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Small Bowel Obstruction

A small bowel obstruction is a blockage within the small intestine of the digestive system. As a result of the obstruction, the movement of waste is slowed down or stopped completely. If the obstruction is “complete,” this could be considered a medical emergency. Failure to treat the problem can lead to serious and permanent damage. It can also cause Bowel Ischemia, which can be potentially fatal. Therefore, it’s critical for a small bowel obstruction to be properly diagnosed so corrective action can be taken.

Recognizing An Obstruction

Small bowel obstruction can be associated with several symptoms, though some can easily be confused for other distinct disorders. These symptoms include:

  • Abdominal distension
  • Abdominal pain (intermittent cramps or spasms)
  • Bowel sounds (as the bowels try to overcome the obstruction)
  • Constipation (usually occurs after vomiting)
  • Diarrhea
  • Fever (occurs as the problem progresses and can be a sign of serious complications)
  • Nausea
  • Vomiting (can involve actually vomiting fecal matter!

If this symptom occurs, call 911 or get to an emergency room immediately as it indicates a severe problem.

As a result of even normal vomiting, dehydration and electrolyte imbalance can occur.  Pressure placed on the diaphragm from the obstruction can cause respiratory problems.  Each of these complications can lead to serious problems stemming from the small bowel obstruction. Address all aspects of the issue and report even seemingly unrelated symptoms to your doctor.

Diagnosing An Obstruction

In order to diagnose this disorder, you must see a physician. He or she can diagnose the obstruction with x-rays, blood tests, ultrasound, or CT scanning. It may take a combination of several of these tests to perform an accurate diagnosis. The doctor may also perform a colonoscopy, laparoscopy, or endoscopy to investigate the small bowel and determine the exact location and nature of the obstruction.

Causes of Small Bowel Obstruction

  • Adhesions (or internal scars) caused by prior surgeries
  • Carcinoid (a type of tumor)
  • Crohn’s Disease (can include adhesions or tissue inflammation)
  • Foreign bodies (may be caused by swallowing an indigestible object)
  • Hernias in the small bowel
  • Intussusception (a condition occurring when one part of the intestine prolapses into another part)
  • Ischemic strictures (a restriction in blood vessels usually caused by damaged tissue)
  • Intestinal atresia (a narrowing of the bowels)
  • Neoplasms (abnormal tissue growths)
  • Volvulus (bowel twisting)

Adhesions are the most common culprit behind bowel obstruction, with approximately 60% of cases being attributed to scarring. Certain surgical procedures appear to promote a higher incidence of obstruction following surgery.

These procedures include:

  • Colorectal surgery
  • Gynecological surgery
  • Hernia repair
  • Upper gastrointestinal procedures
  • Appendectomy

Research has also shown lower abdominal surgeries and pelvic surgeries are more likely to cause an obstruction than those of the upper gastrointestinal region.

Treatment for Bowel Obstruction

In rare cases, a small bowel obstruction will resolve itself. Adhesive obstructions are the most likely to heal themselves. Nonetheless, in most cases, an obstruction must be resolved through surgery.

The side effects of the obstruction also need to be addressed.  If dehydration has occurred, for example, it will be necessary to correct any electrolyte abnormalities or other related issues. Vomiting may necessitate the intervention of pain or other medications. Since a small bowel obstruction is potentially fatal, it is important to seek qualified medical support if you have any of the symptoms. This recommendation is particularly true if you have undergone any surgical procedures in the abdominal area.

Insist the doctor follow perform specific testing to determine the seriousness of your obstruction. Even for experienced physicians, it is sometimes difficult to diagnose which obstructions require immediate attention and which ones do not. Hence, for the sake of your health if not your life, make sure you feel comfortable with the diagnosis and that proper action is being initiated to treat your condition.

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