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Overview of Intestinal Obstruction
The partial or total blockage of either the small or large intestines is referred to as intestinal obstruction. The obstruction in the intestines causes failure in passing intestinal contents out of the body. Intestinal obstruction can happen to anyone, but it is more common in patients with Crohn's disease.
The symptoms of intestinal obstruction frequently depend on which part or parts of the intestines are affected. When the obstruction occurs in the small intestine, patients may manifest with symptoms such as pain around the umbilicus, vomiting green-colored vomitus, constipation, inability to pass out gas, and bloating. When the large bowels are affected, patients may complain of pain below the umbilicus, generalized abdominal bloating, diarrhea, constipation and vomiting of brown-colored vomitus. Obstructions caused by cancer have additional symptoms like weakness, lack of appetite, weight loss and presence of blood in the stool.
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Causes of Intestinal Obstruction
Causes of intestinal obstruction are divided into two: mechanical and ileus. When an obstruction is due to mechanical factors, it means that something is blocking the passage of intestinal contents. These include abnormal tissue growth, adhesions after surgery, ingested foreign bodies, hernias, diverticulitis, impacted stool, tumors and volvulus, which is the twisting of the intestine. Intussusception, which is the insertion or telescoping of one part of the intestine into another, is one common cause of obstruction in the intestines seen in children.
When an obstruction is caused by ileus, it means that the intestine is not functioning well. In children, paralytic ileus is the major factor causing intestinal obstruction. Causes of paralytic ileus include electrolyte imbalance, post-operation complications, injury to the abdomen, infection in the abdomen, over usage of narcotics, gastroenteritis, and mesenteric artery ischemia which is the decrease supply of blood to the abdomen. Peritonitis, food poisoning and appendicitis may also cause ileus.
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Diagnosis and Treatment
Diagnosis for intestinal obstruction is usually done with the aid of abdominal X-rays or CT scans. These are imaging tests which may indicate the presence of obstruction, and which part of the intestines is affected.
Treatment for intestinal obstruction often depends whether the block is obstructing partially or totally. Hospitalization is often necessary in both occasions.
Partially obstructed intestines are usually treated with medical management. These include using stents and enemas to open up the obstruction, as well as medications to alleviate accompanying symptoms such as nausea and vomiting. However, if nonsurgical treatments were not able to clear the block, then the physician might request for surgical intervention.
For total intestinal obstructions, open abdominal surgery is often done to relieve the obstruction. Laparoscopy, another form of surgical procedure, can also be done to relieve the blockage. The procedure is performed by inserting a thin scope and other instruments through a few incision made in the abdomen.