Causes of Small Intestinal Blockages in the Elderly
Small intestinal blockages may occur from mechanical causes that physically impede passage of intestinal contents or from paralytic causes (ileus) in which the passageway is open but peristalsis (wavelike muscle contractions that move food along the digestive tract) ceases.
Many things can mechanically obstruct the small intestines in the elderly, including:
- impacted feces
- foreign bodies (swallowed objects)
- the formation of scar tissue after surgery (adhesions)
- Crohn's disease.
The most common cause in developed countries is postoperative adhesions (about 60%). The surgeries that are most closely associated with small intestinal blockages are upper GI (gastrointestinal) procedures, colorectal surgery, appendectomy, and gynecologic procedures. Obstructions can develop within 4 weeks of surgery or decades later.
Common causes after postoperative adhesions are malignant tumors, Crohn's disease, and hernias.
Volvulus (twisted intestine) and intussusception (a condition in which one part of the bowel slips into the lower part) are other causes of mechanical blockages but both are mostly seen in infants.
Nonmechanical obstructions are also mostly seen in infants (and children). However, they can occur in the elderly. Causes can include medications that slow peristalsis (especially narcotics), kidney disease, and long-standing diabetes.