked.
• Ingesting a foreign object: If you swallow something that the body cannot digest and is not intended for food, it can become stuck in the intestines.

What are the complications of intestinal obstruction?

If not treated urgently, complications from intestinal obstruction can be life-threatening .

• Intestinal Perforation and Infection: The accumulation of fluid, air, and digestive juices due to the blockage can increase pressure inside the intestine, causing the intestine to burst or become perforated . This can cause the contents of the intestine to leak into the abdominal cavity, causing an abdominal infection called peritonitis , or a life-threatening infection called sepsis that affects the entire body.
• Strangulation - tissue death: Strangulation causes parts of the intestine to lose their blood supply. This tissue then begins to die (Gangrene) . This can also lead to severe infections and even death.

How do you recognize a bowel obstruction?

Because a bowel obstruction is a medical emergency, diagnosis is usually made quickly. Sometimes, the diagnosis is made during treatment because there is no time to waste. Diagnosis may include:

• Medical History: Your doctor will ask you about things like previous surgeries.
• Physical Examination: The doctor will check your abdomen for swelling, lumps, or other signs of infection. They may also use a stethoscope to listen for sounds that indicate intestinal obstruction.
• Blood Tests: A complete blood count and electrolyte analysis will be done. Blood tests will look for signs of infection. Electrolyte levels can tell if you are severely dehydrated. If so, you will need to be given saline (IV fluids) immediately.

Imaging procedures can help the doctor see the blockage and check for complications. These include:

• Abdominal X-rays: X-rays can show where the blockage is. They can also show if there is air around the intestine or around the diaphragm (the muscle that separates the stomach from the chest). Air in these areas can mean that part of the intestine has died or is perforated.
• CT scan (Computed Tomography - CT scan): A CT scan can produce more detailed images than X-rays. This may be necessary to confirm your diagnosis and get accurate information about where the blockage is and what is causing it.
• Barium Enema X-ray: This is an X-ray of the colon. While you are under anesthesia, a doctor inserts a thin tube (catheter) through your rectum.This tube is inserted into your colon and filled with a safe liquid. X-ray pictures are taken as this liquid passes through your colon. This liquid makes your colon show up clearly on the X-ray pictures.

These imaging methods use radiation. If there is a risk of radiation exposure (even at safe levels), you may want alternatives to these methods. Pregnant women and young children may be able to have ultrasound or MRI scans, which do not use radiation.

What is the treatment for intestinal obstruction?

Most people with intestinal obstructions need immediate treatment in a hospital. Complete obstructions usually require immediate surgery. Partial obstructions can be treated to stabilize your condition, followed by non-surgical solutions (such as resting the bowel). This all depends on how severe the obstruction is. Treatment may include:

• Intravenous (IV) fluids: You will be given IV fluids and electrolytes to treat dehydration.
• Nasogastric Tube: You may need to have this tube inserted to remove fluid and air that has accumulated due to a blockage. This is a long, thin tube that is inserted through your nose and threaded down into your stomach or intestines.
• Medications: Anti-emetics may be given to stop nausea and vomiting, and painkillers may be given to reduce pain.
• Bowel Rest: To allow time for the blockage to clear and for the bowel to contract to its normal size, you may need to stop eating or drinking. Or, you may be given a special liquid to drink that contains the nutrients from the food.
• Surgery: If your bowel is completely blocked, surgery is often necessary. Your doctor may remove any scar tissue or tumors that are causing the blockage. Rarely, they may also remove diseased tissue. Sometimes, your doctor may place a stent ( like a mesh tube) to keep the blockage open, resolving the blockage without additional surgery. Or, a stent may be placed as a temporary solution until you are well enough to have surgery to correct the blockage.

What can you expect if you have a bowel obstruction?

Many people recover after treatment. Signs that the blockage is healing include flatulence, decreased bloating, and the ability to have a bowel movement. On the other hand, if the blockage causes a perforation in the intestine, the condition can be life-threatening. Therefore, it is important to seek treatment before complications develop and to seek medical advice as soon as symptoms appear.

When should I see a doctor?

See a doctor if you have any of these:

• Fever.
• Persistent vomiting.
• A sharp stomach pain or cramping that comes and goes or is constant.
• Symptoms of dehydration.

What questions should I ask my doctor?

You can ask questions like these:

• Why did I get a bowel obstruction?
• What kind of treatment do I need?
• Am I at risk of developing intestinal obstruction in the future?
• What complications should I be aware of from treatment?
• How should I change my diet and activity levels while I recover?

Finally, the most important thing to remember

If you have symptoms of a bowel obstruction, act quickly and seek medical attention. Many people tend to put off seeing a doctor when they feel pain, thinking it's no big deal. But when it comes to a bowel obstruction, "waiting it out" is never a good option. Don't ignore abdominal pain , especially if you've had previous abdominal surgery or have a risk factor like IBD. A bowel obstruction is a treatable condition. Don't delay.

---

` Bowel obstruction, stomach ache, constipation, vomiting, intestinal diseases, surgery