Bowel obstruction is a serious condition that affects many people every year. It can become a surgical emergency if not treated correctly.
Definition of Bowel Obstruction
A bowel obstruction is a blockage of flow, usually through the large or small intestines.
Anatomy of a Bowel Obstruction
A bowel obstruction can occur anywhere along the large or small intestines. Most commonly, this happens to small bowel due to adhesions or scar tissue after previous procedures.
Causes of a Bowel Obstruction
There are a number of causes for a bowel obstruction. Most commonly this occurs due to scar tissue after a previous abdominal procedure. Some patients have colon cancer that blocks the bowel. Children can develop a volvulus or an intussusception that blocks their bowel. This is a twisting of the bowel that prevents it from moving stool appropriately. Finally, patients with inflammatory bowel disease can have severe inflammation which can decrease the size of the bowel lumen that could also lead to a bowel obstruction.
Symptoms of a Bowel Obstruction
Patients with a bowel obstruction complain of abdominal pain, bloating, and a lack of stool and gas. If they develop an infection of their bowel they can develop a fever and excruciating pain.
Diagnosis of a Bowel Obstruction
A patient’s history and physical exam are often enough to diagnose a bowel obstruction. However, computed tomography (CT) with oral contrast can be both diagnostic and therapeutic. Plain x-rays can also demonstrate a bowel obstruction.
Prevention of a Bowel Obstruction
For most patients, a bowel obstruction cannot be prevented. However, for those patients with an obstruction due to irritable bowel disease taking medication as prescribed and seeing your physician regularly can help prevent flairs and obstructions. Patients should also have routine colonoscopies to treat and prevent colon cancer.
Am I At Risk?
Patients who are at an older age or at risk for colon cancer can develop a bowel obstruction. Patients with inflammatory bowel disease are also at risk for a bowel obstruction. Finally, any patient who has previously had abdominal surgery is at risk of a bowel obstruction.
Treatment of a Bowel Obstruction
Treatment will typically start with fluids and bowel decompression with a nasogastric tube. The tube removes fluid and air from the bowel. For many patients, this is the only treatment necessary. Oral contrast can also be used to help pull water into the bowel and propel bowel contents out of the body. For most patients, no surgical intervention is needed. However, for patients with colonic obstructions, or those unresponsive to medical management, surgery is necessary. The extent of surgery will depend on the patient’s condition, cause of obstruction, and overall health. This will be discussed by the patient and surgeon to fit the patient’s particular needs.
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