Intestinal Obstruction

A blockage in your intestines stops food and liquids from moving through the small or large intestine (colon). This blockage, called intestinal obstruction, can have several causes. One common cause is scar tissue, called adhesions, that forms in your belly after surgery. Another reason is a hernia, a bulge in the muscle of your abdomen. Sometimes, colon cancer can create a blockage. Certain medicines can also cause problems. Inflammation of the intestines, like that seen in Crohn's disease or diverticulitis, can narrow the intestines (create strictures), leading to a blockage.

Your intestines get blocked sometimes, and this can cause some uncomfortable symptoms. Here's what to watch out for:

• Belly pain: You might feel a tightening or cramping pain in your stomach that comes and goes. This pain can be mild or severe.
• No appetite: You might not feel like eating as much as usual.
• Trouble going to the bathroom: This could mean you're constipated (you haven't had a bowel movement in a while) or you're unable to have a bowel movement at all. You might also have trouble passing gas.
• Vomiting: Your body might try to get rid of the buildup by making you vomit.
• Swollen belly: Your abdomen (belly) might feel swollen or bloated.

If you notice any of these signs, it's important to talk to a doctor. They can figure out what's causing the problem and recommend the best treatment.

If you have severe stomach pain or other signs of a blocked intestine, get medical help right away. A blocked intestine can lead to serious problems. These problems can include infections, dehydration, and even organ damage. Don't delay; prompt medical attention is crucial.

Common causes of a blocked intestine (intestinal obstruction) differ depending on age.

In adults, the most frequent reasons for a blocked intestine include:

• Scar tissue (adhesions): After surgery on the belly or pelvis, scar tissue can sometimes form bands that wrap around and squeeze the intestines. These bands can prevent food and waste from moving through normally.
• Bulges (hernias): A hernia happens when a part of the intestine pushes through a weak spot in the muscle wall of your belly. This bulge can block the intestine.
• Colon cancer: Sometimes, colon cancer can grow and block the intestine.

In children, the most typical reason for a blocked intestine is intussusception. This is when one part of the intestine slides into the part right next to it, like a telescope collapsing. This creates a blockage.

Several health issues can make it harder for food to pass through your intestines, potentially leading to a blockage. These include:

• Previous abdominal or pelvic surgeries: Sometimes, scar tissue, called adhesions, forms after surgery. These adhesions can wrap around and press on the intestines, causing a blockage. This is a fairly frequent problem after such procedures.
• Crohn's disease: This is a condition that affects the digestive system. In Crohn's disease, the lining of the intestines can become inflamed and thickened. This thickening can narrow the space inside the intestines, making it difficult for food to move through.
• Cancer in your belly (abdomen): Tumors in the abdomen can grow and press on the intestines, blocking the normal flow of food. This can happen if the cancer spreads to the intestines or if it grows large enough near the intestines.

A blocked intestine, if left untreated, can lead to very serious and potentially life-threatening problems.

• Damage to the intestines. When your intestines are blocked, the blood supply to that part of your gut can be stopped. Without blood, the tissue in the intestines can die. This dead tissue can create a hole (perforation) in the intestine. This hole can allow bacteria to enter your body, causing a dangerous infection.

• Infection in your belly. The medical term for infection in your belly (abdomen) is peritonitis. This is a very serious condition that needs immediate medical attention, often requiring surgery.

Diagnosing a blocked intestine (intestinal obstruction) involves several steps. Doctors use a combination of physical checks, imaging tests, and sometimes procedures to pinpoint the problem.

1. Physical Exam: The doctor will first talk to you about your health history and symptoms. They'll also examine you physically. A swollen or tender abdomen, or a lump in the area, could suggest a blockage. The doctor might use a stethoscope to listen for the sounds of your intestines. These sounds are usually present and normal, but changes might indicate a problem.

2. X-ray: An X-ray of your abdomen is often the first imaging test used. It can show some blockages, but not all. If the X-ray doesn't clearly show the obstruction, further tests are needed.

3. CT Scan: A CT scan is a more detailed imaging test. It uses X-rays taken from many angles to create cross-sectional pictures of your body. These detailed pictures can often reveal a blocked intestine that might not be visible on a regular X-ray.

4. Ultrasound: For children, an ultrasound is sometimes the preferred imaging method for suspected intestinal blockages. An ultrasound can create detailed images of the internal organs, including the intestines. In cases of intussusception (one part of the intestine sliding into another), an ultrasound often shows a characteristic "bull's-eye" pattern.

5. Air or Barium Enema: This procedure is used to better view the colon. A doctor inserts air or a special liquid (barium) into the colon through the rectum. This can help identify certain types of blockages. Importantly, for children with intussusception, an air or barium enema can sometimes fix the problem directly. If successful, no further treatment is necessary.

These tests and procedures help doctors accurately diagnose intestinal obstruction and determine the best course of treatment.

Treating Intestinal Blockages

Intestinal blockages, or obstructions, need treatment, and usually require a hospital stay. The best approach depends on what's causing the blockage.

Hospital Care: When you arrive, doctors will first stabilize you. This might involve:

• Giving fluids through an IV (intravenous) line: This helps keep your body working properly.
• Using a nasogastric tube: This tube goes through your nose and into your stomach to remove excess air and fluids, reducing swelling.
• Using a catheter: A thin tube inserted into your bladder helps drain urine and check its content.

Specific Treatments:

• Intussusception (in children): A special type of enema (a liquid solution inserted into the intestines) is often used to treat this. If the enema works, you won't need further treatment.
• Partial Blockage: If you can still pass some food and liquid, you might only need to be stabilized and then follow a special, low-fiber diet. If the blockage doesn't clear up on its own, surgery to remove the obstruction might be necessary.
• Complete Blockage: When nothing can pass through your intestines, surgery is usually needed to clear the blockage. The type of surgery depends on the cause and the location of the blockage. This may involve removing the blockage itself, or sections of damaged or dead intestine.
• Stents: Sometimes, a metal tube called a stent can be used to widen the blocked area. This tube is inserted through an endoscope (a thin tube with a camera) into your intestine. Stents are often used for colon cancer or as a temporary solution when surgery is too risky. You might still need surgery later.
• Pseudo-obstruction (Paralytic Ileus): If this is the cause, doctors might just monitor you for a day or two in the hospital. They'll try to find and treat the underlying cause, if known. This condition can sometimes resolve on its own. To prevent malnutrition, you'll likely get nutrition through a feeding tube (nasogastric) or through your veins (IV). If it doesn't improve, medication to stimulate muscle contractions might help move food and fluids through your intestines. If the cause is an illness or medication, treating or stopping that will help. In rare cases, surgery is needed.
• Enlarged Colon: If your colon is enlarged, a procedure called decompression can help. This can be done using a colonoscopy (a thin tube with a camera) or through surgery.

It's important to remember that the exact treatment will depend on the specific cause of your intestinal obstruction. Your doctor will explain the best course of action for you.