Summary about Disease
Bowel obstruction, also known as intestinal obstruction, is a blockage that prevents food, fluids, and gas from passing through the intestines normally. This can occur in the small or large intestine (colon). It can be partial or complete, and without prompt treatment, it can lead to serious complications, including tissue death, infection, and even death.
Symptoms
Common symptoms of bowel obstruction include:
Abdominal pain, cramping, and distension (swelling)
Inability to pass gas or stool
Nausea and vomiting (vomit may contain fecal matter)
Constipation
Loss of appetite
High-pitched bowel sounds (early on) followed by absent bowel sounds (later on)
Severe bloating
Causes
Causes of bowel obstruction can be mechanical or non-mechanical (ileus).
Mechanical Obstruction:
Adhesions (scar tissue) from previous abdominal surgeries
Hernias
Tumors (benign or malignant)
Inflammatory bowel disease (Crohn's disease)
Volvulus (twisting of the intestine)
Intussusception (telescoping of the intestine)
Impacted stool
Foreign bodies
Non-Mechanical Obstruction (Ileus):
Surgery (especially abdominal surgery)
Infections (intra-abdominal infections like appendicitis or diverticulitis)
Certain medications (e.g., opioids)
Electrolyte imbalances (e.g., low potassium)
Vascular insufficiency
Medicine Used
Medications used to treat bowel obstruction typically focus on supportive care and addressing the underlying cause:
Pain Relief: Pain medications are given but can sometimes mask worsening symptoms, so they must be used judiciously and under medical supervision.
Anti-emetics: Medications to reduce nausea and vomiting (e.g., metoclopramide, ondansetron).
Stool softeners or enemas: May be used for partial obstructions due to stool impaction (use is dependent on the location and severity of obstruction)
Antibiotics: If infection is suspected.
Intravenous fluids: To correct dehydration and electrolyte imbalances. It's crucial to note that medication alone is usually not* sufficient to resolve a complete bowel obstruction. Surgery is often required.*
Is Communicable
Bowel obstruction itself is not communicable (i.e., it cannot be spread from person to person).
Precautions
Precautions to potentially reduce the risk of bowel obstruction depend on the underlying cause:
After Surgery: Follow all post-operative instructions carefully to minimize adhesion formation.
Healthy Diet: A balanced diet with adequate fiber and hydration can help prevent constipation and stool impaction.
Manage underlying conditions: Properly manage inflammatory bowel disease and other conditions that can increase the risk of obstruction.
Be aware of potential symptoms: Seek medical attention promptly if you experience symptoms of bowel obstruction.
How long does an outbreak last?
Bowel obstruction isn't an "outbreak" like an infectious disease. The duration of the obstruction depends entirely on the cause, severity, and promptness of treatment. Without treatment, a complete obstruction can become life-threatening within hours to days. With treatment, resolution can occur within days, but some cases may require weeks of recovery, especially after surgery.
How is it diagnosed?
Diagnosis typically involves:
Physical Examination: The doctor will examine the abdomen for distension, tenderness, and listen for bowel sounds.
Medical History: Detailed history of symptoms, previous surgeries, and medical conditions.
Imaging Studies:
X-rays: Abdominal X-rays can often reveal dilated loops of bowel and air-fluid levels, indicating an obstruction.
CT Scan: More detailed imaging that can help identify the location, cause, and severity of the obstruction. CT scans are usually the preferred imaging modality.
Barium enema or small bowel follow-through: May be used in select cases to visualize the colon or small intestine.
Timeline of Symptoms
The timeline of symptoms can vary, but a general progression might look like this:
Early Stages: Intermittent abdominal cramping, bloating, increased bowel sounds, nausea.
Progression: Pain becomes more constant and severe, vomiting starts (especially after eating), constipation, inability to pass gas.
Late Stages: Severe abdominal distension, constant pain, vomiting becomes fecal-smelling, absent bowel sounds, signs of dehydration (decreased urination, dizziness).
Complications: Fever, rapid heart rate, sepsis, shock, peritonitis (inflammation of the abdominal lining).
Important Considerations
Prompt medical attention is crucial: Bowel obstruction is a serious condition that requires immediate evaluation and treatment.
Surgery is often necessary: Complete obstructions almost always require surgical intervention to remove the blockage.
Dehydration is a major concern: Vomiting and inability to absorb fluids can lead to severe dehydration.
Strangulation risk: If the blood supply to the bowel is cut off (strangulation), tissue death (necrosis) can occur, leading to peritonitis and sepsis. This requires emergency surgery.
Underlying causes: Identifying and addressing the underlying cause of the obstruction is important to prevent recurrence.