If the abdomen feels full and may be painful, but there is no relief, it may be an intestinal obstruction. The disease is serious but rather rare.
In the case of an intestinal obstruction, the contents of the intestine remain in one place in the intestine. The intestinal passage is blocked by obstacles (mechanical intestinal obstruction) or because the intestine is no longer able to move its contents forward (functional intestinal obstruction). The disease can be life-threatening. If there is a suspicion, those affected should not eat or drink anything else until the examination. A transfer to the hospital usually takes place immediately. In addition to the complete, there is also the incomplete intestinal obstruction.
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| Intestinal obstruction |
Intestinal Obstruction Causes, Risk Factors And Frequency
Mechanical bowel obstruction
The majority of mechanical bowel obstructions (mechanical ileus) occur in the small intestine. Many causes can narrow the intestines from the inside or from the outside, such as:
- Adhesions between intestinal loops (adhesions) or strands of scars (brides), as they can develop directly or only after months or years as a result of abdominal surgery. The most common reason for intestinal blockages is the removal of the appendix after inflammation.
- Tumors such as colorectal cancer, which is the most common cause of mechanical obstruction of the colon
- Foreign bodies (e.g. gallstones, fecal balls)
- Scars that form after injuries, peritonitis (e.g. after appendicitis with perforation) or when inflammatory bowel diseases (e.g. Crohn's disease) heal
- Connective tissue sacs (hernias), usually on the groin or testicles, in which loops of intestine get caught
- Entrapment of parts of the intestine after a hernia
- Injuries in the intestine
- Twisting of intestinal blood vessels (strangulation ileus) or of intestinal loops (volvulus)
- Invagination of intestines
Functional intestinal obstruction
In the case of a functional intestinal obstruction (functional ileus), the intestine is not narrowed, but the intestinal movement comes to a standstill. Paralysis is usually the reason (paralytic ileus). This form is also known as intestinal paralysis. More rarely, the trigger is a spasm (spastic ileus) in a section of the intestine. Causes of both forms can be, for example:
- Inflammatory diseases in the abdomen
- Inflammation of the peritoneum (peritonitis)
- Inflammation of the pancreas (acute pancreatitis)
- Inflammation of the gallbladder (acute cholecystitis)
- Appendicitis (acute appendicitis)
- Inflammation of bowel protuberances (diverticulitis or perforated diverticulitis when perforated)
- Abscesses
Risk Factors and Frequency
Intestinal obstructions are considered moderately common. Affects less than 1 in 100 people. The risk factors arise from the causes: They include operations, inflammatory diseases and injuries in the abdominal cavity.
Intestinal Obstruction Symptoms
Do you have cramping abdominal pain with vomiting and a bloated stomach?
Is nausea associated with belching, slowly increasing permanent pain and gushing vomiting?
Both combinations of symptoms can indicate an intestinal obstruction. Normally, the intestine pushes its contents through its movement (peristalsis) until it leaves the body as feces through the anus. This natural passage is blocked in intestinal obstruction. The intestinal contents build up where the blockage is. In addition, more fluid often flows into the intestine and this returns less fluid from its contents to the body. The size of the intestine increases and causes discomfort. These occur quickly or slowly and stronger or weaker, depending on how quickly the blockage of the intestinal passage occurs and where in the intestine the blockage is. Sometimes there are signs such as persistent constipation, bloating and loss of appetite. Common symptoms are:
- Feeling of fullness, excessive accumulation of gas in the intestines (meteorism), belching
- Stool and wind behavior. Despite the feeling of fullness, it is impossible to evacuate gas or solid intestinal contents, which is particularly the case with functional intestinal obstruction.
- Pain in the stomach. They can appear suddenly and severely, spasmodically (colic), which is common with a mechanical bowel obstruction. In the case of paralysis of the intestinal movement, mild to moderate permanent pain develops more slowly.
- Vomit. The contents of the stomach, intestines and even faeces (miserere, vomit) can escape through the mouth.
When to the doctor?
An intestinal obstruction can lead to permanent damage and life-threatening complications! A doctor should be consulted immediately if severe, dull or cramping pains in the abdomen suddenly occur, even after meals, if there is a noticeable change in stool behavior and nausea with vomiting occurs.
Intestinal Obstruction Treatment
Treatment for intestinal obstruction consists in treating its cause. Obstacles such as foreign bodies, adhesions, twisted intestinal blood vessels or intestinal loops and tumors usually have to be removed by surgery. Only extremely rarely can the suction of the intestinal contents (intestinal tube) or the stretching of the sphincter muscle together with medication (laxatives) remove a mechanical intestinal obstruction, which, however, was then usually not complete. The type and extent of the operation depend on what is blocking the intestine, where the blockage is and whether the blood supply to the intestine is still working properly. If the blood vessels that supply the intestinal mesentery and the intestines are pinched off (strangulation ileus), this is considered a medical emergency. Without blood, the affected part of the intestine dies quickly (intestinal or mesenteric infarction). Doctors have to surgically remove the dead section. In some cases, they additionally fasten intestinal loops in the abdomen in order to prevent further intestinal obstructions caused by twisting or displacement of intestinal loops.
In the case of functional intestinal obstructions, the treatment often does not require surgery. The intestinal contents are suctioned out and the intestinal movement (peristalsis) is stimulated by enemas and medication (e.g. laxatives, parasympathomimetics). In order not to put additional strain on the intestines, the patients are not allowed to eat anything. Stool is drained through the anus via an intestinal tube. At the same time, the cause is treated. These are often inflammatory diseases in the abdomen.
Upon arrival at the hospital, doctors try to relieve the burden on the intestines by pumping out the contents of the stomach using a gastric tube. Patients receive infusions to compensate for loss of fluids and possible lack of food. In addition to physical examinations, blood is drawn and imaging procedures (ultrasound, X-rays, etc.) take place. A mechanical intestinal obstruction often reveals itself when listening to the abdomen, because the intestines are initially working harder here than normal. In the case of an occlusion due to paralysis, bowel sounds cannot be heard. Patients with intestinal blockages are also often given urinary catheters to urinate and antibiotics to prevent blood poisoning (sepsis) from developing. With timely, correct treatment, intestinal obstructions usually go well. The risk of consequential damage such as permanent digestive problems, organ damage or an increased risk of further intestinal blockages increases if complications have already occurred. This is often the case when patients arrive at the hospital late. About one in seven people affected die after intestinal obstruction.
Prevention
Regular bowel movements and a diet that is primarily based on easily digestible foods have a positive effect on the risk. Apart from that, general measures are useful that maintain health and prevent diseases such as circulatory disorders and kidney weakness, e.g. balanced diet, regular exercise, drinking enough.