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How to fix a bowel obstruction

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If your digestive system comes to a grinding halt, you won’t be able to make a bowel movement or pass gas. You might also have stomach pain and a swollen belly.

These could all be signs you have a bowel obstruction, which is a serious problem that happens when something blocks your bowel, either your large or small intestine.

A common type of obstruction, or blockage, is called fecal impaction. Fecal impaction is when a large, hard mass of stool gets stuck in your digestive tract and can’t be pushed out the normal way. When the bowel is blocked by something other than hard stool, doctors call it a bowel obstruction.

Causes

There are different ways that your bowel could become blocked:

  • Part of your bowel may become twisted, which can close it off and stop anything from passing through.
  • Your bowel may become inflamed and swell up.
  • Scar tissue or a hernia could make your bowel too narrow for anything to pass through.
  • A tumor or other type of growth inside your bowel could block the passage.
  • Damaged blood vessels leading to the bowel can cause some bowel tissue to die.

In many cases, inflammation, prior surgeries, or cancer can cause the bowel obstruction. It’s more likely to happen in older people.

Bowel obstructions can happen in your small or large intestine, but they’re more likely to be in the small intestine. Common causes are:

Continued

Symptoms

Signs of an intestinal blockage will depend on how bad the obstruction is. But it almost always comes with abdominal pain and cramping. Here are some other possible signs you have a bowel obstruction:

  • You’re constipated.
  • You can’t pass gas at all.
  • Stomachcramps come and go.
  • You don’t get hungry.
  • You throw up or feel like you’re going to.
  • Your belly is swollen

If you’ve been constipated and any of these symptoms appear, contact your doctor right away. They should let you know whether or not you’re having an emergency and should call 911.

Many people with bowel obstructions are older and may have other serious illnesses, so a bowel obstruction may be life-threatening. You’ll most likely need to go to the hospital to get better.

Diagnosis

Your doctor will ask about your medical history — whether you’ve been constipated, if you’ve had cancer, what new symptoms you’ve had. She’ll do a physical exam to see if you have pain in your abdomen, if you’re able to pass gas, or if there’s a lump that she can feel in your abdomen. You may need blood tests, or you may need to have your urine tested.

She may also send you to have a CT scan, because it’s likely to show a blockage if you have one. Sometimes a bowel obstruction can appear on an X-ray, so your doctor may ask you to get X-rays of your abdomen instead.

Your doctor may give you a barium enema. This means a special liquid that contains barium (a whitish-silver metal) will be inserted into your rectum. It will spread into your bowels and appear on an X-ray as a bright area. If there’s a blocked area, the barium may show it.

Treatment

If you have a complete blockage of your bowel, you will likely have to be hospitalized for treatment, which typically includes surgery or a procedure to open up the blockage.

Surgery. If you’re healthy enough for surgery, you may need to have the area causing the blockage removed. The surgeon also will remove any tissue in your bowel that has died due to lack of blood flow.

Stent. This is the safer option for people who are too sick for emergency surgery. A stent made out of wire mesh is placed in the bowel at the site of the blockage to force the bowel open. This will allow matter to pass through again. Some people may not need anything more than a stent. Others may need surgery after they become stable.

Sources

Mayo Clinic: “Intestinal obstruction: Overview,” “Intestinal obstruction: Symptoms and causes,” “Intestinal obstruction: Treatment.”

National Cancer Institute: “Gastrointestinal complications (PDQ) – patient version: Bowel obstruction.”

Cleveland Clinic: “Large bowel (intestinal) obstruction.”

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A twisted bowel is a serious condition that needs quick care. Your treatment plan depends on where the twist is in your intestine and your overall health. Explore the options, then talk with your doctor to figure out the best option for you.

What Is Twisted Bowel?

Your doctor may call it volvulus. It happens when your intestine twists around itself or the tissue that holds it in place. The affected spot blocks food and liquid from passing through. It may even be tight enough to cut off blood flow. If this happens, the tissue in that area of the intestine can die. That can cause serious problems.

The most common form of twisted bowel is sigmoid volvulus. It’s the twisting of the last part of your colon, called the sigmoid colon. It can also happen in the beginning of the large intestine (the cecum and ascending colon). If it’s twisted there, that’s called cecal volvulus.

Nonsurgical Options

In some cases, you won’t need surgery to straighten things out.

If the twist is in the sigmoid colon, your doctor may first try a sigmoidoscopy. He’ll put a flexible tube (or sigmoidoscope) through your rectum and into the lower part of your colon. Small amounts of air get pumped into the colon to open it. This is usually enough to straighten your intestine. But the chance of the bowel twisting again in the same spot is very high. Your doctor may suggest surgery as a permanent solution.

A similar procedure, colonoscopy, can fix twists in the beginning of the colon. But the chance of it twisting again is high. Most cases in this area need surgery.

Surgeries

Surgery is an option to treat volvulus and stop the intestine from twisting again. Types of surgeries for twisted bowel include:

Colectomy: This is a surgery that removes all or part of your colon. For a twist in the lower colon, your doctor will take out the affected part of your intestine. Then, he’ll put the two healthy ends together in a procedure called bowel resection. The chance of volvulus coming back after this surgery is very low.

Continued

If you have cecal volvulus, the beginning of your large intestine is removed, including the cecum and ascending colon. The part that’s left is then attached to the end of your small intestine.

Colostomy: Like a colectomy, this surgery involves taking out the twisted portion of the lower intestine. With a colostomy, instead of putting the two parts of the colon back together, one end attaches to a hole made in your belly. Then a colostomy bag gets attached to the opening to catch bodily waste.

If you show signs of infection or other serious symptoms from a twisted bowel, your doctor may do what’s called a Hartmann procedure. It’s the same as a colostomy, except that it can be reversed in 3 to 6 months if you’re feeling better.

Cecostomy: The twist in the beginning of the colon gets straightened out. Then, your doctor puts a thin tube in your cecum through a small cut in your belly. The tube helps get rid of waste and attaches your cecum to your stomach’s inner wall.

People with cecal volvulus may get a cecostomy if they’re not healthy enough for other surgeries. Your chance of an infection is high, but your colon probably won’t twist again.

Cecopexy: This can also treat cecal volvulus. Doctors will untwist the beginning of the colon and stitch it to the inner belly wall. After this procedure, there’s a high chance the same area will twist again. So it’s usually saved for people whose condition is unstable.

Sources

The National Institute of Diabetes and Digestive and Kidney Diseases: “Anatomic Problems of the Lower GI Tract.”

Medscape: “Sigmoid and Cecal Volvulus Treatment & Management.”

Diseases of the Colon & Rectum: “Clinical Practice Guidelines for Colon Volvulus and Acute Colonic Pseudo-Obstruction.”

Mayo Clinic: “Flexible Sigmoidoscopy,” “Colectomy,” “Colostomy.”

Clinics in Colon and Rectal Surgery: “Management of Colonic Volvulus.”

Intestinal obstruction repair is surgery to relieve a bowel obstruction. A bowel obstruction occurs when the contents of the intestines cannot pass through and exit the body. A complete obstruction is a surgical emergency.

Description

Intestinal obstruction repair is done while you are under general anesthesia. This means you are asleep and DO NOT feel pain.

The surgeon makes a cut in your belly to see your intestines. Sometimes, the surgery can be done using a laparoscope, which means smaller cuts are used.

The surgeon locates the area of your intestine (bowel) that is blocked and unblocks it.

Any damaged parts of your bowel will be repaired or removed. This procedure is called bowel resection. If a section is removed, the healthy ends will be reconnected with stitches or staples. Sometimes, when part of the intestine is removed, the ends cannot be reconnected. If this happens, the surgeon will bring one end out through an opening in the abdominal wall. This may be done using a colostomy or ileostomy.

Why the Procedure is Performed

This procedure is done to relieve a blockage in your intestine. A blockage that lasts for a long time can reduce or block blood flow to the area. This can cause the bowel to die.

Risks

Risks of anesthesia and surgery in general include:

  • Reactions to medicines, breathing problems
  • Bleeding, blood clots, infection

Risks of this procedure:

  • Bowel obstruction after surgery
  • Damage to nearby organs in the body
  • Formation of scar tissue (adhesions)
  • More scar tissue forming in your belly and causing a blockage of your intestines in the future
  • Opening of the edges of your intestines that are sewn together (anastomotic leak), which may cause life-threatening problems
  • Problems with colostomy or ileostomy
  • Temporary paralysis (freezing up) of the bowel (paralytic ileus)

After the Procedure

How long it takes to recover depends on your overall health and the type of operation.

Outlook (Prognosis)

The outcome is usually good if the obstruction is treated before bowel blood flow is affected.

People who have had many abdominal surgeries may form scar tissue. They are more likely to have bowel obstructions in the future.

Alternative Names

Repair of volvulus; Intestinal volvulus – repair; Bowel obstruction – repair

Patient Instructions

Images

  • Intussusception – x-ray
  • Before and after small intestine anastomosis
  • Intestinal obstruction (pediatric) – series
  • Intestinal obstruction repair – series

References

Mahmoud NN, Bleier JIS, Aarons CB, Paulson EC, Shanmugan S, Fry RD. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 51.

Mizell JS, Turnage RH. Intestinal obstruction. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 123.

Nausea, swollen abdomen, constipation, and a change in your stool are all bowel obstruction symptoms. Get the facts about this uncommon but serious condition.

How to Fix a Bowel Obstruction

A change in bowel movements, nausea, and a bloated abdomen are all signs of bowel obstruction, a condition that tends to strike people in certain circumstances, such as those recovering from abdominal surgery. Bowel obstruction is not a common problem for most people.

“A bowel obstruction is a very generic term,” says Jay Pasricha, MD, professor of gastroenterology at the Stanford School of Medicine in Stanford, Calif. “Technically it’s the small bowel or intestine and the large bowel or intestine. You could have obstruction of either one of those regions of the gastrointestinal tract.”

What Causes Bowel Obstruction?

When something blocks the bowel, it is a bowel obstruction. An obstructed bowel can have many causes. These are usually due to:

  • Cancer
  • Scarring from previous surgery
  • Scarring from radiation therapy
  • Scarring from endometriosis

Besides a physical blockage, says Dr. Pasricha, there are also the pseudo-obstructions. These are “a failure of the bowel itself to be able to push things down. It can behave like a mechanical obstruction although it is not due to anything physically” obstructing the bowel.

Bowel Obstruction Symptoms

Obstructed bowel symptoms depend on the cause of the obstruction, where the obstruction is located, and how long it has taken for the obstruction to cause problems.

“In general, the lower down the obstruction occurs, the longer it takes to really manifest itself,” says Pasricha. “There is a lot of capacity of the bowel to expand and adapt. Eventually the contents start backing up.”

Here are the most common bowel obstruction symptoms:

  • Distended (swollen or bloated) abdomen
  • Nausea
  • Vomiting — color and texture of vomit may help diagnose the obstruction
  • Change in bowel habits
  • Constipation
  • Very thin stools
  • Blood in the stool, especially likely if cancer is a cause

In general, Pasricha advises people with some of these symptoms, especially nausea, constipation, and abdominal bloating, and no other obvious cause for those symptoms, to contact their doctor for an evaluation. Although bowel obstruction can take a long time to create serious problems in most people, it can require urgent attention. “If you have unrelieved obstruction, there is a risk of ischemia [decrease in the blood supply] and that can be fatal,” warns Pasricha.

Diagnosing Bowel Obstruction

Diagnosis of bowel obstruction is not difficult, says Pasricha. The diagnostic process will include:

  • Description of symptoms. Give your doctor a detailed description of the bowel obstruction symptoms that are causing you concern.
  • Medical history. Tell your doctor about any recent surgeries or medical treatments as well as ongoing health conditions and medications or supplements you are taking.
  • Physical examination. Your doctor may want to examine your abdomen and any other parts of your body where you are experiencing pain or discomfort.
  • Imaging tests. “To diagnose [bowel obstruction], you rely on imaging,” says Pasricha. Your doctor may use an X-ray or CT (computed tomography) scan.
  • Colonoscopy. If your doctor suspects that the obstruction is in the large bowel, he may order a colonoscopy. You will be sedated for this test while your doctor inserts a camera at the end of a thin tube into your colon. This allows him to see inside the colon.

Treating Bowel Obstruction

“For most mechanical obstructions [scarring, cancer] the real treatment is surgery, but a lot of patients with post-operative obstruction due to adhesions sometimes can be managed by putting a tube through the nose down into the bowel,” say Pasricha. This decompresses the bowel, allowing it to get untwisted. This may not solve the original problem causing the obstruction, but it is often a first step, even for patients who are going to have surgery.

The length and ease of recovery depends on the cause, warns Pasricha. Older people may find recovery takes longer. Additionally, some people who tend to develop obstructions as a result of scarring from abdominal surgery can experience repeated obstructions.

“Typically, if it is a mild to moderate obstruction caught early in time, they usually recover well,” he says.

Learn more in the Everyday Health Digestive Health Center.

Key Points

  • A bowel obstruction is a blockage of the small or large intestine by something other than fecal impaction.
  • The most common cancers that cause bowel obstructions are cancers of the colon, stomach, and ovary.
  • Assessment includes a physical exam and imaging tests.
  • Treatment is different for acute and chronic bowel obstructions.
    • Acute bowel obstruction
    • Chronic, malignant bowel obstruction

A bowel obstruction is a blockage of the small or large intestine by something other than fecal impaction.

Bowel obstructions (blockages) keep the stool from moving through the small or large intestines. They may be caused by a physical change or by conditions that stop the intestinal muscles from moving normally. The intestine may be partly or completely blocked. Most obstructions occur in the small intestine.

Physical changes

  • The intestine may become twisted or form a loop, closing it off and trapping stool.
  • Inflammation, scar tissue from surgery, and hernias can make the intestine too narrow.
  • Tumors growing inside or outside the intestine can cause it to be partly or completely blocked.

If the intestine is blocked by physical causes, it may decrease blood flow to blocked parts. Blood flow needs to be corrected or the affected tissue may die.

Conditions that affect the intestinal muscle

  • Paralysis (loss of ability to move).
  • Blocked blood vessels going to the intestine.
  • Too little potassium in the blood.

The most common cancers that cause bowel obstructions are cancers of the colon, stomach, and ovary.

Other cancers, such as lung and breast cancers and melanoma, can spread to the abdomen and cause bowel obstruction. Patients who have had surgery on the abdomen or radiation therapy to the abdomen have a higher risk of a bowel obstruction. Bowel obstructions are most common during the advanced stages of cancer.

Assessment includes a physical exam and imaging tests.

The following tests and procedures may be done to diagnose a bowel obstruction:

  • Physical exam: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. The doctor will check to see if the patient has abdominal pain, vomiting, or any movement of gas or stool in the bowel.
  • Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
  • The number of red blood cells, white blood cells, and platelets.
  • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
  • The portion of the blood sample made up of red blood cells.

Treatment is different for acute and chronic bowel obstructions.

Acute bowel obstruction

Acute bowel obstructions occur suddenly, may have not occurred before, and are not long-lasting. Treatment may include the following:

  • Fluid replacement therapy: A treatment to get the fluids in the body back to normal amounts. Intravenous (IV) fluids may be given and medicines may be prescribed.
  • Electrolyte correction: A treatment to get the right amounts of chemicals in the blood, such as sodium, potassium, and chloride. Fluids with electrolytes may be given by infusion.
  • Blood transfusion: A procedure in which a person is given an infusion of whole blood or parts of blood.
  • Nasogastric or colorectal tube: A nasogastric tube is inserted through the nose and esophagus into the stomach. A colorectal tube is inserted through the rectum into the colon. This is done to decrease swelling, remove fluid and gas buildup, and relieve pressure.
  • Surgery: Surgery to relieve the obstruction may be done if it causes serious symptomsthat are not relieved by other treatments.

Patients with symptoms that keep getting worse will have follow-up exams to check for signs and symptoms of shock and to make sure the obstruction isn’t getting worse.

Chronic, malignant bowel obstruction

Chronic bowel obstructions keep getting worse over time. Patients who have advanced cancer may have chronic bowel obstructions that cannot be removed with surgery. The intestine may be blocked or narrowed in more than one place or the tumor may be too large to remove completely. Treatments include the following:

What is a Bowel Obstruction?

Bowel obstruction is a blockage in the intestine, which prevents the contents of the intestine to pass normally through the digestive tract. The blockage in the intestine can be caused by adhesions, twisting, tumors, lodged food and hernia.

What Are The Symptoms Of Bowel Obstruction?

The symptoms presented by a patient suffering from bowel obstruction are: abdominal cramping, nausea, vomiting, a bloated abdomen, rapid pulse and breathing, constipation, diarrhea and lack of bowel movement.

A bowel obstruction requires immediate medical attention. With proper diagnosis and care, the patient suffering from bowel obstruction starts feeling better within a few weeks.

Diagnosis of Bowel Obstruction

This is the first step involved in clearing the obstructed intestine. With the help of the doctor, the cause of the bowel obstruction is diagnosed so that it can be cleared as soon as possible.

The doctor notes down the symptoms of the patient suffering from bowel obstruction and performs a physical examination. The abdomen is examined for any sign of tenderness. Colonoscopy is performed if the blockage is suspected in the large intestine. A blood test is performed to get information about any other infection. Barium X-ray or a CT scan helps locate the site of obstruction in the bowels.

How to Fix a Bowel Obstruction

How is Bowel Obstruction Treated or Cleared?

The treatment of bowel obstruction relies basically on the cause, but the patient mostly requires hospitalization. To clear the bowel obstruction, hospitalization is done to stabilize the patient’s condition so that the treatment can be performed. Patient with bowel obstruction is given intravenous fluids. A naso-gastric tube is inserted to suck out the air and fluid to relieve abdominal swelling due to bowel obstruction. A thin catheter is inserted to collect the patient’s urine for testing

Barium or air enema is used to clear the intussusceptions and bowel obstruction. Usually, no further treatment is required, if the enema works in clearing the bowel obstruction.

Patients with partial bowel obstruction do not require further treatment after being stabilized. The patient is recommended a low-fiber diet, which is easier to process. But if the bowel obstruction does not clear on its own, then surgery is required to clear the bowel obstruction.

In cases where the intestine is completely obstructed then also surgery is mandatory. The procedure of the surgery for clearing the bowel obstruction depends on the cause of the obstruction and the part of intestine affected. Surgery removes the obstruction as well the section of the intestine that is damaged.

Stenting is done to provide temporary relief to the patient in whom the emergency surgery for bowel obstruction is risky. Self-expanding metal stents are inserted into the colon to force open the intestine to clear the obstruction. But once the condition is stabilized, surgery for clearing the bowel obstruction can be performed.

Conservative Treatment for Bowel Obstruction

If the doctor cannot be reached immediately, the following tips can prove to be helpful in providing relief from bowel obstruction:

  • Move around as it brings about the movement in the intestines as well and helps in clearing the bowel obstruction.
  • A warm bath or a heating bath helps the muscles relax and let the intestines do their job with ease.
  • Drink a lot of water and fluids. It helps to push the blockage if it is due to the lodged food and clear the obstruction. The most effective fluids are grape juice, carbonated beverages, and hot tea.
  • Change position, as this can also help in clearing the bowel obstruction.
  • Massage the area around the abdomen. It encourages the food to come out of the stomach.

How to Avoid Bowel Obstruction?

  • Avoid hard to digest food, such as nuts, seeds, mushroom, uncooked veggies and corn.
  • Chew well, as completely chewed food help in digestion of food and prevents bowel obstruction.
  • To prevent bowel obstruction, stay hydrated and drink plenty of fluids after meals.

Natural Remedies To Clear A Bowel Obstruction

Water. The best thing that can be done for colon cleansing is drinking plenty of water. About 10-12 glasses of water every day helps flush out toxins and waste from the body naturally. It also helps in the natural peristaltic action, which helps the food move through the digestive system. Along with water fresh fruits and vegetable juices can be consumed to clear the bowel obstruction.

Apple Juice. Apple juice helps in bowel movements, breakdown toxins and boosts the liver and digestive system health and hence helps clear bowel obstruction.

Lemon Juice. Antioxidant properties and the rich vitamin C content in lemons make them really good for the digestive system. Lemon juice is great for colon cleansing and clearing bowel obstruction.

Mix the juice of one lemon with a pinch of salt, honey and a glass of lukewarm water. Drink it every morning for more energy, better bowel movement and good skin condition.

Raw Vegetable Juice. Processed and cooked food should be kept away if suffering from the obstructed colon. Instead, drinking fresh vegetable juice is recommended. Green vegetables contain chlorophyll, which helps force the toxins out of the body.

Fiber-Rich Food. Fiber helps keep stool soft and help in bowel movement. Foods rich in fiber helps get rid of any kind of intestinal problems including bowel obstruction. Raspberries, artichokes, peas, nuts, beans, and seeds are some good source of fiber-rich food.

Yogurt. Yogurt is a probiotic food and brings good bacteria and helps in digestion. Yogurt also helps fight inflammatory bowel disease and also prevents bowel obstruction.

A stricture is an abnormal narrowing of a passage or opening. Intestinal strictures often result from a build up of thickened scar tissue as a result of chronic intestinal inflammation such as in inflammatory bowel disease (particularly Crohn’s disease). Recent reports have associated strictures with a lack of “good’ protective bacteria and an overgrowth of bad bacteria (viruses, parasites, fungi, candida, etc.) in the small intestine.

An intestinal obstruction, or bowel obstruction, is a partial or complete blockage of the intestine or colon, stopping or slowing the movement of the contents of the bowel through the digestive tract. Common causes of bowel obstruction are strictures, hernias, tumors, impacted feces or a malfunctioning or twisted bowel.

Bowel obstruction and/or intestinal stricture symptoms vary depending on the degree of intestinal obstruction, but commonly begin with abdominal pain, bloating, and cramping. If the stricture continues to narrow, symptoms progress to more severe pain and bloating, nausea and vomiting, and constipation.

In severe cases, the strain of trying to force the contents of the bowel through an intestinal blockage can weaken parts the bowel and cause it to rupture, or perforate. A perforated bowel is a serious and dangerous condition that can cause shock and widespread infection. Bowel and colon perforation symptoms include fever, a very rigid abdomen, severe shaking or shivering, and constipation – where you’re not passing any stool, or even gas. A ruptured intestine is a serious bowel problem that requires immediate surgery, so if you find yourself with these symptoms, call an ambulance right away – delayed treatment could result in death.

How to Fix a Bowel Obstruction

Natural Remedy For Intestinal Stricture or Bowel Obstruction

Note: This Natural Remedy Page provides only basic information about natural treatment for intestinal stricture or bowel obstruction. You can purchase the eBook Jini’s Healing Guide: Natural Treatments for Intestinal Strictures in our Shoppe for full, detailed instructions and dosages.

We have a tried and tested procedure you can use for bowel stricture and intestinal strictures and adhesions that has worked for many to relieve pain and release a constricted bowel obstruction (especially when paired with an elemental liquid diet):

  • Apply a hot castor oil pack to the abdomen over the affected area (see instructions below).
  • Leave the hot castor oil pack on for 30 minutes, then remove the heat source and gently perform colonic massage (see video at the bottom of this page).
  • Go on an elemental liquid diet (such as the IBD Remission Diet) to flush the bowel and to provide bowel rest. If you are not underweight, then you can use just homemade bone broths, diluted juice, protein shakes made with coconut water, and Emergen-C as your liquid diet.
  • If you’re on the IBD Remission Diet liquid diet, supplement with MucosaCalm and George’s Aloe Vera juice. If you don’t follow the Diet, then take MucosaCalm as directed on the bottle, and at least 1 tablespoon of flax and/or fish oil per day. Of course, you can also take George’s “Always Active” Aloe Vera juice.
  • Take the full spectrum of probiotics (L. acidophilus, B. bifidum, L. bulgaricus) in powder form, 3 times per day on an empty stomach.
  • Use Jini’s Probiotic Retention Enema if you have strictures or obstructions in your colon.
  • Simultaneously begin craniosacral treatments to release and soften scar tissue.

“Medical treatments for intestinal strictures include dilating or stretching the narrowed segment, or surgically removing it. Unfortunately, both of these procedures result in more scar tissue, and possibly recurrent inflammation (with post-operative intestinal fistulas and abscesses), so neither are an effective long-term solution.

Until now there has only been three likely treatments for a serious stricture or bowel blockage in the small or large bowel:

  1. Surgery – which then creates more scar tissue and may result in additional strictures in anywhere from six months to ten years time.
  2. Manual manipulation of affected tissue to increase circulation and movement in the tissue – therapies like the Wurn Technique, myosfacial release, craniosacral therapy.
  3. Liquid or semi-liquid diet – until the stricture either releases enough on its own for a more normal diet to be resumed, or surgery is performed.

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Digested food particles must travel through 25 feet or more of intestines as part of normal digestion. These digested wastes are constantly in motion. However, intestinal obstruction can put a stop to this. An intestinal obstruction occurs when your small or large intestine is blocked. The blockage can be partial or total, and it prevents passage of fluids and digested food.

If intestinal obstruction happens, food, fluids, gastric acids, and gas build up behind the site of the blockage. If enough pressure builds up, your intestine can rupture, leaking harmful intestinal contents and bacteria into your abdominal cavity. This is a life-threatening complication.

There are many potential causes of intestinal obstruction. Often, this condition can’t be prevented. Early diagnosis and treatment are crucial. An untreated intestinal obstruction can be fatal.

Intestinal obstruction causes a wide range of uncomfortable symptoms, including:

Some of the symptoms may depend on the location and length of time of the obstruction. For example, vomiting is an early sign of small intestine obstruction. This may also occur with an obstruction of your large intestine, if it’s ongoing. A partial obstruction can result in diarrhea, while a complete obstruction can result in an inability to pass gas or stool.

Intestinal obstruction may also cause serious infection and inflammation of your abdominal cavity, known as peritonitis. This occurs when a portion of your intestine has ruptured. It leads to fever and increasing abdominal pain. This condition is a life-threatening emergency requiring surgery.

An obstruction can be partial, which may resolve without surgery. A complete blockage is more likely to need intestinal surgery.

Mechanical obstructions

Mechanical obstructions are when something physically blocks your intestine. In the small intestine, this can be due to:

  • adhesions, which consist of fibrous tissue that can develop after any abdominal or pelvic surgery or after severe inflammation
  • volvulus, or twisting of the intestines
  • intussusception, a “telescoping,” or pushing, of one segment of intestine into the next section
  • malformations of the intestine, often in newborns, but can also occur in children and teens
  • tumors within your small intestine
  • gallstones, although they rarely cause obstructions
  • swallowed objects, especially in children
  • hernias, which involve a portion of your intestine protruding outside of your body or into another part of your body
  • inflammatory bowel disease, such as Crohn’s disease

Although less common, mechanical obstructions can also block your colon, or large intestine. This can be due to:

  • impacted stool
  • adhesions from pelvic infections or surgeries
  • ovarian cancer
  • colon cancer
  • meconium plug in newborns (meconium being the stool babies first pass)
  • volvulus and intussusception
  • diverticulitis, the inflammation or infection of bulging pouches of intestine
  • stricture, a narrowing in the colon caused by scarring or inflammation

Nonmechanical obstruction

Your small and large intestines normally work in a coordinated system of movement. If something interrupts these coordinated contractions, it can cause a functional intestinal obstruction. This is generally known as a nonmechanical obstruction. If it’s a temporary condition, it’s referred to as an ileus. It’s called a pseudo-obstruction if it becomes chronic, or long term.

Causes for ileus include:

  • abdominal or pelvic surgery
  • infections, such as gastroenteritis or appendicitis
  • some medications, including opioid pain medications
  • electrolyte imbalances

Intestinal pseudo-obstruction can be caused by:

  • Parkinson’s disease, multiple sclerosis, and other nerve and muscle disorders
  • Hirschsprung’s disease, a disorder in which there is a lack of nerves in sections of the large intestine
  • disorders that cause nerve injury, such as diabetes mellitus
  • hypothyroidism, or an underactive thyroid gland

Intestinal obstruction in infants typically arises from infections, organ diseases, and decreased blood flow to the intestines (strangulation). Some children experience the condition after having a stomach flu. This can cause inflammation in their intestines.

Intussusception is most common in children 2 years old and younger. This occurs when one part of their bowel collapses or slides into another part. As a result, their intestine becomes blocked.

Any type of intestinal obstruction is difficult to diagnose in infants because they can’t describe their symptoms. Instead, parents must observe their children for changes and symptoms that could indicate a blockage. Examples include:

  • abdominal swelling
  • drawing knees up to their chest
  • appearing excessively drowsy
  • having a fever
  • grunting in pain
  • passing stools that appear to have blood in them, known as a currant jelly stool
  • very loud crying
  • vomiting, particularly bile-like vomiting that is yellow-green
  • displaying signs of weakness

If you notice these symptoms or other changes in your child, seek immediate medical attention.

Seek medical care if you have symptoms of an intestinal obstruction, especially if you’ve recently undergone abdominal surgery. If you experience abdominal bloating, severe constipation, and a loss of appetite, seek immediate medical attention.

This leaflet is to help you understand what Fetal Bowel obstruction is, what tests you need and the implication of being diagnosed with Fetal Bowel Obstruction for your baby and your family.

What is a Fetal Small Bowel Obstruction?

Fetal bowel obstructions can either be in the small bowel or the large bowel, which is also called the colon. The small bowel, also called the small intestine, has three parts to it: the duodenum, the jejunum and the ileum, and any part can have a blockage in it. (This information sheet does not discuss blockages in the duodenum or in the colon). Normal bowel has a muscular wall which contracts to propel fluid through it. When there is a blockage or narrowing in the bowel, the normal movements the bowel makes become exaggerated as the bowel tries to propel fluid through the blockage. These movements, also called peristalsis, can be seen over several seconds with ultrasound. The bowel also appears to be larger than expected in some areas and the size (diameter) of the bowel changes over time. There can be one or more blockages in the bowel, but, unfortunately, ultrasound isn’t really helpful in figuring out the location or number of blockages. Sometimes, there are additional signs on ultrasound which can lead doctors to think that the obstruction is in one or another of the areas of the bowel. These can include extra amniotic fluid (polyhydramnios), an enlarged stomach, fluid inside the fetal abdomen but outside the bowel (ascites) and calcifications (accumulation of calcium) in the abdomen of the fetus.

How does a Fetal Small Bowel Obstruction happen?

Fetal Bowel obstructions are relatively rare and occur in 1 of 300-5000 live births. The exact reason why they occur is not known yet, but it is thought that they happen due to damage to the blood vessels that feed the bowel during the first 6-12 weeks of fetal life. Bowel obstructions can occur as a result of twisting of the bowel on itself (volvulus), improper rotation of the bowel in early pregnancy (malrotation), or sometimes a portion of the bowel moves inside another portion of it (intussusception). Maternal medications, including some decongestants as well as maternal use of nicotine, amphetamines, or cocaine, have been associated with bowel obstructions.

Should I have more tests done?

Many women will choose to have more tests done to know more about the condition of their baby. The tests available depend on where you live. Tests to ask about include a blood test or amniocentesis (where a thin needle is used to take some of the fluid from the womb) or blood sample to look for cystic fibrosis. Unless there are additional ultrasound findings, amniocentesis for chromosomes is typically not recommended but this can be performed in any pregnancy. Occasionally, severely increased amniotic fluid volume (polyhydramnios) occurs and patients request an amniocentesis to temporarily reduce the amount of amniotic fluid to make them more comfortable for a few days. There is currently no prenatal treatment for bowel obstruction in the fetus. Your doctor may wish you to be evaluated by a specialist in ultrasound for more information.

What are the things to watch for during the pregnancy?

Babies with bowel obstructions should have additional ultrasound examinations. These ultrasound examinations will focus mostly on the baby’s growth and amniotic fluid volume, since the most common complications in babies with bowel obstructions are a small baby and extra amniotic fluid (polyhydramnios). Fortunately, this does not happen in every case.

Re-evaluation of the abdominal cavity for pseudocysts (collections of fluid from the bowel that have leaked out due to a rupture of the bowel), calcifications on the lining of the abdomen, and extra fluid outside the bowel (ascites) which could indicate rupture of the bowel, may be performed. The baby’s anus and rectum may be evaluated to see if there is anal atresia (where babies have imperforate anus). Sometimes a baby with a bowel obstruction has an enlarged stomach.

What does it mean for my baby after it is born?

After the baby is born, he or she will be transferred to a neonatal intensive care unit, where additional studies will be performed. A nasogastric tube will be placed to drain the secretions from the mouth and stomach and an IV will be placed. The baby will have X-rays taken to further evaluate the abdomen and a surgeon will be consulted. The baby will not be fed until the studies are completed. If surgery is indicated, the neonatal intensive care team will decide how best to provide nutrition for the baby and when feeding by mouth can begin. Additional testing may be done if cystic fibrosis is suspected.

When the baby is stable, a surgeon will remove the portions of the bowel which are not functioning well and will attempt to reconnect the portions of bowel which are not connected. The surgeon will determine how many blockages there are and how best to fix them. Most babies can have their bowel connected in one surgery, but, occasionally, the baby will need a colostomy (bag to collect intestinal fluids) until the intestine can be fully connected. The baby will be discharged once there are no issues with the bowel function and feeding. Some children may stay in the hospital for several months, but others are discharged after a several week stay.

In the long term, the outcome for most children is excellent. There are some children who have long-term issues which are related to the amount of bowel that needs to be removed and additional bowel malformations. These problems can include short gut syndrome (poor absorption of nutrients due to lack of functional small intestine), bowel movement problems and recurrent blockages. Unfortunately, prenatal ultrasound is not able to predict which children will have these problems.

Will it happen again?

Most cases of small bowel blockage are sporadic, meaning that they are very unlikely to happen again. There are some rare families where there are recurrences of bowel obstruction. This is more of a concern if the baby is found to have the “apple-peel” or “Christmas tree” form of atresia, or if there are multiple blockages discovered at the time of surgery, or if the baby is diagnosed with cystic fibrosis. If any of these conditions are diagnosed, additional information will be available from your doctor, a genetic counsellor or a geneticist.

What other questions should I ask?

  • Does this look like a typical small bowel obstruction?
  • Do I have extra amniotic fluid?
  • Do you see additional abnormalities in my baby?
  • How often will I have ultrasound examinations done?
  • What will you be looking for during these examinations?
  • Where should I deliver?
  • Where will the baby receive the best care after he or she is born?
  • Can I meet in advance the team of doctors who will be looking after my baby when he or she is born, and tour the nursery?

A bowel obstruction can be a serious condition, which can occur in the large or small bowel. A small bowel obstruction commonly occurs where loops of intestine can easily get blocked or twisted. A blockage can be partial or total, mechanical (caused by an object) or non-mechanical (caused by paralysis of movement to the bowel). A blockage can stop the passageway of all food, liquid and gas and cause considerable pain.

Small Obstruction Condition

There are many reasons why a small bowel obstruction may happen including:

  • Mechanical obstruction
  • Adhesions – fibrous tissues that develops usually after abdominal or pelvic surgery
  • Volvulus – otherwise known as a twisted bowel
  • Intussusception – ‘telescoping’ of the bowel, when a segment of bowel pushes into another segment causing it to collapse
  • Tumours – more likely in the large bowel. Small bowel cancer is still relatively rare
  • Hernias – which can cause strangulation of the bowel
  • Swallowed objects – Foreign objects swallowed by children can get stuck in the bowel
  • Inflammatory Bowel Disease – diseases like Crohn’s and Ulcerative Colitis can cause strictures or narrowing in the bowel which can cause obstructions
  • Impacted stool
  • Infection
  • Diverticulitis

Non-mechanical obstruction

A non-mechanical obstruction is also referred to as ‘ileus’ or ‘paralytic ileus’, this is when the natural movement of the bowel called peristalsis fails to happen. Ileus is usually temporary. Some medical conditions can cause this to have a long term effect and this is called ‘Intestinal pseudo-obstruction. This can be caused by:

  • Abdominal or pelvic surgery
  • Infections such as gastroenteritis or appendicitis
  • Opioid pain medications such as morphine or codeine
  • Parkinson’s Disease
  • Diabetes Mellitus
  • Hirschsprung’s Disease
  • Hypothyroidism

Symptoms of a bowel obstruction or a small bowel obstruction

Bowel obstruction symptoms of a bowel obstruction can be painful and distressing. You may experience the following symptoms:

  • Severe abdominal pain, cramps and bloating
  • Decreased appetite or inability to eat
  • Nausea and/ or vomiting
  • Inability to pass gas or stool
  • Constipation or diarrhoea
  • Abdominal swelling

A bowel obstruction becomes an emergency if your abdominal pain increases and you start to experience a fever. This could be a sign of intestinal rupture, which can become life threatening.

How is a bowel obstruction diagnosed?
Your doctor may feel around your stomach to feel for any obvious signs of swelling or a lump. You may be sent for x-rays or a CT Scan to see if there is anything causing an obstruction. You may also have a colonoscopy, which is a camera inserted via the rectum to view the inside of the colon to check for any abnormalities.

To find out about treatments for a bowel obstruction and further resources, click the links above to navigate to the pages.

What is the small bowel?

The small bowel, also called the small intestine, ranges from 20 to 30 feet long and is about 1 inch in diameter. It has many folds that allow it to fit into the abdominal cavity. One end of the small bowel is connected to the stomach and the other to the large intestine.

The small intestine consists of 3 parts: the duodenum, the jejunum and the ileum. Partly digested food passes from the stomach to the small intestine, where the final digestive processes occur. Nutrients, vitamins, minerals and water are absorbed by its lining.

What is small bowel obstruction?

Small bowel obstruction is a partial or complete blockage of the small intestine. If the small bowel is functioning normally, digested products will continue to flow onward to the large intestine. An obstruction in the small bowel can partly or completely block contents from passing through. This causes waste matter and gases to build up in the portion above the blockage. It could also interfere with the absorption of nutrients and fluids.

What causes small bowel obstruction?

Small bowel obstruction can occur in people of all ages. There are many common causes and risk factors, including:

  • Adhesions: These are bands of scar tissue that may form after abdominal or pelvic surgery. An earlier abdominal surgery is the leading risk factor for small bowel obstruction in the United States.
  • Hernias: Segments of the intestine may break through a weakened section of the abdominal wall. This creates a bulge where the bowel can become obstructed if it is trapped or tightly pinched in the place where it pokes through the abdominal wall. Hernias are the second most common cause of small bowel obstruction in the United States.
  • Inflammatory disease: Inflammatory bowel disorders such as Crohn’s disease or diverticulitis can damage parts of the small intestine. Complications may include narrowing of the bowel (strictures) or abnormal tunnel-like openings (fistulas).
  • Malignant (cancerous) tumors: Cancer accounts for a small percentage of all small bowel obstructions. In most cases, the tumor does not begin in the small intestine, but spreads to the small bowel from the colon, female reproductive organs, breasts, lungs or skin.

What are the symptoms of small bowel obstruction?

Symptoms of small bowel obstruction may include the following:

  • Abdominal (stomach) cramps and pain
  • Bloating
  • Vomiting
  • Nausea
  • Dehydration
  • Malaise (an overall feeling of illness)
  • Lack of appetite
  • Severeconstipation. In cases of complete obstruction, a person will not be able to pass stool (feces) or gas.

Last reviewed by a Cleveland Clinic medical professional on 03/20/2019.

Any disturbance to the normal functioning of the digestive system can result in inflammatory bowel disease. The exact cause of bowel obstruction is not clear but certain diseases such as gastric ulcers, bowel ischemia, diverticulitis, Crohn’s disease, partial bowel obstruction, ulcerative colitis, and ascariasis are considered to cause bowel obstruction.

X-rays, blood tests, and CT scans are some of the vital elements essential to diagnosis. Proper treatment mandates identification of the obstruction and the surgical removal of parts of the intestine. In some cases antibiotics are adequate while in other cases the obstruction must be cleared or perforation repaired in order to prevent further damage.

The obstruction of bowel content often results in abdominal pain, vomiting, nausea, and other symptoms. It is very important to diagnose and treat bowel obstruction to prevent death of intestines due to lack of oxygen. The point here is to give an account of medical negligence or hospital neglect in diagnosing bowel obstruction and directions for filing a lawsuit by utilizing the help of Jackson, MS medical malpractice lawyer dealing with failure to diagnose bowel obstruction lawsuits.

You can find a reliable and personable lawyer if you press right here.

Signs and symptoms of bowel obstruction:

  • Flatulence
  • Nausea
  • Vomiting
  • Constipation
  • Rectal bleeding
  • Fever
  • Cramping pain in abdominal region
  • Weight loss
  • Fatigue
  • Tenderness of the abdomen

Complications due to failure to diagnose bowel obstruction

Prolonged obstruction of bowel contents causes swelling of intestines, over-stretching the walls and finally puncturing the walls. Rupture of intestinal walls causes waste materials and toxic contents of intestines to flow in to blood resulting in infection. This in turn, causes the body to fight back infection causing further inflammation and obstruction of blood flow. Severe infection may sometimes cause loss of limb or shock. Other complications such as jaundice and dehydration may also be observed in a few people.

Causes for failure to diagnose bowel obstruction

Bowel obstruction often goes undiagnosed due to medical negligence and hospital neglect. Here is a list of causes for failure to diagnose bowel obstruction:

  • Wrong diagnosis due to similarity of symptoms to other intestinal diseases.
  • Messing up at the time of intestinal surgeries.
  • Inappropriate treatment of intestinal infections.
  • Post-surgical sutures.
  • Misuse of surgical equipment.
  • Wrong interpreting of lab results such as x-rays, blood tests, and CT scans.
  • Not changing feeding tube periodically.
  • Placing of nastogastric tube.

Seek help from a sagacious Mississippi medical malpractice lawyer

If you consider medical error or hospital neglect as the major cause contributing to failure in diagnosing bowel obstruction it is important to seek legal assistance from a Jackson, MS medical malpractice attorney to evaluate your case and the chances of suing the doctor that treated you. Your legal counselor will then go ahead with the claim process and collect all medical reports, lab results, list of medications, and treatment strategies adopted by the doctor.

Your Mississippi medical malpractice lawyer will have all this information validated by medical experts. If the medical expert identifies flaws in the doctor’s treatment or in the care provided by nurses or other medical personnel then the hospital can be held liable and made to pay you compensation for damages and pain and suffering.

How to Fix a Bowel Obstruction

I recently had surgery to correct a small bowel obstruction. I have been following a low fiber diet, but now I’ve been instructed to transition to a high fiber diet. My question is how much fiber do I need and should I increase it all at once?

For readers who are not familiar, a small bowel obstruction (SBO) is just as it sounds; it’s a blockage in the small intestine, and digested food cannot pass into the colon (large intestine). The obstruction is often caused by scar tissue known as adhesions. Sometimes SBOs resolve with rest and no food or drink by mouth, while others require surgery.

A low fiber diet is often prescribed after a bowel obstruction is corrected. This is because fiber passes through the GI tract unchanged and adds bulk to the stool. A low fiber diet helps the bowel rest and return to its normal function. This diet is temporary; then the patient is transitioned to a high fiber diet. We know that fiber is beneficial in keeping us regular and helps manage certain chronic conditions, such as high cholesterol and diabetes. There is some research to suggest that fiber may help protect us from certain types of cancer, but more studies are needed before a definitive statement can be made.

Fiber is found in plant foods: fruits, nuts, seeds, vegetables, beans, legumes, and whole grains. The American Heart Association suggests that we consume 25-35 grams of fiber each day, but most Americans get half that amount. The mantra to apply here is “Easy does it.” Start with one to two servings of fiber-rich foods each day. Add a fruit at breakfast and a vegetable at dinner, which will give you about 8-10 grams of fiber. Then gradually increase fiber by 5-gram increments weekly until you reach the goal of at least 25 grams each day. For a list of high fiber foods, click here. It is important to drink plenty of water and/or decaffeinated beverages while increasing fiber intake in order to prevent constipation.

If you have gas or discomfort when eating these foods, consider taking an over-the-counter enzyme with the first bite. Since the body cannot break down fiber, it is digested by bacteria in the colon, which produces gas in the process. The enzyme actually helps break down some types of fiber. You may also consult your doctor or pharmacist about taking simethicone.

Enjoy your new diet, and if you have any questions, please write again.

The treatment for a bowel obstruction will depend on what is causing it. For a total mechanical blockage, surgery will most likely be required. Most bowel obstructions will need some form of hospital intervention to relieve the problem. If you suspect that you have a bowel obstruction, you should seek medical advice as soon as possible to avoid the situation becoming life-threatening.

CONSERVATIVE TREATMENTS

Nasogastric Tube (NG Tube)

In order to help you feel more comfortable and release any pressure, your doctor may insert a small tube through your nose and down into your stomach. The tube will remove any fluids or gas trapped in your stomach and relieve any pain and vomiting. You will not be able to have anything to eat or drink to avoid adding any pressure or bulk to the blockage.

Watchful Waiting

If a paralytic ileus is suspected then your condition maybe monitored for a few days to see if it resolves on it’s own accord. Mose cases of ileus just require the bowel to be rested. You will be given fluids via a drip to keep you hydrated.

MEDICINAL

Therapeutic Enema

A barium or enema may be used to diagnose and treat an intussusception. During the procedure air or a liquid containing contrast is injected through the rectum into the bowel. The air or liquid will create pressure in the large bowel which will hopefully push out the folded piece of bowel. This is not always successful though and further surgery may be required.

SURGICAL

For a total blockage or severe stricture, surgery will be required to rectify the problem. There are several surgical procedures that can be performed depending on the cause of the blockage. It is common for someone with a chronic illness such as Crohn’s or Ulcerative Colitis to require surgery in order to relieve blocked or narrowed intestines. Some of the surgical procedures may require you to have a stoma in the form of a colostomy or ileostomy on a temporary basis.

Large Bowel Resection

The blocked or diseased part of your colon or large bowel may be removed surgically if you have a total blockage. The surgery can be performed laproscopically (via keyhole) or may be done as open surgery in an emergency. If the two pieces are bowel left are healthy then the ends will be stitched together or you may be given an colostomy where the colon is routed through an opening cut into your abdomen. You will then need to wear an ostomy bag over the top to collect the waste.

Small Bowel Resection

A small bowel resection is when the diseased or blocked part of the small bowel is surgically removed. The surgery can be performed laproscopically (via keyhole) or may be done as open surgery in an emergency. If the two pieces are bowel left are healthy then the ends will be stitched together or you may be given an ileostomy where the small bowel is routed through an opening cut into your abdomen. You will then need to wear an ostomy bag over the top to collect the waste.

Strictureplasty

This operation may be performed on patients with Crohn’s disease at this mostly affects the small bowel. Crohn’s disease can cause narrowing or strictures which can block the bowel and cause extreme pain. A strictureplasty is when the narrowed section is cut and sewn horizontally to widen the intestine.

Further information and downloads can be found in the RESOURCES section. Living with bowel condition or caring for someone with a bowel condition can affect you emotionally and socially; sometimes it can help to speak to others who understand your situation. The Bladder & Bowel Community Forum is available 24 hours today and will allow you to connect with those who share your condition. Start your own topic today or just follow one that interests you.

By: Colon Cleansing & Constipation Resource Center
Updated: April 27, 2009

A bowel obstruction occurs when a part of the bowel (the small or large intestine) is blocked. This blockage may be partial or complete, making it difficult or impossible for waste to pass through. Almost anyone can experience an obstruction and for a variety of reasons. However, an obstruction is commonly associated with Crohn’s disease, also known as Inflammatory Bowel Disease (IBD).

Types of Bowel Obstruction

Obstructions manifest themselves in different ways, result from different factors, and present varying symptoms. Minor obstruction is normally associated with partial blockage and occurs in the small intestine. More severe cases of obstruction can cut off the bowel’s blood supply in a condition known as bowel strangulation or ischemia. In these instances, emergency medical treatment is required.

Pseudo-obstruction is difficult to explain medically and occurs when the bowel slows down or doesn’t function as it should. A nutritional or metabolic imbalance, such as potassium deficiency, causes pseudo-obstruction. Certain prescription medications that slow down the bowel’s activity can also cause obstruction as a side effect. Surgical complications, infections, inflammation, and kidney or thoracic disease are other reasons for the bowel to become obstructed.

Mechanical obstruction is more easily explained and occurs when stool is physically blocked so it cannot pass through the intestines. This type of bowel obstruction happens for a myriad of reasons, including:

  • Ingestion of a foreign item
  • Gallstones
  • Scar tissue or adhesions
  • Hernia
  • Abnormal tissue growth
  • An intestinal twist or kink (volvulus)
  • Narrowing of the intestines
  • Crohn’s disease
  • Diverticulosis
  • A benign or malignant (cancerous) tumor

Sometimes, an obstruction can occur if one part of the intestine folds into another part, similar to collapsing a telescope’s concentric sections. This type of blockage is called Intussusception. The most common causes of small-bowel obstruction are adhesions, hernias, and tumors. For obstruction of the colon or large-bowel, the causes are most likely volvulus, diverticulosis, and colorectal cancer.

Symptoms of An Obstructed Bowel

A bowel obstruction can incur a whole host of symptoms and complications, with constipation and diarrhea being two of the main problems. Most sufferers of an obstruction will experience either a total lack of stool (because it can’t pass through) or diarrhea, which occurs because sometimes only liquid stool can go around the blockage.

Other common symptoms associated with obstruction include intense abdominal pain, cramping, bloating, distention, and fullness. The pain is mild to moderate in minor bowel obstruction, and more severe if the bowel’s blood supply is cut off. Other symptoms include nausea and vomiting, bad breath, cramps, and rapid pulse and breathing.

Obstruction of the small bowel is more likely to produce the symptoms of nausea and vomiting, abdominal pain, abdominal distention and tenderness, inability to release gas, and rapid pulse and breathing due to cramps. Obstruction of the large bowel could produce symptoms of abdominal pain, bloating, constipation, leaky diarrhea, and rectal bleeding or bloody stool if a colon tumor is the cause.

Obstruction Complications

As mentioned, a bowel obstruction is commonly a complication of Crohn’s disease. However, an obstruction can also develop into other complications if left untreated. Whether an obstruction is minor or serious, it can lead to significant complications including death of part of the bowel, which can cause severe infection and even gangrene necessitating removal of the affected area. An obstruction can also cause the intestines to tear, which will require emergency medical surgery.

Diagnosing Obstruction

An obstruction of the bowel is diagnosed with a physical examination as well as various diagnostic tests, including those for bowel sounds, X-ray, barium enema, CT scanning, or an ultrasound. A bowel obstruction can be treated with certain medications or by decompressing the intestine via a nasogastric tube inserted into the stomach to relieve distention and blockage. Surgery may be necessary if this method doesn’t work, if the obstruction is complete and stemming from the large intestine, or in cases of bowel strangulation.

Sometimes, however, a minor obstruction (particularly if it is a partial blockage or located in the small intestine) is monitored to see if it will go away on its own. Sometimes, medication is prescribed. Other times, patients choose to use a colon cleanser to help clean out their digestive system, regulate their digestive tract, and relieve symptoms of constipation. Some colon cleansers are very effective in dealing with minor obstruction.

Oxy-Powder® is a natural colon-cleansing compound that is effective, safe, and is highly recommended for helping to improve your overall colon health and relieve constipation, one of the most bothersome symptoms of bowel obstruction.

Without the inconvenient and potentially harmful side effects of laxatives and synthetic colon cleansers, Oxy-Powder® gently cleanses the colon by helping to flush out accumulated, toxin-laden waste, thus relieving constipation and lower intestinal discomfort, which in turn helps to relieve the symptoms of bowel obstruction.

How to Fix a Bowel Obstruction

A bowel obstruction means there is a blockage in the bowel. It is a serious complication, which is much more common with advanced cancer.

About bowel obstruction

Your bowel might become completely or partly blocked. This means that the waste from digested food can’t get past the blockage. The diagram shows the bowel and the rest of the digestive system.

How to Fix a Bowel Obstruction

Bowel obstruction can happen when:

  • cancer in the abdominal area (such as ovarian, bowel or stomach cancer) presses on the bowel
  • other cancers (such as lung or breast cancer) spread to the abdomen and press on the bowel
  • cancer grows into the nerve supply of the bowel and damages it – this can stop the muscles working
  • a solid mass of indigestible material collects in the bowel (called a bezoar)

Bowel obstruction is much more common with advanced cancer. People who have had surgery or radiotherapy to the tummy (abdomen) are more at risk of developing a bowel obstruction.

Symptoms of bowel obstruction

The symptoms include:

  • feeling bloated and full
  • pain (usually colicky tummy pain)
  • feeling sick
  • vomiting large amounts (including undigested food or bowel fluid)
  • constipation (shown by not passing wind and no bowel sounds)

Diagnosing a bowel obstruction

Your doctor will examine you and ask you questions. They will then arrange some tests and investigations. These might include blood and urine tests.

You may also have an abdominal x-ray. Or you might have a barium enema to find out exactly where the obstruction is in your bowel.

Treating a bowel obstruction

It’s important to understand what your doctors are trying to achieve with any treatments they recommend. So talk it through with them or with your specialist nurse.

Treatments for a blocked bowel can include:

Drips and drains

Your doctor might suggest treatment to give your bowel time to rest. You need to stop eating and drinking until your bowel is working normally again. You may need fluids through a drip so you don’t get dehydrated. This is called an intravenous infusion.

Sometimes you can have an infusion of fluids at home. You have this through a fine needle put just under the skin, instead of into a vein.

This may fix the blockage. But if it isn’t successful, you may need other treatments.

You might have a tube that goes up your nose and down into your stomach (called a nasogastric tube). This drains fluid from your stomach and stops you feeling sick.

Or your doctor might suggest that you have a venting gastrostomy to help relieve nausea and vomiting. This is when they put a special tube called a percutaneous endoscopic gastrostomy tube (PEG tube) into your stomach through an opening made on the outside of your abdomen. You usually have this under sedation.

Surgery

If your cancer is advanced and cannot be cured your doctor might suggest surgery to offer you longer term relief from your symptoms. The surgeon removes enough of the cancer to unblock the bowel. They might remove part of the bowel as well.

After the operation your surgeon is most likely to repair the bowel by stitching the ends back together. But sometimes it isn’t possible to do this and you may need to have a colostomy or ileostomy (stoma). A stoma is an opening from the bowel onto the abdomen. Your poo comes out of this opening into a plastic bag that sticks over it.

Deciding whether to have an operation like this can be difficult.

The surgery won’t cure your cancer. But it can relieve the symptoms that you have. Unfortunately, no one can tell beforehand how much you will benefit from an operation to unblock your bowel.

The operation could be successful and the cancer might not grow back to block the bowel again. But it is quite a big operation to have when you are likely to be feeling very weak and ill.

You might want to talk through having this operation with your close family and friends as well as your doctor and nurse.

A stent

A stent is a tube that the surgeon puts into the bowel. It expands to keep the bowel open. This can relieve the symptoms caused by the obstruction.

Your surgeon may be able to put in a stent if you are not able to have a big operation.

Medicines

Instead of an operation, medicines can sometimes help to control symptoms of a blocked bowel. Unfortunately these types of treatment will usually only control your symptoms for a while.

A drug called hyoscine butylbromide (Buscopan) stops muscle spasms and reduces pain. You can also have painkillers and anti sickness medicines.

You might also have a drug called octreotide. Octreotide reduces the amount of fluid that builds up in your stomach and digestive system. It can help to control sickness.

Or you might have steroids. Steroids can help to reduce the inflammation of your bowel. They can also help to control sickness.

Small bowel obstruction (SBO) accounts for 80% of all mechanical intestinal obstruction, the remaining 20% results from a large bowel obstruction. It has a mortality rate of

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Clinical presentation

Classical presentation is cramping abdominal pain and abdominal distension with nausea and vomiting. Radiographic findings can be evident 6-12 hours before the onset of clinical symptoms 9 .

Pathology

Aetiology

Causes can be divided into congenital and acquired. Acquired causes may be extrinsic causing compression, intrinsic, or luminal.

In developed countries, adhesions are by far the most common cause, accounting for

75% of obstructions while in developing countries incarcerated hernias are much more common accounting for 80% of obstructions 3 .

Congenital
  • jejunal atresia
  • ileal atresia or stenosis
  • enteric duplication
  • midgut volvulus
  • mesenteric cyst
  • Meckel diverticulum
Extrinsic causes
  • fibrous adhesions
    • main cause in developed countries (75% of cases)
    • almost all are related to post-operative adhesions with a small percentage secondary to peritonitis
    • diagnosis of exclusion as adhesive bands are not seen on CT
    • abrupt change in calibre without mass lesion, inflammation or bowel wall thickening at transition point
  • abdominal hernia
    • 10% of cases in developed countries
    • external hernia related to abdominal or pelvic wall defect (congenital weakness or previous surgery)
    • internal hernia with protrusion of viscera through peritoneum or mesentery into another abdominal compartment
  • endometriosis
    • rare cause of SBO
    • endometrial implants are typically on anti-mesenteric edge of the bowel
    • solid enhancing nodule contiguous with or penetrating the thickened bowel wall
    • may infiltrate the submucosa with a hypoattenuating layer between the muscularis and mucosa
  • masses
    • extrinsic neoplasm
    • intra-abdominal abscess
    • aneurysm
    • haematoma
Intrinsic bowel wall causes
  • inflammation, e.g. Crohn, tuberculosis, eosinophilic gastroenteritis
    • small bowel obstruction in Crohn disease may relate to:
      • acute flare with luminal narrowing secondary to transmural inflammation
      • cicatricial stenosis in long-standing disease
      • adhesions or incisional hernias from previous surgery
  • tumour (rare)
    • primary small bowel neoplasms are rare ( 1 year after therapy)
  • intestinal ischaemia
    • occlusion or stenosis of the mesenteric arterial or vascular supply
    • produces small bowel wall thickening and obstruction
    • pneumatosis and portal venous gas if advanced
  • intramural haematoma
    • trauma, iatrogenic, anticoagulant therapy, Henoch-Schonlein purpura
    • produces luminal narrowing
    • better seen on non-enhanced CT with homogenous, regular and spontaneously hyper-attenuating wall
  • intussusception
    • rare in adults ( 3 . In most cases, the abdominal radiograph will have the following features:
      • dilated loops of small bowel proximal to the obstruction (see 3-6-9 rule)
      • predominantly central dilated loops
      • three instances of dilatation > 2.5 – 3 cm ref required
      • valvulae conniventes are visible
      • gas-fluid levels if the study is erect, especially suspicious if 8
        • >2.5 cm in width
        • in same loop of bowel but at different heights (> 2 cm difference in height)

      However, obstruction (which may be high-grade mechanical obstruction) may also present with the following features:

      • gasless abdomen: gas within the small bowel is a function of vomiting, NG tube placement and level of obstruction
      • string-of-beads sign: small pockets of gas within a fluid-filled small bowel
      Ultrasound

      Bedside test help to diagnose small bowel obstruction, findings suggestive of small bowel obstruction 7 :

      • dilated bowel loop (diameter > 3 cm)
      • ineffective peristalsis
        • results in “to-and-fro” or “whirling” appearance of intra-luminal contents
      • prominence of the valvulae conniventes
        • present in dilated jejunal loops

      Extent of obstruction is typically implied rather than sought directly based on the involvement of the ascending/descending colon, the morphology of the small bowel loops (high mucosal folds pattern present in the jejunum, absent in the ileum), and involvement of the stomach. Findings suggestive of bowel ischaemia/infarction (will need urgent surgical evaluation):

      • extraluminal free fluid
        • the “pointy” triangular appearance of inter-loop free fluid is often referred to as the tanga sign
      • loss of peristalsis
      • bowel wall thickening >3 mm
        • with effacement of mural architecture
      • mural gas

      CT is more sensitive than radiographs and will demonstrate the cause in

      80% of cases 3 . Features on CT may include:

      • dilated small bowel loops >2.5 cm up from outer wall to outer wall
      • normal calibre or collapsed loops distally
      • small bowel faeces sign

      Closed-loop obstructions are diagnosed when a bowel loop of variable length is occluded at two adjacent points along its course. May be partial or complete with characteristic features:

      • radial distribution of several dilated, fluid-filled bowel loops
      • stretching of prominent mesenteric vessels converging towards the point of torsion
      • U-shaped or C-shaped configuration
      • beak sign at site of fusiform tapering
      • whirl sign reflecting rotation of bowel loops around a fixed point

      Strangulation is defined as closed-loop obstruction associated with intestinal ischaemia. Mainly seen when the diagnosis is delayed (up to 10% of small bowel obstructions) and associated with high mortality. Features are non-specific and include:

      • thickened and increased attenuation of the bowel wall
      • halo or target sign
      • pneumatosis intestinalis
      • portal venous gas
      • localised fluid or haemorrhage in the mesentery

      Positive oral contrast is not usually necessary for the diagnosis of small bowel obstruction 4 :

      • usually, becomes dilute in the setting of SBO and does not usually reach the transition point before the scan occurs
      • may obscure the evaluation of the small bowel wall, limiting evaluation of bowel ischaemia

      Some literature sources recommend Gastrografin (diatrizoate meglumine) to shorten the postoperative course of those with non-operative small bowel obstruction 5 .

      Written by Bel Marra Health
      | –> Colon And Digestive | –> Published on January 12, 2017

      Bowel obstruction or intestinal obstruction happens in the small or large intestine. Essentially, it can be a partial or total blockage that prevents fluid and digested food from passing. While this may not sound so bad, the fact is, if enough pressure builds up as a result of the intestinal obstruction, the intestine can rupture. What would cause a bowel or intestinal obstruction? How do you know if you have such a blockage? How do you deal with a diagnosis of bowel obstruction? Read on to find out.

      There are many potential causes of bowel or intestinal obstruction, but the most important point to consider is that early diagnosis and treatment is very important. An untreated intestinal obstruction can be fatal.

      Bowel obstruction: Causes, risk factors, and complications

      Bowel obstruction can be extremely uncomfortable and, of course, frightening at the same time. There are a number of different bowel obstruction causes, including those listed here:

      • Abdominal adhesions
      • Tumors in the intestines
      • Hernias
      • Inflammatory bowel diseases
      • Intestinal twisting
      • Intussusception

      Abdominal adhesions are the formation of scar tissue between bowel loops and the inner lining of the abdominal wall. Intussusception occurs when part of the intestine slides into another part of the intestine.

      Who is at risk? Bowel or intestinal obstructions can occur after surgical procedures. Sometimes, surgery to the abdomen or the pelvis can lead to the formation of adhesions, which cause the obstruction. In other situations, people may have Crohn’s disease that causes a thickening of the intestinal walls, making it hard for stools to pass through the rectum. Additionally, abdominal cancer can cause intestinal obstruction, particularly in cases where there is surgical removal of a tumor or radiation treatments.

      When intestinal obstruction goes untreated, it can lead to life-threatening consequences. For example, it can cut off the blood supply to part of the intestine. Lack of blood supply can cause the intestinal wall to die. When tissue dies, it can tear and lead to infection. Infection in the abdominal cavity is referred to as peritonitis and requires immediate medical intervention and most often surgery.

      Symptoms of bowel obstruction

      “Incredibly uncomfortable” is how many people describe bowel obstruction symptoms. Below is a list of some of the most common signs and symptoms.

      • Abdominal pain
      • Severe bloating
      • Nausea
      • Vomiting
      • Constipation
      • Decreased appetite
      • Diarrhea
      • Severe abdominal cramping
      • Abdominal swelling

      Bowel obstruction symptoms often depend on the location of the obstruction. For instance, vomiting is a sign of a small intestine obstruction. Diarrhea is often associated with a partial obstruction, while a total obstruction usually leads to constipation. If an obstruction causes the intestinal wall to rupture, a high fever is also possible.

      Diagnosing intestinal obstruction

      It is true that some of the symptoms mentioned above could also be a sign of some other medical issue, so you might be wondering how a person would even know that they have a bowel or intestinal obstruction. Well, there are a few different tests and procedures for bowel obstruction diagnosis.

      • Physical exam – The doctor will review your history and symptoms. They will also conduct a thorough physical assessment, checking the abdomen for swelling and tenderness, as well as listening to the bowel with a stethoscope.
      • X-ray – While an X-ray may be ordered, it does not show all intestinal obstructions.
      • CT scan – This combination of X-ray images taken from different angles produces a cross-section view and is more likely to detect an obstruction.
      • Ultrasound – Young children are often tested with this type of imaging. It can pick up twisted intestines.
      • Air or barium enema – This is enhanced imaging of the colon that involves inserting air or liquid barium into the colon through the rectum to help enhance images.

      Treating bowel obstruction

      When it comes to intestinal obstruction treatment, it depends on the cause of the obstruction. In the majority of cases though, hospitalization is required. If you have an obstruction, a stay in the hospital can help stabilize your condition. Doctors will order an intravenous line so that you get enough fluids. They will also most likely put a nasogastric tube through your nose and into your stomach in order to suck out air and fluid. This can relieve the swelling in the abdomen. In many cases, a catheter will be inserted in the bladder to drain and collect urine for testing.

      Here are the other intestinal or bowel obstruction treatment procedures:

      Partial obstruction: A low fiber diet that is easy for a blocked abdomen to process. If that doesn’t help, surgery may be necessary.

      Complete obstruction: Surgery may be needed and could involve removing the obstruction and a section of the intestine that has died or sustained damage. The doctor may also suggest treatment with a self-expanding metal stent, which forces the colon open so that the obstruction can clear.

      Intussusception: A barium or air enema is used as a treatment for children with intussusception. If an enema works, further treatment is usually not required.

      Pseudo-obstruction: Known as paralytic ileus, this is a blockage that doesn’t seem to have an actual physical obstruction, but is caused by malfunctioning nerves and muscles. Often doctors will prescribe medications to cause muscles to contract and thus move food and fluids through the intestines. If paralytic ileus is caused by another medical condition, the doctor will treat that condition to help bring the pseudo-obstruction under control.

      Fluids and digested food particles have to travel through 25 feet of intestines or more before new wastes enter the body. In other words, the waste system in our bodies is a constant assembly line. If that line slows and suddenly stops, creating a blockage, it is easy to see how that could cause a problem.

      While we shouldn’t panic every time we get a stomachache, people do need to pay attention to severe abdominal signs like those outlined here. An intestinal obstruction is serious, but if caught and treated in a timely manner a good outcome is possible.

      Bowel obstruction or intestinal obstruction refers to functional or mechanical obstruction of the intestines preventing the movement of digestive products. Either the large or small intestines can be affected. Some of the causes of bowel obstruction include hernias, adhesions, volvulus, inflammatory bowel disease, endometriosis, diverticulitis, appendicitis, tumors, intussusception, and more. The most common causes of small bowel obstruction are hernias and adhesions. In the large intestines, the obstructions are most commonly caused by volvulus or tumors.

      The diagnosis of a bowel obstruction can be made based on the patient’s history, physical examination, and medical imaging (X-ray, computed tomography scan, ultrasound, or magnetic resonance imaging). Treatment of bowel obstruction can be conservative or surgical. Intravenous fluids and pain medications can be given. Complications of bowel obstruction include bowel ischemia, sepsis, and perforation.

      Abdominal pain or stomach ache is a symptom that can be seen in both serious and non-serious conditions such as gastroenteritis, irritable bowel syndrome, appendicitis, abdominal aortic aneurysm, ectopic pregnancy, diverticulitis, and more.

      The abdomen can be divided into nine regions: right hypochondriac, epigastric, left hypochondriac, left lumbar, umbilical, right lumbar, right iliac, suprapubic, and left iliac regions. The pain felt in the different regions of the abdomen can provide clues to the underlying condition. In bowel obstruction, there is pain as the bowels are contracting (cramps) trying to push past the obstruction.

      Abstract

      Laparoscopic hernia repair is a frequently performed operation. Although it has many advantages over open inguinal hernia repair, laparoscopic surgery is not without complications. Small bowel obstruction is a complication unique to laparoscopic repair of inguinal hernias. It is reported following transabdominal preperitoneal repairs. We present a case of small bowel incarceration through a peritoneal defect after a totally extraperitoneal inguinal hernia repair. Techniques to avoid this complication are presented. The literature is reviewed.

      INTRODUCTION

      Inguinal hernia repairs are a very common procedure in the United States. The goals of laparoscopic repair versus open repair include decreased pain, faster recovery, less time lost from work, and lower recurrence and complication rates. The enthusiasm for laparoscopic procedures has led to their rapid acceptance with adequate investigations of some, but not all, of the possible perioperative complications.

      Some of the complications are well known, including trocar injuries, port-site herniation, and neuropathy from improperly placed staples. 1–3 A less well-recognized complication after laparoscopic inguinal hernia repair is small bowel obstruction. This may be due to adhesions to, or entrapment under, the mesh as seen with the intraperitoneal on-lay mesh technique, which has been reported. 4,5 Several reports in the literature discuss obstruction after transabdominal preperitoneal repair (TAPP) due to small bowel herniation through, or adherence at, the site of the peritoneal closure. 1,6–8 The complication rate after totally extraperitoneal repair (TEP) is reported to be lower than that after TAPP. 9 The abdominal cavity is not entered in TEP; the risk of bowel obstruction after TEP was thought to be essentially zero. 10,11 However, a few reports do exist of bowel obstruction following TEP. 11,12 We present one such case and a review of the literature.

      CASE REPORT

      A 47-year-old male presented with bilateral inguinal hernias of 2-weeks duration. The patient noted the hernias while doing some heavy lifting at work. Over the next week, he had the intermittent appearance of a bulge in the groin, especially with straining or coughing. He denied any obstructive symptoms. He was otherwise healthy and had no prior abdominal surgeries.

      Bilateral laparoscopic total extraabdominal preperitoneal hernia repairs were performed with the patient under general anesthesia. An infraumbilical incision was made down to the level of the posterior rectus sheath. The posterior sheath was not violated. A balloon dissector (Preperitoneal Distension Balloon and Inflation Bulb; Tyco Healthcare, Norwalk, CT, USA) was placed posterior to the rectus muscle fibers and anterior to the posterior rectus sheath. This was followed by insertion of a 10-mm 0° laparoscope into the lumen of the dissecting balloon. The dissecting balloon was inflated with air to develop the preperitoneal space. The balloon dissector was next replaced with a 10-mm structural trocar (Structural Balloon Trocar and Inflation Bulb; Tyco Healthcare, Norwalk, CT, USA). A 30° scope was inserted and used for the rest of the procedure. Three additional 5-mm ports were placed in the preperitoneal space, one midway between the umbilicus and pubic symphysis and one each medial to the right and left anterior superior iliac spines. A large direct defect was noted on the right. This was repaired first, followed by dissection and repair of the left side. The left side had components of both direct and indirect defects. The hernia sacs were dissected off the cord structures to the level of the peritoneum. The sacs were not entered during dissection nor were they amputated. A piece of 15×11-cm Prolene mesh was used to cover the defects on either side. The mesh was placed such that 2/3 of it covered the anterior abdominal wall and 1/3 covered the posterior surface. The mesh was secured to the pubic tubercle on either side, using Protacks (Protack, Tyco Healthcare, Norwalk, CT, USA). No Protacks were used to anchor the mesh to the lateral abdominal wall and inferior to the ileopubic tract. The inferior and lateral edges of the mesh were held in place with graspers while the preperitoneal space was deflated. The patient was discharged home on oral narcotics later that same day.

      He returned 3 times, once on postoperative day 1, again on postoperative day 3, and a third time on postoperative day 7, each time with abdominal distention, nausea, and vomiting. No evidence was found of a recurrent hernia on examination. Acute abdominal series showed air-fluid levels and a distended small bowel. The patient was admitted and treated with nasogastric decompression and intravenous fluids. Each time, his symptoms resolved in less than 24 hours. On his second readmission, computed tomography (CT) scans of the abdomen and pelvis and a small bowel follow-through series were obtained. The CT scan did not show evidence of mechanical small bowel obstruction and was interpreted as being consistent with postoperative ileus. The small bowel follow-through showed delayed transit through the small bowel at 3 hours with contrast reaching the distal colon and rectum. This was also consistent with ileus. Due to the recurrent nature of his symptoms, the patient was advised to undergo laparoscopy at this time but refused. He tolerated a regular diet and went home. When he returned on postoperative day 7 with recurrent symptoms, laparoscopy was again recommended, and this time he consented.

      At laparoscopy, a Veress needle was inserted into the left upper quadrant, away from the prior trocar sites. Pneumoperitoneum was obtained, and a 5-mm scope was inserted there. The anterior abdominal wall was inspected. No adhesions to the abdominal wall were observed. Additional ports were placed under direct visualization. Inspection of the peritoneal cavity showed that approximately 18 inches of small bowel had herniated through a defect in the peritoneum in the right lower quadrant ( Figure 1 ). The loops of bowel were incarcerated in the preperitoneal space adjacent to, but not adherent to, the mesh. The hernia repair was visualized through the peritoneal defect and was intact. The bowel was reduced from the preperitoneal space. No evidence of strangulation was found. The defect in the peritoneum ( Figure 2 ) was repaired with a running 2-0 silk suture with intracorporeal suturing on an Endostitch device (Endostitch, Tyco Healthcare Norwalk, CT, USA) ( Figure 3 ). No other defects were found in the peritoneum. The bowel was run from the terminal ileum to Treitz’s ligament. No other pathology was observed. The patient was discharged home the following day after tolerating a regular diet and demonstrating normal bowel function. He has had no further complications.

      As much as we love our dogs, it’s fair to say that every now then, they can get themselves into hot water. If you have a chewer on your hands, it’s common to walk in on them chowing down on your favorite shirt or tearing apart your socks. While most of the time, this leads to some guilty eyes and a scolding, there is a risk of a far more severe consequence. That consequence is Dog Bowel Obstruction.
      What is it?

      How to Fix a Bowel Obstruction

      Say your dog eats a sock out of the hamper. Once swallowed, the sock could cause a complete or partial blockage of the intestines. This blockage can lead to a decrease in blood flow to the bowels. Without the blood flow, the bowels will begin to deteriorate, causing toxic contents to be absorbed. If your dog eats something that you feel could cause dog bowel obstruction, you should contact your veterinarian immediately.

      Something as small as a button or chewed up sticks could ultimately lead to death. As scary as this is, being knowledgeable and prepared for the situation will help you in recognizing if your pup is in danger. First, we need to know what causes dog bowel obstruction.

      What Causes Dog Bowel Obstruction

      Dogs tend to be curious. When they encounter new and unusual things, it is common for them to give it a sniff followed by scooping it up in their mouths. While this is normal, it is also the leading cause of dog bowel obstruction.

      Things like tennis balls, string, chewed up pieces of toys, coins, bones, or sticks can all be harmful to your dog. Laundry is another big one and is probably one of the most common. If your dog enjoys picking up larger sticks, pieces could break off and get stuck in their throats or stomachs. Anything they can pick up and swallow should be monitored with caution.

      Along with eating large objects, intestinal parasites or other medical conditions can cause dog bowel obstruction. Intestinal parasites can be picked up from ingesting dirty water, contaminated food, garbage, or from the fecal matter of other dogs with the parasites.

      Dog Bowel Obstruction Symptoms

      I know what you are thinking…”What do I do?” Keep my dog wrapped in bubble wrap, depriving him of all chew toys and fun? The answer is no. Most of the causes are what makes your dog happy. Dogs find great pleasure in gnawing on a bone or destroying your wardrobe. But you should know the symptoms in case the worst case scenario occurs.

      If your dog ingests a foreign object, it could take 10-24 hours for it to move through its digestive system. If it makes its way to the stomach, it could linger there for much longer. If the object is sharp, it could cause punctures or tears making things even worse.

      If you notice that your dog is either constipated or having a prolonged case of diarrhea, this could mean that he/she is dealing with bowel obstruction issues. Loss of appetite, severe discomfort, vomiting, or refusing to be picked up are some other red flags that your dog is having issues. If you suspect your dog may have swallowed something, keep an eye on the belly. If you notice some unusual bloating, it may be time to call the vet.

      If your dog is pawing at the mouth and gagging, these are signs that something may be caught in their throat.

      So, your dog ate something crazy, and you noticed some signs of bowel obstruction. What do you do?

      Treating Dog Bowel Obstruction

      Once you notice that your dog is dealing with bowel obstruction, it is extremely important that you take action as quickly as possible. The first step should be to contact your veterinarian.

      Once at the veterinarian’s office, an endoscopy will most likely be performed. This involves going down your dog’s throat with a tiny camera to get a good glimpse at what could be causing the blockage. If it isn’t too bad, the vet will be able to retrieve the object during the endoscopy.

      If that doesn’t work, your doctor will most likely hook your dog up to some fluids. The fluids are to assist with hydrating your dog. This hydration can help with passing the foreign object naturally. If neither of these methods works, then your dog is off to surgery.

      First, x-rays will be taken to locate the exact location of the blockage. After that, your dog will be put under with some anesthesia. Once your dog is safely snoozing, the veterinarian will open up the abdomen and remove the object along with the blockage. This is the worst case scenario, but it isn’t uncommon for things to get this far.

      Preventing Dog Bowel Obstruction

      The best prevention for dog bowel obstruction starts in the early stages of your dog’s life. As a puppy, it is crucial to train your dog not to eat laundry and other random objects off the floor. Discouraging this type of behavior at an early age can help with the prevention throughout your dog’s entire life.

      Another good method is to dog-proof your house. Keep your clothes in dressers, closets, and laundry bins only. Keep everything off the floor as much as possible. Try not to leave anything laying around for your dog to inevitably gobble up. Don’t buy toys that have small, hanging pieces that can be easily swallowed. If you give your dog bones, try and get rid of them once they start getting too small.

      While dog bowel obstruction can be scary, arming yourself with the facts is the best first step you can take in your defense. Knowing how to properly prevent it, along with having the knowledge to identify and take action if it occurs, is essential for all dog owners. After all, it could be a matter of life or death. Be sure to keep a watchful eye and be on the alert!

      A bowel obstruction impairs the body’s ability to move food through the intestines for proper digestion. It’s crucial to know the warning signs, because this acute condition requires fast medical attention.

      How to Fix a Bowel Obstruction

      If you’ve had abdominal surgery recently, it’s important to be on the lookout for symptoms of a complication known as a bowel obstruction.

      While not extremely common, a bowel obstruction — also called intestinal obstruction — can occur when scar tissue forms inside the abdomen after a surgical procedure, causing a kink in the intestines. In some cases, food movement is totally blocked; with a partial bowel obstruction, a limited amount of food can move through.

      “A bowel obstruction is not really anything on the inside of the bowel,” explains Richard A. Desi, MD, a gastroenterologist at Mercy Medical Center in Baltimore. “It can twist the bowel into a funny position, to close or clamp it off.”

      Other bowel obstruction causes can include cancer or a hernia, but those cases are rare, Dr. Desi says. On occasion, a foreign body can cause a bowel obstruction. Women tend to develop bowel obstructions more often than men because they are more likely to have had Caesarian sections, gallbladder removals, and other types of abdominal surgery.

      Identifying Bowel Obstruction Symptoms

      Bowel obstruction symptoms usually come on suddenly, and they are severe — acute pain in the abdomen, along with nausea or vomiting. Most people affected by a bowel obstruction are unable to pass gas or have a bowel movement, and may have a swollen abdomen.

      Infrequent bowel movements or hard stools usually do not indicate obstruction. “A lot of people have nonspecific symptoms like abdominal pain, and they’re concerned about obstructions because they’re constipated,” Desi says. “Obstruction and constipation are two different things. Bowel obstruction is nothing chronic — there’s usually a very dramatic progression of symptoms.”

      Why It’s Critical to Treat Bowel Obstruction

      If you have bowel obstruction symptoms, it’s important to see a doctor right away. Doctors may use a CT scan, which creates a cross-sectional picture of your body, to look for an obstruction. Regular abdominal X-rays can also be used. If you have a complete obstruction, immediate surgery is required.

      Partial bowel obstruction may be treated in a hospital setting with a few days of “bowel rest,” a technique in which any remaining food is drained from a patient’s stomach and further food is eliminated. Intravenous fluids help you stay hydrated. “Sometimes, within a few days things can open up and start moving along,” Desi says. “Patients can respond and do very well.” If bowel rest does not work or bowel tissue begins to die due to the blockage, surgery may then be attempted.

      In some cases, people with bowel obstruction symptoms are found to have no blockage in their intestines. This is known as intestinal pseudo-obstruction, a disorder that happens when nerves or muscles lack the ability to move food through the body. Children and older adults are more likely to develop intestinal pseudo-obstruction. Treatment may involve ingesting liquid food through a feeding tube or intravenously.

      Bowel obstruction can be a very serious condition requiring immediate medical attention — be aware of the symptoms and contact your doctor to get the treatment you need.

      Learn more in the Everyday Health Digestive Health Center.

      Learn about our expanded patient care options for your health care needs.

      An intestinal obstruction means that something is blocking your intestine. Food and stool may not be able to move freely.

      When your intestine works normally, digested food moves from your stomach to your rectum. Along the way, your body breaks food down into usable parts and turns the rest to feces (stool). You eventually eliminate it through a bowel movement.

      An intestinal obstruction may partially or completely block this natural process. A complete blockage is an emergency and needs medical attention right away.

      Among the many possible reasons for an intestinal obstruction are:

      Abdominal adhesions. These are growths of tissue in bands that may force your intestines out of place.

      Hernia. A hernia is a split in the muscle wall of your abdomen. Hernias can cause bulges and pockets. These may block your intestine.

      Volvulus. A volvulus happens when part of your intestine twists around itself. This creates a blockage.

      Intussusception. This condition means that a segment of your intestine slides into another segment. This narrows but may not block your intestine.

      Scarring. When your body heals small cuts (wounds), scar tissue forms. This can happen inside your intestine as well. These scars can build up and create partial or total intestinal blockages. Scarring can result from tears in your intestinal wall, belly (abdominal) or pelvic surgery, or infections.

      Inflammatory bowel disease. Crohn’s disease and ulcerative colitis are 2 examples.

      Diverticulitis. Tiny pouches (diverticulae) can grow off the large intestine lining. These may become inflamed.

      Tumors. Growths may be cancer or harmless (benign). Either way, they can block your intestine completely or partially.

      Foreign objects. Nonfood objects that you swallow on purpose or accidentally may cause partial or complete intestinal obstruction.

      Meckel diverticulum. About 2 in 100 people are born with this additional small pouch inside the intestine.

      Symptoms

      Symptoms of intestinal obstruction are:

      Severe pain in your belly

      Severe cramping sensations in your belly

      Feelings of fullness or swelling in your belly

      Loud sounds from your belly

      Feeling gassy, but being unable to pass gas

      Constipation (being unable to pass stool)

      Who’s at risk

      You may be at risk of an intestinal obstruction if you have:

      Abdominal surgery. This can increase the risk for scar tissue or other growths. They also increase the risk for hernias.

      Diverticulosis. This condition means that something irritates the lining of the intestine. It may cause inflammation, infection, and scarring, which can lead to blockage.

      Inflammatory bowel disease

      Swallowed foreign objects

      Diagnosis

      To diagnose your condition, your healthcare provider will consider your overall health and health history. He or she will ask you about your symptoms. Tell your provider where your pain is and how strong it is. Also tell your provider if you have had changes in your bowel movements or appetite. Tell your provider if you have any other unusual symptoms, such as digestive sounds or a feeling of being bloated.

      Your provider will give you a physical exam. You may also need certain tests. These may include:

      Barium contrast study

      Treatment

      The treatment your healthcare provider recommends will depend on what is causing the blockage. For a simple blockage you may need to have only fluids and no solids to eat. Your provider will work to fix any metabolic problems. You may have an intestinal decompression. This is usually done with a nasogastric tube. You may also have bowel rest.

      You will need surgery right away if your intestinal obstruction is more complicated. This could be from a tear (perforation) in the intestine or a problem with blood flow. You may also need surgery if other treatment does not remove the blockage. The goal is to remove the blockage and repair your organs.

      Your provider also might recommend using a small, flexible tube to keep your intestine open, instead of having more invasive surgery.

      Complications

      Complications are problems caused by your condition. Complications of intestinal obstruction include:

      Loss of appetite

      Inability to keep food or fluids down

      Tear (perforation) of the intestine

      Prevention

      Abdominal adhesions that occur after surgery may be prevented if your medical team takes certain measures. These include keeping the incision site moist instead of dry. Discuss in advance what steps your medical team can take to reduce your risk for adhesions after surgery.

      When to call the doctor

      Get medical help right away if you have symptoms of intestinal obstruction. These include severe abdominal pain, vomiting, and inability to pass stool.

      How to manage or live with this condition

      Follow your doctor’s instructions. If he or she has told you to change your diet as part of your treatment, stick to the new plan. The goal of the diet is to reduce the work that your digestive tract has to do, while still giving you the nutrition you need.

      Closed loop obstruction is a specific type of bowel obstruction in which two points along the course of a bowel are obstructed, usually but not always with the transition points adjacent to each other at a single location. The closed loop refers to a segment of bowel without proximal or distal outlets for decompression.

      On this page:

      Clinical presentation

      Patients present with signs/symptoms of bowel obstruction, including crampy abdominal pain, vomiting, abdominal distension, and high pitched or absent bowel sounds.

      Complications

      Closed loop obstructions are at higher risk than non-closed loop obstructions for strangulation (compromised blood supply) or distension-related ischemia, resulting in intestinal necrosis and perforation.

      Pathology

      Closed loop small bowel obstructions are usually secondary to adhesions, volvulus, or hernia. A similar related pathology is the large bowel volvulus (either sigmoid or cecal). Large bowel obstructions occurring at a single point combined with a competent ileocecal valve, which occurs in 75% of patients, also create closed loop physiology with risk of cecal perforation 8 .

      Some publications describe two separate components of the obstruction 15 .

      • closed loop syndrome
        • incarcerated loop (closed loop) continues to secrete fluid and distends, inducing parietal vascular constraints (normally it does contains very little or no gas with the exception of when it involves the colon (fermentation gases).
        • induced extravasation of blood and plasma from venous stasis both in the excluded loop and in the adjacent mesentery, increasing the intestinal distension.
      • supralesional syndrome
        • segment of intestine upstream from proximal point of obstruction progressively distends to the stomach.
        • slower than in case of an incarcerated segment.

      Radiographic features

      CT findings of a closed-loop obstruction depend in part on the orientation of the loop relative to the plane of imaging. Some or all of the following signs may be demonstrated on CT:

      • marked distension of a segment of small bowel
        • >3 cm is the generally accepted caliber for distended small bowel (see the 3-6-9 rule)
      • radially distributed, C or U-shaped small bowel loops
      • “double beak sign”: tapering bowel loops at the point of obstruction
      • “whirl sign”: of the tightly twisted mesentery
      • two adjacent collapsed loops of bowel
      • if strangulation is present, signs of bowel ischemia

      Treatment and prognosis

      Risk of strangulation leads to high morbidity and mortality in closed loop bowel obstructions. Immediate surgical intervention is required.

      Topic Overview

      What is a bowel obstruction?

      A bowel obstruction happens when either your small or large intestine is partly or completely blocked. The blockage prevents food, fluids, and gas from moving through the intestines in the normal way. The blockage may cause severe pain that comes and goes.

      This topic covers a blockage caused by tumors, scar tissue, or twisting or narrowing of the intestines. It does not cover ileus , which most commonly happens after surgery on the belly (abdominal surgery).

      What causes a bowel obstruction?

      Tumors, scar tissue ( adhesions ), or twisting or narrowing of the intestines can cause a bowel obstruction. These are called mechanical obstructions .

      In the small intestine, scar tissue is most often the cause. Other causes include hernias and Crohn’s disease , which can twist or narrow the intestine, and tumors, which can block the intestine. A blockage also can happen if one part of the intestine folds like a telescope into another part, which is called intussusception .

      In the large intestine, cancer is most often the cause. Other causes are severe constipation from a hard mass of stool, and narrowing of the intestine caused by diverticulitis or inflammatory bowel disease .

      What are the symptoms?

      • Cramping and belly pain that comes and goes. The pain can occur around or below the belly button.
      • Vomiting.
      • Bloating and a large, hard belly.
      • Constipation and a lack of gas, if the intestine is completely blocked.
      • Diarrhea, if the intestine is partly blocked.

      Call your doctor right away if your belly pain is severe and constant. This may mean that your intestine’s blood supply has been cut off or that you have a hole in your intestine. This is an emergency.

      How is a bowel obstruction diagnosed?

      Your doctor will ask you questions about your symptoms, other digestive problems you’ve had, and any surgeries or procedures you’ve had in that area. He or she will check your belly for tenderness and bloating.

      Your doctor may do:

      • An abdominal X-ray , which can find blockages in the small and large intestines.
      • A CT scan of the belly, which helps your doctor see whether the blockage is partial or complete.

      How is it treated?

      Most bowel obstructions are treated in the hospital.

      In the hospital, your doctor will give you medicine and fluids through a vein ( IV ). To help you stay comfortable, your doctor may place a tiny tube called a nasogastric (NG) tube through your nose and down into your stomach. The tube removes fluids and gas and helps relieve pain and pressure. You will not be given anything to eat or drink.

      Most bowel obstructions are partial blockages that get better on their own. The NG tube may help the bowel become unblocked when fluids and gas are removed. Some people may need more treatment. These treatments include using liquids or air ( enemas ) or small mesh tubes ( stents ) to open up the blockage.

      Surgery is almost always needed when the intestine is completely blocked or when the blood supply is cut off. You may need a colostomy or an ileostomy after surgery. The diseased part of the intestine is removed, and the remaining part is sewn to an opening in the skin. Stool passes out of the body through the opening and collects in a disposable ostomy bag . In some cases, the colostomy or ileostomy is temporary until you have recovered. When you are better, the ends of the intestine are reattached and the ostomy is repaired.

      If your blockage was caused by another health problem, such as diverticulitis, the blockage may come back if you don’t treat that health problem.

      Related Information

      References

      Other Works Consulted

      • Parangi S, Hodin R (2006). Intestinal obstruction. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd. ed., pp. 819–833. Philadelphia: Saunders Elsevier.

      Credits

      Current as of: August 11, 2019

      Author: Healthwise Staff
      Medical Review:
      E. Gregory Thompson MD – Internal Medicine
      Adam Husney MD – Family Medicine
      Kenneth Bark MD – General Surgery, Colon and Rectal Surgery

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      Summary of Bowel obstruction

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      Bowel obstruction

      Bowel obstruction is when the normal flow of contents moving through the intestines is interrupted.

      The causes of bowel obstruction can be either mechanical or functional, also called ileus.

      Mechanical obstruction is caused by actual blockages in the large or small intestine, and it can be defined as partial or complete.

      Partial obstruction is when gas or liquid stool can pass through the point of narrowing, while complete obstruction is when nothing can pass.

      Functional causes disrupt peristalsis, which are the waves of contraction that move through the smooth muscles of the bowel wall that pushes food through the intestines.

      The small and large intestines are tube-shaped structures through which chyme, or food that has been partly digested by the stomach, and stools pass until they’re excreted.

      Now if we zoom into a cross-section of the intestinal wall, it’s lined by four layers of tissue: First, there’s the adventitia, or serosa; which is the outermost layer that faces the abdominal or peritoneal cavity. This is the space between the abdominal wall and the abdominal organs, and it’s lined by peritoneal membranes that contains a thin film of serous fluid.

      Moving on, there’s the muscularis externa, which is smooth muscle that contract to move food through the bowel.

      Deep beneath this layer is the submucosa, which has connective tissue as well as glands, blood and lymph vessels that supply the intestinal wall.

      And finally, the innermost layer is the mucosa and it’s composed of a few of its own layers: the muscularis mucosae, which has smooth muscle, the lamina propria, which is rich with blood and lymph vessels, and the innermost layer which is the epithelial lining that faces the lumen.

      Okay, so let’s go over some mechanical causes for bowel obstruction.

      The most common cause in the small intestine is postoperative adhesions.

      After a surgery, the scar tissue that forms during the healing process can form fibrous bands that cause organs to attach to the surgical site or to other organs, causing the lumen of the bowel to get kinked or pinched tight in certain spots.

      Another cause of small intestinal obstruction is hernias, and they can occur when a portion of the bowel protrudes out of the abdominal cavity and can get trapped or tightly pinched at the point where it pokes out.

      Mechanical causes for large bowel obstructions, on the other hand, are most often due to a volvulus, which is when a loop of intestine twists upon itself, kinking off the lumen.

      Sometimes the volvulus can occur around a mass like in colorectal cancer.

      Some mechanical causes of both small and large bowel obstruction include inflammatory bowel disease which can cause strictures and adhesions; ingestion of a foreign body, which can get lodged along the gastrointestinal tract; and intussusception, which is where a part of the intestine folds into the lumen of an adjacent section of bowel, kind of like retracting a telescope. This is the most common cause of bowel obstruction in children under the age of 2.

      Now, regarding functional obstruction, causes include anything that decreases smooth muscle contractility.

      The most common one is postoperative ileus, which is transient paralysis of the smooth muscles in the intestinal wall, and it’s usually caused by trauma during surgery.

      Other causes include infection or inflammation, such as appendicitis or peritonitis, hypothyroidism, meaning the thyroid gland does not produce enough thyroid hormones, and electrolyte abnormalities like hypokalemia, meaning low potassium in the blood, or hypercalcemia which is high calcium in the blood, or various medications such as opioids.

      So, when there’s a bowel obstruction, whatever the cause, the bowel contents distal to the obstruction get passed; but after that happens, proximal to the obstruction, gas and stool start to accumulate, causing the bowel to dilate, and therefore, the overall abdominal cavity to distend.

      Over time, all this gas and stool causes pressure inside the bowel lumen to increase, so the intestinal contents push towards the intestinal wall, compressing the mucosal blood and lymphatic vessels.

      Since the walls of veins and lymphatics are weaker and easier to compress compared to arteries, venous and lymphatic drainage are the first ones to get blocked.

      The pressure pushes the water in these vessels into the surrounding tissue, leading to mucosal edema.

      If pressure inside the lumen gets even higher, it also compresses mucosal arteries, leading to ischemia or reduced blood flow to the intestinal wall.

      In turn, ischemia causes hypoxia, or low oxygen supply.

      At the cellular level, this is accompanied by the production of reactive oxygen species; which can damage DNA, RNA, and proteins of the cells in the epithelial layer and lamina propria of the mucosa, leading to cell death, or mucosal infarction.

      So, when the mucosa becomes damaged and capillary blood vessels in the lamina propria rupture, blood enters the bowel lumen.

      All this stool and blood in the lumen becomes a nutritious feast for bacteria that normally reside in the intestines, and they start growing out of control.

      These bacteria can then get into the intestinal wall, where they get attacked by macrophages rushing into the mucosa.

      These macrophages then release inflammatory cytokines like tumor necrosis factor-alpha, which cause blood vessels to become more permeable to fluid and to more immune cells, further increasing mucosal edema, inflammation, and damage.

      The overall result is the compromised ability of the mucosa to absorb food and water, which may lead to dehydration and loss of electrolytes, like sodium, potassium and chloride.

      Now, as all these lumen contents continues to build up, intraluminal pressure rises even higher, making the problem even worse if not corrected.

      And if this pressure becomes high enough, even larger arteries get compressed, meaning that the arterial supply to more layers of the bowel wall is compromised.