Causes of and Treatment Options for Intestinal Blockage or Twisting
written by: Norene A
• edited by: lrohner
• updated: 12/19/2010
Intestinal blockage or twisting interferes with the normal digestive process. Treatment options are determined by the cause of the obstruction. Obstruction can occur at any location in the small or large bowel. Read on to learn about the many possible causes and treatments for bowel blockage.
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Causes of Small Intestinal Blockage
The small bowel, consisting of the duodenum, jejunum and ileum, connects the stomach and the large intestine. It averages about 16 feet in length. An obstruction in the small bowel manifests with symptoms such as nausea, stomach pain, abdominal swelling and vomiting.
Possible causes of small intestinal blockage, according to MayoClinic.com, include adhesions, which are bands of fibrous tissue that surrounds the intestine; tumors; hernias; inflammatory bowel diseases, such as Crohn's disease; and intestinal twisting known as volvulus.
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Treatments for Small Intestinal Blockage
Treatment options depend on the type of obstruction--if it is complete or partial. For complete bowel obstruction, the only option in most cases is surgery to remove the affected part of the intestine. In partial obstructions of the small intestine, such as with Crohn's disease and peritoneal carcinomatosis, the insertion of a nasogastric tube and intravenous delivery of fluids and electrolytes lost from vomiting may be all that is required.
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Causes of Large Intestinal Blockage
The large intestine is almost 5 feet in length and is also called the large bowel or colon. The most common causes of a blocked colon, according to the University of Minnesota Medical Center, include cancer, inflammation, twisting and fecal impaction. The blockage may be partial or complete with symptoms such as abdominal swelling and pain, nausea, vomiting and little or not bowel movements.
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Diagnosing Blocked Intestines
Diagnosing intestinal blockage or twisting begins with a review of your symptoms and a medical history, followed by a physical examination. Your doctor will feel your abdomen for any obvious signs of pain or distention. In addition, tests used to confirm the diagnosis may include blood and urine tests, X-rays of the abdomen, an abdominal CT scan and a colonoscopy. Since a blocked colon can be a medical emergency, it is important to see your doctor right away or seek emergency medical care when symptoms arise.
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Treatment of Large Intestinal Blockage
The treatment of a blocked colon depends on the cause. Treatment for fecal impaction includes removing the impacted stool, which may include enemas or suppositories and manual evacuation of the stool by a health care provider using one or two fingers to gently break up the mass.
Treatment for colon cancer may include surgery to remove the affected colon and radiation/chemotherapy to kill any remaining cancer cells. Stent placement, according to the Mayo Clinic, is a possible treatment for some colon blockages because of cancer. The stent is an expandable wire mesh inserted into the colon to relieve the blockage instead of the older technique of surgical removal of a portion of the colon requiring a colostomy.
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Intestinal blockage or twisting known as intestinal malrotation is a birth defect in which the digestive tract fails to develop properly. The cecum, normally located in the lower right side of the abdomen remains in the upper right side of the abdomen with the appendix where bands of tissue develop and create a blockage at the beginning of the small intestine. This malrotation causes the intestine to become twisted. According to Children's Hospital Boston, between 25 and 40 percent of malrotation are diagnosed within the first week of life.
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Diagnostic procedures may include imaging studies to identify the position of the intestine. Treatment depends on the child's age and extent of the problem and may include immediate surgical repair.