Bowel obstruction is partially or completely blockage of the intestine. Because of it, the process of digestion cannot be performed normally. Obstruction can be caused by a number of factors. The most common causes are entrapment (strangulation) of the hernia, or blockage of the intestine with a tissue, which is a consequence of the previous inflammation or surgery in the abdominal cavity. However, tumors – such as colon cancer and carcinoids – may also interfere with the passage of food through the intestine. Sometimes, a part of the healthy intestine may twist around (this is called volvulus). In rare cases, the cause of bowel obstruction is a partial or complete blockage caused by an indigestible object, e.g. a coin or a key, which the patient accidentally swallowed.
Symptoms depend on the site of obstruction, and whether the obstruction is partial or complete. Obstruction in the small intestine causes intermittent pain, like spasm, in the middle part of the abdominal cavity, with vomiting. However, if the obstruction occurs in the colon, vomiting will not occur. A complete blockage in any part of the digestive tract naturally leads to constipation; if the colon is blocked, the constipation will be so pronounced that the patient will not be able to release gases. Partial obstruction will more likely cause diarrhea than constipation, as only the watery part of the excretion may pass. If the obstruction is a consequence of the volvulus, a ”twisted” part of the intestine may sometimes relax, which will reduce pain and cause flatus and abundant, watery stool. However, the relief is usually only temporary, so you should definitely go to the doctor for advice and treatment.
Bowel obstruction is not frequent. Fortunately, the underlying cause is usually detected and resolved before a complete blockage occurs.
Any interruption in normal functioning of the intestine can cause muscle paralysis. Frequent vomiting can cause dehydration and, after some time, shock. If the blockage is not treated there is a risk of intestinal rupture, which will cause peritonitis. The danger is even greater if the obstruction is a consequence of cancer, because the disease can be expanded.
What to do?
If you notice symptoms indicating the possibility of bowel obstruction, call your doctor or ambulance immediately. The doctor can confirm your suspicions if you explain the symptoms clearly, and after he examines your stomach. In that case, you will be immediately taken to the hospital to determine the cause and the exact place of obstruction. X-ray capture will probably get enough data to get started with therapy, although sometimes a fast exploratory (laparotomy) operation will be needed. You will probably get fluids with infusion to prevent dehydration and shock, while the contents of the gastrointestinal tract, which is accumulated in front of the blockage, will be removed with the tube that passes through the stomach into the intestine.
The surgical procedure is virtually inevitable, and can usually be performed simultaneously with laparotomy. If the source of the problem is volvulus, the surgeon may be able to ”untwist” the intestine to prevent new obstruction. However, surgeons often prefer to remove part of the intestine in which the blockage occured to eliminate any risk of reoccurrence. Prospects for complete recovery after surgery are excellent, and problems are only possible if the underlying disease does not respond to therapy.