BOWEL OBSTRUCTION
A general surgeon is called to see patients with bowel obstruction. My name is Dr. Allen Alvarez, and one of my roles as a general surgeon is to be available for emergencies that require the management of intestinal obstruction. A patient will usually be initially seen at a hospital emergency room and, while “on call,” will contact me at 210-651-0303.
Understanding Bowel Obstruction: Causes, Symptoms, and Treatment
Bowel obstruction, also known as intestinal obstruction, is a condition in which the intestines are partially or completely blocked, hindering the standard passage of stool and gas. It can occur in the small or large intestine (colon) and may result from various underlying causes.
Causes of Bowel Obstruction:
- Adhesions are bands of scar tissue that form between the loops of the intestines, often due to previous abdominal surgery.
- Hernias: Protrusion of a loop of intestine through a weak spot in the abdominal wall, leading to obstruction.
- Tumors: Abnormal growths within the intestines or nearby organs obstructing the normal flow of intestinal contents.
- Volvulus: Twisting of the intestine upon itself, causing obstruction.
- Intussusception: Telescoping of one segment of the intestine into another, leading to obstruction.
- Impacted feces: Severe constipation, known as “obstipation” or hardened stool that blocks the passage of fecal matter.
- Bezoar: impacted food particles
- Foreign Bodies: large unpassable objects ingested or otherwise inserted into the GI tract
- Gallstones: Gallstones from the gallbladder can erode into the intestines and lodge themselves, requiring surgical extraction.
Symptoms of Bowel Obstruction:
- Abdominal pain: Crampy, colicky pain that may come and go in waves. The pain is typically localized and may be severe.
- Abdominal distension: Swelling or bloating of the abdomen due to gas and fluid accumulation.
- Nausea and vomiting: These often occur when an obstruction prevents the normal passage of food and fluids through the intestines.
- Constipation or inability to pass gas: Difficulty passing stool or gas due to the blockage.
- Decreased appetite: Loss of appetite or aversion to eating due to discomfort.
Diagnosis:
Diagnosing bowel obstruction typically involves a combination of medical history review, physical examination, and diagnostic tests. Imaging studies such as X-rays, CT scans, or abdominal ultrasound may be used to visualize the site and severity of the obstruction.
Treatment:
- Conservative management: In cases of partial obstruction or mild symptoms, conservative measures such as bowel rest, intravenous fluids, and pain management may be sufficient to resolve the obstruction.
- Surgical intervention: Complete or severe bowel obstruction often requires surgical intervention to relieve the blockage. Depending on the underlying cause, surgical options may include adhesiolysis (removal of adhesions), hernia repair, tumor resection, or bowel resection.
- Nasogastric decompression: In cases of significant abdominal distension and vomiting, a nasogastric tube may be inserted through the nose into the stomach to help decompress the intestines and relieve symptoms.
- Fluid and electrolyte replacement: Intravenous fluids may be administered to correct dehydration and electrolyte imbalances resulting from vomiting and fluid loss.
Complications:
Untreated or severe bowel obstruction can lead to serious complications such as bowel ischemia (lack of blood flow to the intestines), bowel perforation, peritonitis (inflammation of the abdominal lining), and sepsis (systemic infection).
Conclusion
Bowel obstruction is a potentially severe condition that requires prompt medical attention. Recognizing the symptoms and seeking timely evaluation and treatment are essential for preventing complications and promoting recovery. For information regarding general surgical needs and those related to bowel obstruction, visit me at ( insert about me on sage website )