Bowel obstruction is a serious condition. It can be painful to the point of being unbearable. More importantly, it can lead to grave consequences. When left untreated, it may also lead to death. This is perhaps why many consider bowel obstruction surgery to treat this condition. Read on and find out if the procedure is right for you.
It Could Happen to You: Understanding Bowel Obstruction Problems
A bowel obstruction can affect either your small intestine or large intestine. With this condition, there is a partial or complete blockage of your intestines. This is why this condition is also known as an intestinal obstruction. When this happens, moving through the intestines will be difficult for any substance in your body, whether it be gas, fluids or food.
When you are suffering a blockage in either of your intestines, food, gastric acid, gas and fluids may end up building up right behind the site of your intestinal blockages. When enough pressure in this area build up, you blocked intestine might rupture. This, in turn, may cause harmful contents in your stomach to leak right into your abdominal cavity, leading to an even more serious condition.
Aside from having a physical blockage, it’s also possible that bowel obstructions may happen as a result of pseudo-obstructions. That means your bowel may have a hard time pushing things down as if there an actual mechanical obstruction in your bowel. In this case though, there is absolutely no physical blockage in either of your two intestines.
Bowel Obstructions by the Numbers
According to a study done by Georgetown University Hospital in Washington, D.C, as much as 15 percent of all the visits to the emergency department are due to an intestinal obstruction. Moreover, most of the patients brought in report experiencing abdominal pain.
As far as trips to the emergency room go with regard to bowel obstructions, it was also found by another study that as much as 80 percent of the obstruction cases in the hospital involve the patient’s small intestine.
Why Children Are Susceptible to Bowel Obstructions
While adults may be more prone to suffering from an intestinal obstruction, it must also be noted that this condition may affect children. Among infants, an intestinal stricture may occur as a result of organ diseases, infections and a decreased level of blood flow to the intestines. For older kids, they may also end up experiencing a bowel obstruction after suffering from the stomach flu.
Why Do Bowel Obstructions Happen?
In adult cases, there are several reasons as to why an intestinal obstruction may occur. Here are some of the most common ones:
Complications from Surgery: Adhesions or Scar Tissue
These can occur as a result of a prior abdominal surgery. Studies have also shown that these typically occur in patients who have had gynecological surgeries or operations in the appendix or colon. Adhesions tend to develop outside an injured intestine or pelvic organs. When they are pulled into a shape of a constricting band, these can pinch a portion of the small intestine closed.
On the other hand, adhesions can also end up binding itself to neighboring loops of your intestine. When this happens, the affected intestine will end up tightening, causing a constriction in the flow of various intestinal contents.
Today, adhesions are the most common cause of intestinal obstructions. In U.S. hospitals, adhesions as a result of prior surgeries account for 50 to 70 percent of all admission cases involving obstruction in the small intestine.
Affecting Your Small Intestine: Have a Hernia
A hernia is a protruding segment of the intestine that may appear as a lump under your skin. This happens when there is a structural weakness in the muscles and fibers that line the wall of your abdomen. Because of its weakened state, a hernia may protrude right through.
In the U.S., hernias account for as much as 25 percent of all hospital cases regarding the obstruction of the small intestine. Normally, hernias can be found near the navel, between the navel and the breastbone, the front of your upper thigh or near the groin for men. Sometimes, a hernia can also appear near a healed surgical incision.
A Painful Problem: Volvulus
Volvulus refers to a condition characterized by the abnormal twisting of a segment of the bowel around itself. Because of the twisting, the intestine ends up having a closed loop with a pinched base. This then results in an intestinal obstruction. Typically, patients who suffer from volvulus are over the age of 65. As much as five percent of bowel obstruction cases are caused by volvulus.
An Infection Out of Control: Diverticular Disease
In the large intestine, diverticula refer to small pouches that appear like a balloon, which may protrude from the wall of your intestine. When this becomes infected, the condition is known as diverticulitis. As you heal from a diverticular infection, scars may form along the wall of your colon. These scars may end up encircling the colon and therefore form a stricture requiring diverticulitis surgery.
Over time, these scars tighten. As a result, your intestine will eventually become narrow and you might even experience a blockage in your colon. Today, as much as 20 percent of bowel obstruction cases are said to be due to diverticular disease.
Tumors Can Cause Trouble, Too
Cancerous tumors can end up pressing on the outside of your intestine and then, pinch it close. It is also possible that these tumors could end up growing within the intestinal wall and gradually block its inner passage way. Typically, these tumors don’t initially occur in the small intestine itself. In most cases, cancerous tumors have spread to the small intestine from female reproductive tract, skin, lungs and colon.
Another Reason to Be Tested: Ruling Out Colon Cancer
As much as 50 percent of cases involving obstructions in the large intestine are reportedly caused by colorectal cancer. When left undiagnosed, colon cancer can lead to a gradual narrowing of the inner passageway in the large intestine. Typically, patients suffering from this kind of cancer would suffer intermittent constipation before their bowel becomes obstructed.
Aside from this, other causes of bowel obstruction include:
- Intussusception in the intestine
- Injury inflicted on the abdominal blood supply
- Mesenteric ischemia or the lack of blood supply to the abdomen
- Intraperitoneal infection
- Kidney disease
- Thoracic disease
- Swallowed foreign object that got lodged in the digestive tract
- Paralytic ileus or an intestine that stops contracting and moving stomach contents along.
How to Know If You Have an Obstruction in Your Bowel
It is possible to determine if you are suffering from an obstruction of your small or large intestine. However, it is still better to go to a medical professional for a proper diagnosis. This is especially because symptoms vary between a child and adult whether it’s an obstruction involving the small intestine or large intestine.
In an infant or young child, the following symptoms of bowel obstruction might be observed:
- Swelling of the abdomen
- Passing stools with blood. This is also known as having currant jelly stool.
- Vomiting a bile-like vomit that appears yellow-green
- Crying loudly
- Drawing the knees up to the chest
- Grunting due to pain
For an adult, having the following symptoms may mean that there is an obstruction in the small intestine:
- Abdominal pain cramping that you experience at intervals of five to 15 minutes. This may be felt at the center of the navel or right between the navel and the rib cage.
- Absence of gas that passes through the rectum
- Bloating in the abdomen
- Tenderness in the abdomen
- Rapid pulse
- Rapid breathing
As far as the large intestine is concerned, you’ll know that you are possibly suffering from an obstruction if you experience the following symptoms:
- Pain in the abdomen
- Bloating in the abdomen
- Constipation while there is an obstruction in the intestine
- Tumor in the colon, especially if you have a history of rectal bleeding
- Diarrhea, which is due to liquid stool that is leaking around a partial intestinal obstruction
At the same time, you may also experience a number of other symptoms whether the obstruction in your bowel occurs in the small intestine or large intestine. These include:
- Low fever
- Muscle cramps
- Weight loss
- Bad breath
- Uncontrollable hiccups or burping
- Intense dislike to eat
- Inability to pass bowel
Diagnosing a Bowel or Intestinal Obstruction
When you walk into a clinic or hospital, doctors won’t diagnose you with bowel obstruction straight away. First, these medical professionals will ask you a number of questions pertaining to your:
- Symptoms – Your doctor may ask you to give a detailed description of the bowel obstruction symptoms that you have been experiencing.
- Medical History – It is important for the doctor to know if you may have had any surgical procedure or any other medical treatment recently. During this time, you will also be asked if you have any ongoing medical condition as well as medications and nutritional supplements you are currently taking.
Following this, the doctor will proceed to give you a physical examination. This will primarily concentrate in your abdominal area as well as other parts of your body where you are currently experiencing any pain or discomfort.
After this, your doctor may also decide to have some tests done on you to confirm the diagnosis. These tests typically include:
- Complete blood count
- Metabolic panel
- Computed tomography or CT
- Contrast fluoroscopy
- Magnetic resonance imaging
- Abdominal X-ray
- Colonoscopy, this is normally done when the doctor suspects that the obstruction is occurring in the large intestine.
The Consequences of Having an Intestinal Obstruction
When left untreated, an obstruction in the small intestine or large intestine may lead to graver conditions. Some of which include:
- Electrolyte imbalance
- Abdominal abscesses
- Rupturing of a wound or dehiscence
- Post-operative infection
- Necrosis of the bowel tissue
Can You Die from a Bowel Obstruction?
As with any condition, an intestinal obstruction that is left untreated may lead to fatal consequences. The problem with a bowel obstruction is that it leads to an abdominal swelling that tends to get worse over time. This is due to the fecal, fluid and gas build up that it creates.
In time, the obstruction may also lead to a restriction in the blood supply to the intestine, which in turn, would lead tissue death or the busting of the intestine. When the small intestine becomes completely blocked, a person may die within a matter of hours or days.
This is it is important to see a doctor about a possible obstruction in your bowel right away. In a number of cases, the treatment prescribed to patients with intestinal obstruction is surgery.
The Case for Having Bowel Obstruction Surgery
A bowel obstruction surgery is often recommended when a person is already suffering a from a complete bowel obstruction. In cases when a small intestine is completely obstructed, a doctor may perform a procedure that involves an open surgical exploration of the abdomen known laparotomy.
In the case of a laparotomy, the doctor would relieve the obstruction in the small intestine and afterwards, re-attach the healthy ends of the intestine. This is done by inserting a fiber-optic instrument that is known a laparoscope. This enters the body by way of a keyhole abdominal incision. This way, both risks and bowel obstruction surgery complications are minimal.
This surgical procedure is also often preferred to an open surgery as it produces fewer new adhesions in the intestine. As far as the recovery process, patients who undergo a laparotomy also require relatively shorter bowel obstruction surgery recovery time. This allows them to get to their normal lives much sooner.
Studies have even showed that a laparotomy has lower morbidity while giving patients a faster return to their normal bowel function and diet. Moreover, this type of bowel obstruction surgery for the elderly is also safe.
On the other hand, a complete obstruction of the large intestine normally requires surgical intervention. The purpose of the surgery in this case is to be able to remove the disease or the non-functioning segment of you intestine.
Should the large intestine obstruction be caused by an intestinal volvulus, a doctor may opt to reduce the patient’s intestinal torsion with the help of an endoscope. For some cases, the lower colon and anus may be bypassed during the procedure by placing a shunt through the skin in order to remove the fecal build up. This procedure is known as a colostomy.
According to research, patients who undergo a colostomy are able to return to their normal daily activities. They may, however, need to have their colostomy bags emptied or changed on a routine basis. Those who had a temporary colostomy may also need to undergo a second surgery after a few months in order to reattach the bowel and remove the colostomy. In cases like this, the patient’s bowel function is said to return to normal.
Bowel Obstruction Surgery: An Overview
The surgical procedure involving an obstruction in the bowel differs, depending on whether a complete obstruction of the small intestine or large intestine is involved.
Laparoscopy for Small Intestinal Obstruction
A laparoscopy is a minimally invasive procedure that utilizes multiple trocars. These are thin tubes that are placed through three to five small incisions made around the abdominal area. Typically, these incisions are less than 0.5 cm. With the incision done, carbon dioxide gas is used to inflate the abdomen slowly. Afterwards, the surgeon will then place a thin telescope through one of the trocars to allow them to look inside the patient’s abdomen.
Specialized instruments are then placed through the other trocars. These will allow the surgeon to perform the procedure. With these instruments in place, one of the incisions will be enlarged in order to remove a piece of bowel. Throughout the surgery, you would not feel a thing, as it is done while the patient is under a general anesthesia.
Colostomy for Large Intestine Obstruction
During a colostomy, an opening for the large intestine is created through the abdomen. When doctors perform a permanent colostomy, the end of the large intestine is brought through the abdominal wall where it can be turned under like a cuff. Afterwards, the edges of the colon are stitched to the abdominal wall skin in order to form an opening known as a stoma. The patient’s stool will then drain from the stoma into a bag that has been attached to the patient’s abdomen.
In the case of a temporary colostomy, the surgeon cuts a hole in the side of the large intestine and stitched to a corresponding hole in the patient’s abdominal wall. Later on, this can be reversed by detaching the colon from the abdominal wall. Afterwards, the holes will also be closed in order to help re-establish the flow of the patient’s stool through the large intestine.
Preparing for A Bowel Obstruction Surgical Procedure
In order you to prepare you for surgery, your surgeon and physician may evaluate you and as a result, may decide to run further tests. These include:
- Barium enema
- Chest x-ray
- CT scan of your abdomen
- Blood work
Aside from various tests, you may also be asked to make a bowel preparation before your surgery. Eight hours prior to surgery, patients are typically advised to not ingest solids and go on a liquid diet. You may also be asked to stop taking certain medications, including aspirin, ibuprofen, warfarin and blood thinners.
Beware of These Bowel Obstruction Surgery Risks
Just like any surgical procedure, both laparoscopy and colostomy present a number of risks to the patient. These may include:
- Adverse reaction to the anesthesia used
- Abdominal bleeding
- Abdominal infection
- Another case of bowel obstruction due to new scar tissues
- Blood clots in the legs or lungs
- Organ injury
- Leakage from the intestine
- Heart attack
- Skin Irritation
- Opening of wound
- Development of hernia where the incision was made
- Constipation after surgery
Aside from the said risks, there are more serious bowel surgery complications that a patient may experience after surgeries in the abdominal area. Here are two of them:
Ileus After Surgery Can Happen
A patient may experience ileus after surgery. This is known as a condition where there is a temporary arrest of the intestinal peristalsis. Symptoms of ileus include vomiting, nausea and a vague form of abdominal discomfort. Typically, ileus is treated with the help of IV fluids and nasogastric suction.
Diverticulitis Following Your Bowel Surgery
A patient undergoing an abdominal operation may also develop diverculitis after surgery. This is characterized by small, bulging pouches that line the digestive and therefore cause severe pain in the abdomen as well as fever and nausea. Typically, mild diverticulitis is treated with the help of antibiotics and diet change. Should the condition persist however, surgery may be needed once again.
Alternative Home Remedies
When you’re dealing with just a partial obstruction of the small intestine or large intestine, it is completely understandable if you feel that constipation surgery is not the right solution for you. In this case, you may want to go ahead and try some home remedies that can help treat your bowel obstruction. Here are some of the most recommended ones you can try, but be sure to discuss the issue with your doctor first:
- Water and Honey – It is said that the honey will help lubricate your gastrointestinal tract and therefore, treat the obstruction. To try this remedy, simply boil some water and let it cool down before adding some honey. Drink this mixture right before you go to bed.
- Apples – The fiber in apples will help you move your bowel, although it may take a few days before you can feel this effect. Simply eat an apple every morning before you take in anything else.
- Orange Juice – A refreshing glass of orange juice is said to help you flush out unwanted toxins from your body. Go ahead drink a glass every morning.
- Fiber – This is key in ridding the body of any toxins that can be contributing to your intestinal obstruction. To consume more fiber, simply load up on oats, rice, wheat, cereal, fruits and various leafy vegetables. You may also consider taking some fiber supplements or trying drinks that have been fortified with fiber.
- Mint, Lime and Ginger – Mixing in the juice of lime, mint and ginger together with some black salt is said to be a proven remedy in removing a bowel obstruction. What’s more, it sounds like a delightful mocktail, too.
- Cleansing Drinks – You can find a number of these in today’s health stores. They are usually made up of a blend of fruits, herbs and vegetables. When taken regularly, these can help improve the condition of your gastrointestinal track and keep you from suffering any more bowel obstructions.
- Plain Water – When you’re well hydrated, the blood in your system is able to carry and distribute more oxygen into various parts of your body, including your colon. Drinking more water also helps prevent any obstruction from occurring in your gastrointestinal tract.
Bowel or intestinal obstruction is hard on anyone. When left untreated, your condition can turn from serious into grave quickly. Avoid this by considering going to the doctor and considering your bowel obstruction treatment options including bowel obstruction surgery. The important thing is that you don’t let your problem persist. Seek help right away.