Introduction
Bowel obstruction, also known as intestinal obstruction or “tarmvred” in Swedish, is a serious condition where the normal flow of contents through the intestines is blocked. This blockage can occur in either the small or large intestine and may be partial or complete. Bowel obstruction is a medical emergency that requires prompt diagnosis and treatment to prevent life-threatening complications.
Causes
Bowel obstruction can be caused by a variety of factors, including:
- Adhesions: Bands of scar tissue, often from previous abdominal surgery, are the most common cause in adults.
- Hernias: Portions of the intestine can become trapped in a hernia.
- Tumors: Growths inside or outside the intestine can block the passage.
- Intussusception: One part of the intestine slides into another, more common in children.
- Volvulus: Twisting of the intestine, which can cut off blood supply.
- Impacted stool: Severe constipation, especially in older adults.
- Inflammatory bowel diseases: Such as Crohn’s disease, which can cause narrowing (strictures).
Symptoms
Symptoms of bowel obstruction can develop suddenly or gradually and may include:
- Severe, crampy abdominal pain
- Abdominal swelling or bloating
- Nausea and vomiting (vomit may contain bile or fecal material)
- Inability to pass gas or stool
- Constipation
- Loss of appetite
- Signs of dehydration (dry mouth, decreased urination, weakness)
If the blood supply to the intestine is cut off (strangulation), symptoms may worsen rapidly and include fever, rapid heart rate, and severe pain.
Diagnosis
Diagnosis is based on:
- Medical history and physical examination (checking for abdominal tenderness, swelling, or abnormal bowel sounds)
- Blood tests to look for signs of infection, dehydration, or electrolyte imbalances
- Imaging studies, such as abdominal X-ray, CT scan, or ultrasound, to identify the location and cause of the obstruction
Treatment Options
Treatment depends on the cause, location, and severity of the obstruction:
- Hospitalization: Most cases require admission for monitoring and treatment.
- Nasogastric tube: A tube may be inserted through the nose into the stomach to relieve pressure and remove fluids.
- Intravenous fluids: To correct dehydration and electrolyte imbalances.
- Bowel rest: No food or drink by mouth until the obstruction is resolved.
- Surgery: Required if the obstruction does not resolve with conservative measures, or if there are signs of strangulation, perforation, or severe infection. Surgery may involve removing the blockage, repairing the intestine, or treating the underlying cause.
Prevention
Some causes of bowel obstruction cannot be prevented, but you can reduce your risk by:
- Following medical advice after abdominal surgery to minimize adhesions
- Treating hernias promptly
- Managing chronic digestive conditions
- Eating a high-fiber diet to prevent constipation
When to Seek Medical Care
Seek immediate medical attention if you experience:
- Severe, persistent abdominal pain
- Vomiting, especially if it is green or contains fecal material
- Inability to pass gas or stool
- Abdominal swelling
- Signs of shock (such as rapid heartbeat, low blood pressure, confusion)
Takeaway
Bowel obstruction is a potentially life-threatening condition that requires urgent medical evaluation and treatment. Early recognition and intervention are essential to prevent serious complications.