Overview

Intestinal blockage, also known as bowel obstruction, is a condition where there is a partial or complete blockage that prevents the normal movement of food, fluids, and gas through the intestines. This can occur in either the small intestine or the large intestine (colon). Intestinal blockages can be caused by mechanical obstructions such as tumors or scar tissue, or by functional problems like intestinal paralysis. A blockage can cause severe pain, bloating, and digestive issues and may lead to serious complications like tissue death or infection if not treated promptly.

Causes

Several factors can cause intestinal blockage, which are generally classified into mechanical and non-mechanical (functional) causes:

• Mechanical causes:
• Adhesions: Bands of scar tissue, usually from previous abdominal surgery, are a leading cause of small bowel obstruction.
• Hernias: Protrusion of a portion of the intestine through a weak spot in the abdominal wall can cause obstruction.
• Tumors: Both benign and malignant growths can block the bowel, more commonly in the large intestine.
• Intussusception: One segment of the intestine slides into another, more common in children.
• Volvulus: Twisting of the intestines that cuts off blood supply and blocks the passage of contents.
• Impacted stool or foreign bodies: Hard stool or accidentally swallowed objects can cause blockage.
• Non-mechanical (functional) causes:
• Ileus: A temporary loss of intestinal motility due to surgery, infection, or certain medications.
• Neurological conditions: Diseases like Parkinson's disease or spinal cord injuries can slow bowel movement.

Symptoms

The symptoms of intestinal blockage depend on the location and severity of the obstruction but commonly include:

• Abdominal pain and cramping: Usually intermittent and may come in waves.
• Abdominal bloating and swelling: Due to the accumulation of gas and fluids.
• Nausea and vomiting: Especially prominent in small bowel obstructions; vomiting may be bilious or fecal-smelling in severe cases.
• Inability to pass gas or stool: Complete blockage leads to absolute constipation.
• Diarrhea: May occur in partial obstructions.
• Loss of appetite and general malaise: Due to digestive stagnation and systemic discomfort.

Diagnosis

Diagnosing an intestinal blockage involves a combination of medical history, physical exams, and diagnostic tests:

• Physical examination: Abdominal distension, tenderness, or high-pitched bowel sounds may be noted.
• X-rays: Abdominal X-rays can show air-fluid levels and dilated bowel loops indicative of obstruction.
• CT scan: Provides a detailed image of the intestines to locate the blockage and its cause.
• Ultrasound: Useful in children, especially to diagnose intussusception.
• Blood tests: May reveal dehydration, infection, or electrolyte imbalances.
• Barium enema or contrast studies: Occasionally used to highlight blockages in the large intestine.

Treatment

Treatment for intestinal blockage varies depending on its cause, severity, and whether the obstruction is partial or complete:

• Hospitalization: Most cases require hospital admission for monitoring and supportive care.
• NPO status: Patients are typically advised not to eat or drink (NPO) to rest the bowel.
• IV fluids and electrolytes: To correct dehydration and imbalances.
• Nasogastric tube: A tube inserted through the nose into the stomach to relieve pressure by draining stomach contents.
• Medications: Pain relief, anti-nausea drugs, and sometimes antibiotics to prevent infection.
• Surgery: Required in cases of complete obstruction, strangulated bowel, tumors, or when conservative treatment fails. Surgery may involve removing adhesions, tumors, or the affected bowel segment.
• Endoscopic procedures: In some cases, blockages can be relieved using colonoscopy techniques, especially in large bowel obstructions.

Prognosis

The prognosis for intestinal blockage depends on the underlying cause and how quickly treatment is initiated:

• Good outcome with early treatment: Many cases resolve without long-term effects if treated promptly, especially partial obstructions.
• Risk of complications: Delayed treatment can lead to bowel ischemia, perforation, sepsis, or death.
• Post-surgical recovery: Surgery can be curative, but adhesions may recur in some patients.
• Chronic cases: Conditions like recurrent adhesions or chronic motility issues may lead to repeated episodes.

With timely diagnosis and appropriate treatment, most patients with intestinal blockage can recover fully, though some may require lifestyle changes or long-term follow-up to prevent recurrence.