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Intestinal Obstruction or Bowel Obstruction
he intestine is a long (over 22 ft. in the adult), continuous, tube-like structure, through which the body absorbs nutrients from food through digestion. The intestine is divided into the large intestine (colon) and the small intestine. Under normal conditions, material in the intestines should flow uninterrupted through the small intestine to the large intestine, where it essentially becomes waste material. The material progresses to the rectum, where it is expelled through the anus in the process of defecation (bowel movement). Interruption to the flow as it moves through the intestine (blockage) can result in serious illness. In our society, intestinal obstruction occurs most commonly from abdominal adhesions. Adhesions form INSIDE the abdominal cavity are the direct result of prior abdominal surgery (i.e. appendectomy, cholecystectomy, etc.). These adhesions are nothing more than scar tissue that forms INSIDE the body. Other causes for intestinal obstruction include hernias and intestinal cancers. The elderly, diabetic, and chronically bedridden patient are at increased risk for intestinal obstruction. Some medications may lead to intestinal obstruction (pseudo-obstruction) or paralytic ileus as the result of drug side effects. Common symptoms of intestinal obstruction include: nausea, vomiting, abdominal
pain, abdominal swelling, and constipation (or at least scant bowel movements). Fever may also be present. The abdominal pain is more generalized throughout the abdomen and do not tend to favor one side or region. These patients often become dehydrated from persistent vomiting.
Evaluation will include history and physical examination. The abdomen is generally quite tender to palpation (lightly pushing down on the abdomen). Abdominal x-rays will show changes consistent with obstruction. Blood studies(blood counts, chemistry, liver profile, kidney profile, and amylase) will also be required. Treatment will involve: hospitalization, IV fluids and strict avoidance of
anything taken orally. The patient may have a nasogastric tube inserted into the stomach. Suction will be applied to the tube to remove material and air unable to pass through the GI tract. The nasogastric tube is a flexible, plastic tube that is introduced through the nose (using a topical anesthetic) and passed down the throat into the stomach. With the help of the nasogastric tube, surgery can be avoided in a significant number of cases. Those who do not show signs of improvement or those with obstruction secondary to a hernia will require surgery to correct the problem. The General Surgeon is expert in the management of this problem.
Hope this article will provide you information about intestinal obstruction or bowel obstruction.
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