What is an Intestinal Obstruction?

Intestinal Obstruction Explained: Symptoms, Causes & Diagnosis

Everything you eat travels through your intestines. Intestinal obstruction refers to the blockage (partial or complete) of the intestines that hinders the movement of food, liquid, or even gas through the digestive tract.

It is a grave condition that can affect both the small and the large intestines, causing pain, vomiting, and bowel disorders. However, with early diagnosis, it is easily treatable.

Read on to understand the types of intestinal obstruction, its triad signs, and other details.

What are the Different Types of Intestinal Obstructions?

Intestinal obstructions can be of two types:

1. Mechanical, when a physical blockage in the digestive tract prevents the passage of food, fluid, or gas. This can occur due to scar tissue, tumours, hernias, and related conditions.
2. Functional, when the muscles in the digestive tract fail to work properly, preventing food, gas and fluids from moving through the digestive system.

Based on their location, there are two types of bowel obstructions.

1. Small Bowel Obstruction : Approximately 80% of all bowel obstruction cases are known to have occurred in the small intestines (gut). During blockage, it prevents the passing of digested food or liquid to the large intestine (colon).
2. Large Bowel Obstruction : This condition indicates a blockage in the large intestine. It slows down or completely stops the passage of stool from leaving your body. The classification of large bowel obstructions is as follows:
3. Partial: The intestine is only partially blocked; some food, liquid, and gas can still pass.
4. Complete: In a complete bowel obstruction, nothing can pass through the intestine. This life-threatening situation often requires immediate surgical intervention.
5. Pseudo-obstruction: Pseudo means false. In a pseudo-obstruction, there is no actual blockage, and the problems occur with the GI (gastrointestinal) muscles or associated nerves. Opioid drugs can cause this condition.

What Causes Intestinal Obstruction?

The possible reasons for intestinal obstruction include:

• Abdominal Adhesions: These are bands of fibrous tissue that develop after an abdominal surgery or inflammation.
• Hernias: During an intestinal hernia, a section of the intestine pushes through the weak spot in the abdominal muscles. The bulge causes the blockage.
• Volvulus: This is a twisting of the intestine on itself, thus creating an obstruction.
• Intussusception: This condition is common among children, where one segment of the intestine slides into another segment. It narrows the passage, causing blockage.
• Scarring: Scarring from adhesions (post-surgical) or strictures (e.g., Crohn’s disease)can cause blockage.
• Diseases: Inflammatory bowel diseases (IBD), such as Crohn's disease and ulcerative colitis, are known to cause blockage of the intestines. Diverticulitis (pouches growing in the walls of large intestines) may also be responsible for obstruction in the intestines.
• Tumours: Growth in the intestines, benign or cancerous, can cause intestinal blockage.
• Foreign Objects: Swallowing non-food particles, on purpose or accidentally, can result in intestinal obstruction.
• Meckel’s Diverticulum: About 2% of people are born with this congenital condition. These people have an additional pouch or growth inside their intestines.

What are the triad signs of intestinal obstruction?

The classic triad signs of intestinal obstruction include:

• Abdominal Pain: Chronic pain in the abdomen is one of the earliest symptoms of this condition.
• Vomiting: Frequent vomiting is another classic sign.
• Obstipation: Complete obstruction.

Other signs of a blocked intestine are:

• Lack of appetite
• Fast heartbeat, dehydration
• Fever
• Rectal bleeding
• Distended abdomen

How is Intestinal Blockage Diagnosed?

The doctor will begin by asking for your medical history. A physical examination will follow, looking for signs such as abdominal swelling, dehydration, and the presence of any lumps in the abdomen. They may order imaging tests such as:

• Abdominal X-rays: Doctors recommend this as the first step for detecting an obstruction, though not all blockages are visible on standard X-rays.
• CT Scan: The CT Scan images are more detailed and reliable for effectively locating the obstructions.
• Ultrasound: An ultrasound is preferred while looking for intestinal blockage in children.
• Air or Barium Enema: Used to view the colon more clearly. In children with intussusception, this test can often both diagnose and treat the condition.

What are the treatment options for intestinal obstruction?

The type, location, and severity of the obstruction determine the path of treatment. Non-surgical options are available for partial blockage or early stages. They include:

• Nasogastric Tube: A tube is inserted through the nose into the stomach or intestine to remove excess gas and fluid.
• IV Fluids: Patients may need IV fluids to cure dehydration and electrolyte imbalances.
• Bowel Rest: No food or drink is given to patients to allow the intestine to recover (clear obstruction and revert to its original size).
• Medications: Anti-emetics are prescribed to prevent nausea and vomiting, and painkillers for abdominal pain.

Doctors suggest surgery only in severe cases:

• Stent Placement: The healthcare provider will place a mesh tube (stent) inside your bowel. It will open up the blocked passage, thus treating bowel obstruction.
• Removal of Blockage: The doctors will perform surgery to remove the blockage in your intestine. It includes removing the damaged parts of the bowel or an intestinal hernia repair.
• Colostomy or Ileostomy: The healthy end of the intestine is attached to an opening (stoma) in the abdominal wall. Stool exits the body through this stoma into a disposable bag.

Most people with intestinal obstruction recover well. Early diagnosis is crucial in such diseases. Follow-up care, a clean diet, and routine checkups are key to a better life. Awareness of signs can help in seeking timely medical attention. With proper care and lifestyle adjustments, most people can lead a healthy and fulfilling life after recovery.

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