Intestinal obstructions represent 10 to 20% of abdominal pain in adults and the second cause of surgical hospitalization after appendicitis.
Intestinal obstruction requires urgent hospitalizationand depending on its type, it is processed by medical treatment, endoscopic or surgical.
What is a bowel obstruction?
A bowel obstruction (or intestinal obstruction) corresponds to a partial or total interruption of the activity of the intestine, preventing the normal evacuation of stools and gases. Doctor Anne-Laure Tarrerias, gastroenterologist and proctologist in Paris explains that “this blockage can occur in the small intestine or in the colon”. It exists 2 types of occlusion :
- Upper intestinal obstruction: duodenum and small bowel
- Lower intestinal obstruction: colon and rectum
What is a partial occlusion?
A bowel obstruction is a partial obstruction of the intestines. Doctor Tarrerias recalls that she then translates “by one strong reduction in the progression of feces, gas and abdominal pain which is usually accompanied by nausea and vomiting“. Whatever the cause, a bowel sub-occlusion should be monitored up close because it can eventually turn into a bowel obstruction which is a medical emergency.
What are the symptoms of an intestinal obstruction?
The main symptoms of acute intestinal obstruction in adults as in children are:
- abdominal pain,
- enlargement of the abdomen called abdominal meteorism,
- stool stoppage and gases
- vomiting.
- During colon obstruction, constipation may also occur.
The gastroenterologist nevertheless explains that the symptoms of the occlusion will depend on the level of the attack: “We will observe vomiting and pain from the first transit maintained until complete emptying of the intestine and the downstream colon for the high bites, while for the low bites we will observe a rapid cessation of secondary matter, gas and vomiting.”
What causes bowel obstruction?
It may be due to:
- a accumulation of feces
- an absence of contractions of the muscles of the intestine, often of neurological origin,
- inflammation or infection,
- following an operation, twisting of part of the digestive tract or strangulation
- an obstruction of the intestinal lumen by a tumor,
- or compression exerted by an external structure.
“THE causes of colon obstruction are on the other hand mainly tumors or diverticula complicated” says the doctor.
In the case of a functional bowel obstruction, we speak of paralytic ileus. It is an anomaly in the functioning of the intestines which prevents the proper regulation of intestinal transit. In general, a paralytic ileus occurs after surgery performed on the intestine as a appendicitis, peritonitis, or pancreatitis.
Natural treatments are not relevant in cases of intestinal obstruction
Intestinal obstruction after an operation
Paralytic ileus causes intestinal obstruction, the origin of which is a functional anomaly preventing the intestines from regulating transit. It occurs on more often after bowel surgery. A appendicitis, peritonitis or pancreatitis may be the cause. After surgery intraperitoneal, an occlusion may be caused by intestinal adhesions. This mechanical type occlusion can occur a few days after the intervention or even months or years later. Doctor Tarrerias, however, specifies that “This risk is reduced by the use of laparoscopy“.
What tests to make the diagnosis?
The clinical examination with the practice of an abdominal palpation then a digital rectal examination, generally quickly gives way to additional examinations such as:
- abdominal scan to locate the obstacle more precisely and determine its type;
- blood sampling to look for possible signs of seriousness in the presence of which the patient will be directed to intensive care.
A bowel obstruction that is not treated urgently can cause death.
What are the treatments for bowel obstruction?
Intestinal obstruction requires urgent hospitalizationand depending on its type, it is processed by medical treatment, endoscopic or surgical. Treatment depends on the origin of the bowel obstruction, location and severity. Occlusion by strangulation usually requires emergency treatment to remove the twist. Doctor Tarrerias explains that the treatment is based “on the aspiration of fluids upstream of occlusion, fasting and hydration by infusion”. This treatment makes it possible to remove most of the occlusions but the gastroenterologist specifies on the other hand that “surgery may be necessary if medical treatment fails, aiming to treat the cause of the occlusion”. Functional occlusion requires medical treatment (rehydration, intravenous analgesics and antispasmodics, enema…). natural treatments, effective on certain digestive pathologies, are not relevant here.
What are the potential complications ?
If left untreated, bowel obstruction can lead to complications, such as serious metabolic disorders (dehydration, heart problems, kidney failure…); a bowel perforation with infection of the peritoneal cavity by germs contained in the digestive tract: peritonitis; necrosis of part of a digestive organ during a strangulation of too long duration or a state of shock. A bowel obstruction that is not treated urgently can cause death.
Thanks to Doctor Anne-Laure Tarrerias, gastroenterologist and proctologist in Paris.