Intestinal obstruction is a syndrome that causes disruption of the passage of food bolus or feces through the tract. Its always severe course and high percentage of deaths make it dangerous, so every person should be able to identify the first signs of the disease.

Symptoms

The syndrome begins with sudden pain, severe and unbearable, similar to labor pains. The patient, trying to find a position that can alleviate the condition, tries to squat or bend, touching his knees with his elbows.

Symptoms of intestinal obstruction develop very quickly: by the end of the first day, the pain puts the person into a state of shock, the skin becomes pale, the heartbeat quickens, cold sticky sweat appears, and a “ileus groan” escapes from the mouth. Then vomiting appears. Based on its contents, the doctor can determine where the “congestion” has occurred. The higher it is, the stronger the urge. Eversion of the stomach contents does not bring obvious relief.

Frequent vomiting causes dehydration of the body, peristalsis does not work, putrefactive processes produce a large amount of toxins. Increasing intoxication makes the blood thick, and leukocytosis develops against this background. Gases accumulate in the affected area, the abdomen increases in size, and the contour of a highly swollen intestine is clearly visible through the abdominal wall. If you shake it with your hands, you will hear a noise reminiscent of splashing water. It is created by digestive juice accumulated in the intestine.

On the second day after the onset of illness, other signs of intestinal obstruction appear: the patient stops excreting urine, the body temperature rises (it indicates an increase in the amount of toxins), breathing quickens, peritonitis or sepsis develops, the patient’s condition becomes critical. If left untreated within three days, death occurs. That is why it is so important to deliver the patient to a surgical hospital as early as possible.

Causes of the disease

The following factors can provoke a delay or complete absence of passage of the contents of the digestive tract:

Treatment tactics are developed taking into account the causes of obstruction, as well as the specifics of the clinical picture.

Types and features

Depending on where the “congestion” of the food bolus or feces formed, two forms of the disease are distinguished: upper (obstruction of the small intestine) and lower (obstruction in the large intestine).

Sharp cramping pains that occur in the upper half of the abdomen help to recognize a dangerous disease of the small intestine. They appear immediately, within two hours after the formation of a “congestion”, at the same time vomiting occurs, in its masses you can see the remains of undigested food of an unpleasant yellow-green color.

The second form develops more slowly, it is associated with the failure of already formed feces to pass through, and is preceded by protracted periods of constipation.

There is pain, but it is not pronounced and is localized in the lower abdomen. Nausea appears 10 hours after the formation of intestinal obstruction. It causes vomiting, its mass has a gray or brown color and fetid odor.

Based on the characteristics of the clinical picture, three types of the course of the disease are distinguished. Classification helps differentiate the pathology from others that have similar symptoms.

Acute obstruction

It occurs in three stages. In phase I, a rapid disruption of intestinal passage occurs. During the first two hours, severe pain and local abdominal symptoms appear. After 10 hours, intoxication of the body begins, and a period of apparent well-being begins. The patient feels better, but the disease progresses.

The peritoneum swells, becomes asymmetrical, peristalsis weakens or stops altogether, sounds and signs of dehydration appear. After three days, in the absence of treatment, functional hemodynamic disorders begin to appear and peritonitis develops.

The phases of the course of OKN are conditional, but it is precisely this chain of conditions that makes it possible to make an accurate diagnosis. Examination of the patient makes it possible to identify increased bowel sounds, tympanitis and dullness, protective tension of the abdominal wall, pronounced asymmetry and respiratory involvement.

Partial

This is a syndrome in which there is a slow movement of stool. Its appearance in children is associated with a violation of dynamic contractions of the intestinal walls, provoked by spasm or paralysis of smooth muscles.

In elderly people, stool retention or incomplete obturation can be caused by weakening of the abdominal wall muscles, diverticula, polyps, the presence of a fecal blockage or a ball of worms. Such provocateurs consolidate the effect and aggravate the severity of the condition.

Partial obstruction manifests itself with characteristic symptoms: a bloated abdomen, iridescent pain, constant nausea and vomiting. There is stool, but it is rare.

Chronic

It is diagnosed when there is a violation of the excretion of the contents of the intestinal tract, which is accompanied by prolonged constipation, followed by diarrhea. This phenomenon is associated with an increase in the activity of processes leading to fermentation and rot in places where feces “stand up” and do not move.

Blockage of the intestines provokes cramping pain. It occurs at the moment of a wave of contraction of the walls of the tract; relief occurs between peristalsis intervals. Another characteristic sign of the chronic course of the disease is the presence of false urges to defecate. The accumulation of gases leads to bloating.

If feces are blocked in the small intestine, the peritoneum is symmetrical; with colonic obstruction, it swells asymmetrically. There are several reasons that can provoke such processes: adhesions, scar strictures, tumors inside the lumen, oncology of neighboring organs (in women, the uterus, in men, the prostate).

Treatment of the disease

Since tract obstruction is a severe form of complications of various pathologies, there is no single therapeutic regimen. But general principles have been formulated, taking into account which therapeutic measures are built. They are as follows.

All patients with suspected blockage of the intestinal tract should be immediately hospitalized. It is the timing of admission of such patients to the surgical hospital that determines the prognosis and outcome of the disease. The later a person enters a medical facility, the higher the risk of death.

When diagnosing dynamic obstruction, conservative treatment is used, which is aimed at restoring peristalsis and increasing the tone of the muscle layer. The basis of therapy is medications and diet.

Drugs

To restore motor function, the following are prescribed:

• Neuroleptics that inhibit the functioning of the central nervous system (Aminazin).
• Anticholinesterase drugs that activate peristalsis (“Proserin” or “Ubretide”).

In order to achieve the desired therapeutic effect, it is important to follow the sequence of taking medications: first, drugs of the first group are administered intravenously, then, after 40 minutes, the second. Half an hour later, a cleansing enema is prescribed. To consolidate the results, electrical stimulation of the intestine is performed.

In addition, patients have their stomach and all parts of the tract washed daily. Thus, stagnant contents are removed. For this, three-meter probes with inflatable cuffs are used. In parallel with the main course, measures are taken to eliminate the symptoms of intoxication, relieve pain, and restore water-salt metabolism.

Diet

A restrictive nutrition plan is developed in each specific case, taking into account the severity of the patient’s condition and the characteristics of the clinical picture of the disease. The main task is to facilitate the work of the intestines and restore its functions.

There are general rules, they relate to the organization of the diet.

• A person must eat regularly.
• It is important to divide the number of doses into five parts, the size of each portion being “the size of a fist.”
• Overeating can trigger an exacerbation of symptoms.
• The menu should not contain products that promote gas formation or fatty foods.
• Preference is given to liquid soups and delicacies that have a slimy consistency (jelly).

When acute obstruction occurs, an adult or a child himself refuses to eat, and a zero (surgical) diet is prescribed to maintain his strength. It helps to minimize the appearance of putrefactive processes and eliminates the possibility of irritation of the tract mucosa. The main emphasis is on replenishing the water-salt balance. Allowed are diluted freshly squeezed juices, decoctions of rose hips and currants, tea, boiled cereals not made with milk, dietary meat, steamed lean fish, and white bread crackers.

Operation

All types of obstruction and strangulation (volvulus, nodulation, pinching, compression of blood vessels, mesenteric nerves), any other forms complicated by peritonitis, are subject to surgical treatment only. When it is carried out, a technique is selected to eliminate the cause of the disease. X-ray or colonoscopy, rectal examination in men and vaginal examination in women, laboratory tests of urine, blood, and pathological discharge can suggest a way to solve the problem.

In the acute phase, any surgical intervention is preceded by a period of express preparation; during this time, the patient’s condition is carefully monitored; an experienced surgeon, by examining the abdomen, can independently make a preliminary diagnosis, and, based on it, draw up an operation plan.

After surgery, intensive therapy is carried out: the patient is given blood substitutes and saline solutions using droppers, anti-inflammatory treatment is provided, and drug stimulation of the motor function of the tract is provided. On the first day, fasting is indicated, then feeding with tubes and saline solutions, after which the patient is transferred to a zero diet.

Traditional medicine

Tract obstruction is a disease in which self-medication is unacceptable. Even partial congestion can provoke dangerous complications. Therefore, “grandmother’s” recipes should be taken extremely carefully and only after consulting a doctor.

Official medicine actively uses some means in the fight against chronic pathologies. Sea buckthorn juice is especially helpful. It has anti-inflammatory and laxative effects. To prepare, take a kilogram of berries, crush them in a convenient container, mix and squeeze out the juice using gauze. Take 100 grams daily, once, half an hour before meals.

Dried fruits can boast a mild laxative effect that can improve the passage of stool. To prepare the medicine, take plums, dried apricots, figs and raisins in equal quantities, all ingredients are pre-mixed, washed and steamed with boiling water overnight. The next day, the water is drained, the seeds are removed, the pulp is ground in a meat grinder, and mixed with honey to taste. Take a tablespoon in the morning before breakfast every day.

Obstruction in children

Two forms of the disease are diagnosed: congenital and acquired. The first is a consequence of malformations of the digestive tract: pathological narrowing of the intestinal lumen, infringement of its loops, elongation of the sigmoid region.

In infants, the acute phase suddenly begins with an increase in the hardness of meconium (stool). The lumen of the hollow organ becomes clogged, the baby loses stool, and gases accumulate, which swell the tummy to a large size. The child begins to vomit; the masses coming out are yellow in color. It indicates the presence of bile.

Often newborns experience another specific type of obstruction – intussusception. The diagnosis is made when part of the large intestine “crawls over and swallows” the final segment of the small intestine. With this phenomenon, the baby experiences severe pain, vomits, there is no feces, instead mucus and blood are released. The anomaly is most often detected in 5–10 month old boys.

In babies under one year of age, in most cases, adhesions are diagnosed. They can develop as a result of birth injuries, past infections, immaturity of the digestive tract, after severe bruises and strip operations. In addition, children under three years of age are mobile, constantly moving, and during active games the loops of the small and large intestines can become twisted.

An acute attack of adhesive nature is a complication that often leads to the death of the baby. It is extremely difficult to treat it surgically, since in children the intestinal walls are thin and it is difficult to sew them. Drug treatment is effective only when the disease develops due to dysfunction of the tract.

Having information about existing risks, every parent should be able to recognize the first symptoms of the described pathology:

• Severe pain, children cannot talk about it, so they cry loudly, twist, trying to take a position that reduces the intensity of the syndrome.
• Refusal to eat.
• No stool or gas.
• The occurrence of vomiting.
• Painful urge to defecate.
• Discharge from the anus is purulent or bloody.

The presence of a combination of the listed signs is a reason to call an ambulance. Without treatment, irreversible consequences are possible.

Prevention and prognosis

It is difficult to predict the results of therapy; much depends on when it was started and to what extent it was carried out. The mortality rate in the acute phase is very high. It increases in older people, with late recognized disease, and detection of inoperable tumors. When adhesions are diagnosed, relapses often occur. The patient can be cured, provided there are no inoperable cases (oncological tumors).

Prevention of the disease consists of following the principles of proper nutrition, timely treatment and elimination of processes that can provoke it. To prevent adhesions after surgery, the patient’s recovery is carried out earlier; if there are no contraindications, physiotherapy, therapeutic exercises, and proteolytic enzymes are prescribed.

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Acute intestinal obstruction is a pathological condition characterized by disruption of the movement of incoming food through the human gastrointestinal tract. The causes of the disease can be dynamic, functional and mechanical. Intestinal blockage is most often caused by foreign bodies, tumors, spasms or hernias. But in fact, there are quite a few causative factors and the pathogenesis of acute intestinal obstruction is complex.

Today, medical statistics are such that it is diagnosed in nine percent of the total number of patients admitted to a medical institution with acute surgical pathology of organs located in the abdominal cavity. Most often, the disease is detected in people from the older and middle age categories (from 25 to 50 years). But it is possible that symptoms of acute intestinal obstruction will also appear in children. They are more often diagnosed with mechanical obstruction, caused by blocking the intestinal lumen with a foreign body that the baby could swallow, or intussusception. In general, representatives of the stronger half of humanity more often suffer from pathology. According to ICD-10 (international classification of diseases), acute intestinal obstruction has its own code - K56.6.

Acute intestinal obstruction is an emergency condition, so it is important to diagnose it as soon as possible and immediately provide assistance to the victim. It is worth noting that conservative methods do not bring any effect, so the disease can only be treated with surgery. Otherwise, there is a high risk of not only developing serious complications, but also death.

Classification

The classification of acute intestinal obstruction is based on the causes that provoke its occurrence, as well as on pathogenesis. Depending on this, pathology is divided into two large groups:

• dynamic acute intestinal obstruction. It is divided into several subgroups depending on what causes the intestinal blockage. Most often, this type of obstruction develops due to disruption of the functioning of other organs in the human body. For example, it often happens that the clinical picture of acute intestinal obstruction appears after surgical intervention, as a reflex reaction of the body to damage to the spinal cord or brain, etc. It is worth noting that older people are more susceptible to this type of disease;
• mechanical acute intestinal obstruction. It is divided into two types - obstructive obstruction and strangulation. The pathogenesis of acute intestinal obstruction of the first type is manifested due to blockage of the intestinal lumen by foreign bodies, fecal stones, accumulation of worms, and gallstones. The strangulation form is characterized by wrapping and pinching of the intestine, which causes disruption of microcirculation in it and the development of foci of necrosis.

Reasons for development

The clinic of acute intestinal obstruction develops most often due to the following reasons:

• the formation of a neoplasm of a benign or malignant nature in the intestinal lumen. In this case, acute intestinal obstruction treatment involves surgery, but the plan may also include radiation therapy and chemotherapy;
• strangulated hernia;
• volvulus or formation of nodes;
• blocking of the intestinal lumen with adhesions that formed as a result of previously performed surgical intervention on the abdominal organs;
• intussusception of the intestinal walls. This pathological condition is characterized by the fact that a certain section of one intestine is drawn into another;
• blocking of the intestinal lumen with fecal and gallstones, foreign objects or accumulation of worms.

As mentioned above, the dynamic form of obstruction often develops as a result of previously performed surgical intervention, peritonitis, or poisoning of the body.

Several other etiological factors can contribute to the progression of the disease:

• anatomically elongated sigmoid colon;
• open or closed abdominal injury;
• diverticular disease of the large intestine;
• formation of a hernia of the anterior abdominal wall;
• the occurrence of inflammatory processes in organs localized in the abdominal cavity.

Clinical picture

The clinical picture of the acute form of obstruction manifests itself very clearly - a gradual increase in the intensity of symptoms is not typical for the disease. The disease is expressed by symptoms of intestinal dysfunction:

• nausea and vomiting;
• intense pain syndrome;
• flatulence and increased peristalsis (the intestine itself tries to push through the barrier that blocks its lumen);
• impaired excretion of feces and gases. A person usually experiences constipation.

The pain syndrome in acute intestinal obstruction is very intense. The pain is localized in the navel area, but does not radiate. Has a cramping character. At the time of an attack, a person takes a forced position, which allows him to slightly reduce the manifestation of pain. During this period, the patient may show signs of shock - increased heart rate, pale skin, cold and sticky sweat, etc. Already when this symptom is expressed, it is necessary to take the patient to a doctor and carry out a diagnosis that will make it possible to determine the true cause of the condition.

The second symptom is vomiting. Based on its character, the doctor can even tell at what level the intestinal lumen was blocked. For example, if the vomiting is profuse and particles of food that a person consumed the day before are visible in it, then in this case the small intestine is affected. But it also happens that first vomit with food particles is released, then it turns yellow due to the admixture of bile, and then dark green - fecal vomit. This indicates damage to the large intestine.

Impaired excretion of feces and gases. At first, this process may not be disrupted, since the lower parts of the intestine are reflexively emptied. But after this, persistent constipation and bloating develop. A visual examination can reveal that the patient’s abdomen is enlarged, but asymmetrically. In addition, enhanced peristalsis can be noted on it.

If such signs are expressed, you cannot hesitate - you need to take the patient to a medical facility to see a surgeon who can carry out a full diagnosis and treatment of acute intestinal obstruction.

Diagnostic measures

It is not difficult for a qualified doctor to identify the presence of intestinal obstruction in acute form. Such a diagnosis can be assumed already during the initial interview and examination of the patient. It is important for the doctor to clarify exactly when the symptoms first appeared, how intense they were, and whether surgical intervention in the abdominal cavity has been performed previously. Next, a physical examination is performed. Due to severe pain, it is not always possible to conduct a full palpation of the abdomen.

The standard diagnostic plan for suspected intestinal obstruction includes the following tests and examinations:

• General clinical blood and urine analysis;
• blood biochemistry;
• plain radiography of the abdominal cavity. It can be performed either with or without the use of a contrast agent. If the doctor suspects a possible perforation of the intestine, then in this case the standard barium mixture is replaced with a water-soluble contrast agent;
• ultrasound examination of the abdominal organs;
• computed tomography;
• sigmoidoscopy or colonoscopy (if the patient is a child, then this kind of diagnostic intervention is performed under general anesthesia).

Based on the results obtained, a diagnosis is made, and the doctor selects the most effective way to eliminate the obstruction.

Treatment

Treatment of acute intestinal obstruction is carried out in three stages. At first, it is important to normalize the patient’s condition and replenish the water balance in his body. For this purpose, isotonic solutions are administered intravenously. During this period, additional medications, in particular antibacterial drugs, may also be administered.

The second stage is the evacuation of contents from the digestive tract. It is important to completely cleanse the intestines of accumulated contents. For this purpose, a special nasogastric tube is used.

The third stage is surgery. Performed under general anesthesia. Laparotomy is used. The surgeon, after opening the anterior abdominal wall, eliminates intussusception, if any, as well as the immediate cause of obstruction - adhesions are dissected, benign neoplasms are removed, and a foreign object is removed. If there are lesions with necrotic tissue, then their resection must be performed.

After the operation, there is a possibility of developing postoperative complications for several weeks. During this period, the patient is prescribed certain medications to stabilize his condition. In addition, it is very important to follow the diet prescribed by your doctor. Parenteral feeding may be required for several days after the intervention. Gradually the person will be transferred to a normal diet. It is worth noting that the diet will need to be followed not only in the postoperative period, but also for some time after it. The following are completely excluded from the diet:

• alcoholic drinks;
• carbonated drinks;
• coffee and strong tea;
• spicy, salty and fatty foods;
• spices;
• marinades and pickles;
• mushrooms;
• baked goods, sweets;
• fatty meat and fish, etc.

Instead, your diet should include:

• dietary meat and fish, steamed, oven-baked or boiled;
• baked fruits and vegetables;
• decoctions and compotes;
• vegetable broth soups;
• low-fat dairy products and so on.

The exact diet that the patient will need to follow must be prescribed by his attending physician. He will also tell you for what period of time you need to observe it. A person who has been operated on for intestinal obstruction will need to be seen periodically (twice a year) by a gastroenterologist.

Similar materials

Dynamic intestinal obstruction (functional intestinal obstruction) is a disease that consists of a significant decrease or complete cessation of the activity of the affected organ without a mechanical obstacle to progress. During the development of the disease, stagnation of intestinal contents is often observed. Among other forms of intestinal obstruction, this occurs in every tenth patient. It affects people of any age group, so it is often diagnosed in children.

Intestinal obstruction occurs more often in adults and older people. If symptoms of this disease appear, you should not ignore them and self-medicate. Medical intervention is necessary to determine the causes and determine treatment.

Intestinal obstruction is a process in which digested food does not move through the intestines. An obstruction occurs that causes feces to accumulate in the body. Such accumulation is dangerous due to the appearance of new microorganisms. During their life, they produce harmful substances that enter the organs through the blood and poison them.

How to distinguish constipation from intestinal obstruction?

When a person is constipated, a number of symptoms occur:

When the body cannot get rid of feces, a blockage has formed somewhere. This is why constipation is a symptom of obstruction.

Intestinal obstruction (symptoms in adults may vary depending on the type of illness) occurs with the first symptoms as in constipation, with the addition of new ones:

• Severe abdominal pain. They are accompanied by painful cramps in the abdomen. They arise abruptly, and there is no clear understanding of the location of the pain.
• Partial swelling. There is a clear swelling of a certain part of the abdomen where the obstruction has formed.
• Nausea and vomiting. This happens due to poisoning of the body. Long-term intoxication of the body can worsen the patient’s condition and contribute to death.

Constipation indicates the presence of partial obstruction. The main difference is that constipation is a more tolerant form of obstruction that can be treated with medication.

Types of intestinal obstruction

View	Characteristic	Classification
Acute	Impaired release of digested food from the stomach to the anus. This is a collective term that combines a number of intestinal diseases in a complicated form. Requires mandatory medical intervention; if left untreated, death is possible.
Partial	It occurs when the passage of feces through the intestines is disrupted; this process is chronic. The reasons for its occurrence may be related to: neoplasm, postoperative period or adhesive disease.	The disease occurs in a periodic manner. At the moment of exacerbation, the following appears: increased accumulation of gases, stool disturbances, pain, nausea.
Paralytic	There is a deterioration in the functioning of the intestinal muscles and a decrease in tone, and complete paralysis is also possible. This situation does not arise independently; it appears due to a number of serious diseases.	The disease occurs in several directions: Complete paralysis. Partial. Occurs in one area, in rare cases in several areas at once.
Obstructive	Poor output of intestinal contents that does not involve the mesentery. Compression occurs in the intestinal tube due to factors acquired during life.	Blockage occurs due to the impact of a foreign body. It forms both inside the intestine (fecal or gallstones, tumors) and outside (cyst, tumor). Partial Complete
Mechanical	A closure of the intestinal tube is created in a separate area, blocking the exit of intestinal contents.	Strangulation. A certain area is involved in this process, where blood circulation is disrupted due to a volvulus or intestinal knot. This leads to a sharp deterioration in the patient’s condition, and gangrene develops within a few hours. An obstruction (blockage) is formed due to an obstruction, the section of the intestine above it suffers secondarily from poor blood flow caused by severe stretching due to feces. This process can cause death of intestinal tissue within a few days. Congestion occurs for a variety of reasons, for example: malignant tumors, gallstones or foreign bodies. A mixed appearance occurs when one part of the intestine enters another, and the intestinal mesentery is involved in this process.

Reasons

Intestinal obstruction can occur for various reasons.

For ease of initial diagnosis, they are divided into groups:

• The list is large, it includes all diseases that provoke changes in the surface of the intestinal tube, resulting in internal obstruction.

It includes diseases such as:

• Diseases of the second group can cause poor blood flow in the intestinal tissues.

This group includes, for example:

1. intestinal volvulus;
2. intestinal hernia (internal, external);
3. the entry of one part of the intestine into another (intussusception).

• The third group includes diseases that cause disruption of the nerves in the intestinal tissues.

These include:

1. stroke;
2. injury;
3. hyperocalea.

• The fourth group includes pathologies caused by external influences on the intestines, due to which it is compressed.

For example:

The list of causes of intestinal obstruction includes the 10 most common diseases:

1. intestinal tumors;
2. abdominal diseases;
3. hypokalemia;
4. stroke;
5. surgical operations in the abdominal area;
6. fecal and gallstones;
7. the appearance of hernias (external, internal);
8. non-standard intestinal development;
9. mesenteric diseases;
10. the formation of cysts in and near the intestines.

Symptoms of intestinal obstruction in adults

Intestinal obstruction (symptoms in adults proceed mainly according to one development pattern) has its own special symptoms.

Initially, the first main symptoms appear:

After a day without treatment, complications appear, the list is added with new symptoms:

• strong contraction of the intestines (peristalsis);
• bloating due to accumulated gases and feces in the intestines. The abdomen takes on a firmer shape, different from its previous appearance;
• strong rumbling and noise appears;
• dehydration appears;
• dry mouth.

If for any reason treatment was not started after the appearance of all symptoms, then after 3 days the patient’s condition worsens significantly:

• accumulated masses poison the body and cause intoxication;
• fever appears;
• a state of shock may occur.

It is important to remember that the sooner the doctor begins treatment, the greater the chance of a positive outcome. And also some symptoms differ in their expression from other diseases, thanks to this you can suspect it as early as possible presence of intestinal obstruction:

Stages

Stage	Characteristic	Symptoms	Stage duration
Initial (ileus scream)	Manifested by pronounced abdominal pain	Abdominal pain with cramps; Reduced pressure; Pale skin; Frequent heartbeat; Abundant number of breaths.	Until 12 – 16 hours
Intoxication	Poor circulation and the appearance of severe intoxication in the body	Nausea and vomiting; Flatulence; Abnormal stool; Abdominal pain becomes constant.	Does not exceed 36 hours
Peritonitis	Associated with the process of severe inflammation and poisoning of the body.	Organ function deteriorates; The stomach becomes hard; Bloating; Low blood pressure; Decreased heart rate; Vomiting feces.	From 36 hours onwards

First aid for intestinal obstruction

Intestinal obstruction in 60% of cases requires surgical intervention. Therefore, an adult should immediately seek help.

It is necessary to monitor the patient’s symptoms and also carry out the following manipulations:

Diagnostics

When a patient is admitted to the hospital with suspected obstruction, the initial examination and diagnosis is carried out by a surgeon. He decides whether it is an operational case or not.

To examine the patient, the following procedures are performed:

1. Collection of information about the patient (history).

2. Initial examination.

It includes a visual examination and examination of the abdomen:

• Feeling the abdomen with your fingers (palpation) - the doctor examines the abdomen and finds the exact location of the source of pain.
• Tapping on the abdomen (percussion) - thanks to tapping on the abdomen, the doctor determines the necessary information by sounds.
• Listening to the abdomen (auscultation) - noises in the patient’s abdomen are determined.

3. The patient's temperature, pressure, pulse are checked, and the oral cavity is examined.

4. After the procedures, the surgeon prescribes an X-ray examination using one or more ways:

5. Ultrasound examination. Allows you to view the condition of the abdominal cavity in real time.

6. Collection of blood for tests. The patient is examined for general and biochemical indicators; venous blood is required for examination.

Can intestinal obstruction be treated without surgery?

About 35 – 40% of cases are cured with medication. After examining the patient, bowel cleansing is prescribed.

This can be done in several ways, depending on where the problem is:

• If the source of the congestion is in the upper part of the intestine, then tubes are installed through the nose to the gastrointestinal tract.
• If the outbreak is in the lower part (large intestine), then an enema is given, with the help of which the intestinal contents are emptied using warm water introduced by a special probe.

These manipulations primarily help relieve the load on the intestines and remove the cause of its poisoning from the body. Next, drug treatment is introduced.

When a patient sees a doctor, treatment decisions are made quickly. If the chosen plan does not bring results within a few hours, then surgery is prescribed.

Treatment of intestinal obstruction at home

Only cases of partial obstruction are treated at home.

The treatment process is divided into several stages:

Drugs

Drugs that help in the conservative treatment of intestinal obstruction:

1. Restoring the normal amount of fluid in the body:

• Methuselah.
• Quintasol.

2. Relieving spasms and cramping pain in the intestines:

3. To improve regional blood circulation:

• Rehydration.
• Reopoliglyukin.
• Pentoxifylline.

4. Replenishment of protein levels in the body:

• A mixture of amino acids.
• Albumen.
• Protein hydrolyzate.

5. Restoring intestinal motor function:

• Neostigmine.
• Distigmine bromide.
• Sorbitol.

6. Relieving intoxication of the body and reducing risk of developing purulent-septic complications:

• Hemodez.
• Mannitol.
• Disol.

Diet

After the operation, the patient is excluded from eating and drinking for 12 hours. Afterwards, using a dropper, a nutrient solution is administered for 1 to 2 days.

After this time, if the patient is still unable to eat on his own, then an umbrella is inserted through the mouth for nutrition.

After removal of the foreign tubes, you are allowed to eat only fermented milk products and baby food from jars. If you have an obstruction, you need to eat in small portions, but often. Depending on the condition, light, unsalted, liquid foods are gradually added to the diet.

If the transition proceeds without complications, then the patient is prescribed a diet close to No. 4. It is designed to prevent food accumulation in the intestines. You need to steam, boil or bake without oil.

The diet is allowed to include:

All foods that can lead to the formation of problems in a new way are excluded from the diet:

• Flour products.
• Fatty foods.
• Salting.
• Smoked products.
• Canned food (fish, meat and legumes).
• Raw vegetables.
• Heavy porridges (barley, barley, millet).
• Products with coarse fiber (cabbage, radishes).
• Drink: milk, coffee, sparkling water.

Intestinal obstruction (symptoms in adults and signs of its development are reduced if you follow the prescribed diet) can be cured. The diet is designed to reduce the load on the intestines, eliminate heavy foods and reduce the amount of their consumption.

Exercise

After the operation, physical exercises are introduced on day 2. To begin with, the set of exercises is designed for a lying position. When the patient sits down on his own, the exercises move to stage 2.

A set of exercises aimed at combating the appearance of intestinal obstruction and recovery of postoperative intervention:

1. Lying position.

2. Sitting position.

• Bend your arms at the elbows, press your hands to your shoulders. In this position, the elbows rise to the side; do the exercise 6–8 times.
• Place your hands on the bed and move your legs, imitating walking, duration 2 – 3 minutes.
• Without lifting your heels from the bed, pull your toes towards you, then lower them away from you. The exercise is done 10 times.

When the patient begins to get out of bed, the load is increased by walking. Initially, you can walk around the ward, then the corridor, then move on to walking along the street.

Folk remedies

The use of traditional methods should be discussed with your doctor.

The most popular remedies for intestinal obstruction:

How to treat intestinal obstruction at home

Since intestinal obstruction is one of the serious diseases, it cannot be treated at home. Any actions blur the picture and make it difficult to determine the correct diagnosis.

• Taking painkillers may make it difficult to pinpoint the source of pain.
• Take a laxative.

Inexperienced intervention may distort the exact causes of obstruction. If you suspect it, you must call an ambulance and go to the hospital for examination and determine a treatment regimen.

When is surgery necessary?

If the patient suffers from mechanical intestinal obstruction, then mandatory surgical intervention is required.

The main reasons for its appearance:

Surgical treatment of intestinal obstruction

The main objective of the operation is to eliminate the cause of obstruction, remove the main obstacle and reduce the risk of postoperative complications. The main actions of the surgeon begin with preparing him for the operation and undergoing the preoperative washing procedure.

1. The patient is given anesthesia with muscle relaxants.

2. An incision is made in the abdomen to provide full access to the intestinal area.

3. The entire intestine is examined, since in some cases the congestion occurs in more than one place.

4. If the operation is urgent and it was not possible to free the intestines in advance, this is done at the time of the operation using an incision in the intestine or through a feeding tube.

5. After freeing the intestine, the surgeon begins to eliminate the cause itself.

The procedure can be carried out in several ways, depending on the type of problem:

6. Checking the condition of the intestines. If the operation is performed correctly, the intestinal tissues are pink and all vessels allow blood to pass well. If any doubt arises, the error must be corrected immediately.

7. Colon lavage.

8. Final removal of purulent intestinal contents.

9. Stitching the incision.

Intestinal obstruction (symptoms in adults may reoccur after surgery) occurs with poor diet or an inactive lifestyle. To reduce the risk of recurrent obstruction, you must carefully follow your doctor's recommendations after surgery.

Postoperative period

Intestinal surgery is considered major, and the recovery process takes a long time. The patient is sent to the intensive care unit and is under constant monitoring.

A number of procedures must be carried out daily:

• The intestines are washed through the inserted probe, which remains after the operation. With its help, accumulated liquids and gases are removed. This reduces the risk of re-intoxication.
• Introducing fluids into the body to prevent dehydration.
• Feeding occurs through tubes.
• Droppers with antibacterial agents.
• Physiotherapy.
• Dressing the wound.
• Anesthesia.

If no complications arise, then after 4–5 days the patient is removed the tube and allowed to eat on his own. The diet includes only liquid food.

Complications

The outcome after surgery directly depends on the patient’s condition upon admission. If the patient is admitted in a serious condition with obvious intoxication of the body, the risk of death increases to 40%, this is due to extensive intoxication of all organs.

The remaining 60% are at high risk of developing postoperative complications, such as:

And also in rare cases, it is possible for all operated patients to develop such complications as:

• bleeding;
• spread of adhesive disease;
• the appearance of fistulas;
• seam tears.

Intestinal obstruction is a serious disease, its symptoms should not be ignored. In 60-65% of cases, drug treatment has to be abandoned and urgent surgery is prescribed. If the first signs of illness appear in a child or adult, you must immediately call an ambulance.

Article format: Mila Friedan

Video about intestinal obstruction

Elena Malysheva will talk about intestinal obstruction:

All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative in nature and are not applicable without consulting a doctor.

right/left hemicolectomy

For tumors of the small intestine – subtotal resection of the small intestine. If the tumor is located in the sigmoid colon, a Hartmann operation is possible. For rectal cancer, extirpation or amputation of the rectum is performed.

If it is impossible to remove the tumor, palliative operations are performed - an unnatural anus or a bypass anastomosis is created to restore patency.

Forecast

Mortality in acute intestinal obstruction remains quite high - on average about 10%. The prognosis depends on the timing of treatment. For those admitted to the hospital within the first 6 hours from the onset of the disease, the mortality rate is 3-5%. Of those who arrive later than 24 hours, 20-30% already die. Mortality is very high in elderly weakened patients.

Price

The operation to eliminate intestinal obstruction is an emergency. It is carried out free of charge at any nearest surgical hospital.

A paid operation is also possible, but you need to know clinics that specialize in providing emergency care. The price depends on the volume of intervention. The minimum cost of such operations is 50 thousand rubles. Then everything depends on the length of stay in the hospital.

The cost of laparoscopic surgery for adhesive intestinal obstruction is from 40 thousand rubles.

Video: intestinal obstruction in the program “Live Healthy!”

In surgery, there is the term “acute five,” which includes diseases that require rapid surgical intervention. This list also includes intestinal obstruction, a disease that can be caused by a variety of factors, which means that no one is immune from it. Therefore, it is important to know why such a pathology occurs, how to recognize it, and whether it is possible to use conservative therapy methods and avoid surgical intervention.

Intestinal obstruction - what is it?

The term “intestinal obstruction” refers to a condition in which the movement of intestinal contents slows down or stops altogether. A healthy intestine has peristalsis - contraction of the intestinal tube so that its contents move through and leave the body naturally.

The cause of intestinal obstruction is the lack of peristalsis, which is caused by various factors. It is important to understand that the condition of intestinal obstruction is very dangerous; if medical assistance is not provided to a person within 24-36 hours from the onset of symptoms, the pathology will lead to death.

Speaking about the reasons why intestinal motility is disrupted, we can highlight:

• formation of adhesions;
• tumors that compress areas of the intestinal tube, preventing its contents from passing through the narrow cavity;
• the presence of foreign objects in the digestive tract;
• volvulus.

Important! Most often, pathology occurs as a result of surgical interventions performed on the tissues of the digestive tract or organs of the female reproductive system.

Symptoms and signs of the disease

The most important sign of intestinal obstruction is the cessation of stool and gas production. At the same time, the patient’s abdomen swells, and bubbling may be heard.

The second symptom of the disease is pain. It can be periodic or constant, tolerable or strong, leading a person to a state of painful shock - it depends on the stage of the disease.

In most cases, the patient begins to vomit, especially if the small intestine is involved in the process. Sometimes in this way the body tries to get rid of toxins that enter the blood during stagnation of feces, but instead of toxins, the body leaves a large amount of liquid and the person begins to suffer from dehydration.

Even at the earliest stage, the patient experiences severe malaise, his face turns pale, he becomes lethargic and exhausted.

Forms and types of pathology

Intestinal obstruction is classified according to the reasons that caused its occurrence.

Mechanical intestinal obstruction- this is a condition when feces cannot move through the intestinal tube due to a certain obstacle, a kind of barrier.

The following may act as a barrier:

• fecal stones, which should not be confused with feces: coprolites are more compacted, they have a rounded shape;
• clumps of hair - paradoxically, this reason is often found among people if they suffer from a neurosis that forces them to literally bite their hair;
• gallstones that enter the intestines in the presence of cholelithiasis;
• foreign objects accidentally swallowed during meals;
• tumors of the intestinal walls or nearby organs that narrow the space of the intestinal tube cavity.

Strangulating intestinal obstruction– a pathology when, due to a number of reasons, the position of certain parts of the intestine changes in such a way that feces cannot pass freely through the digestive tract.

This happens when:

• volvulus;
• a knot formed during intestinal volvulus;
• strangulation of a section of the intestine;
• intestinal adhesions.

Mixed form– a subtype of intestinal obstruction, when several causes act as provoking factors.

Clinical picture

Most somatic pathologies develop slowly, each stage can flow into another for years, months, or less often - weeks. But intestinal obstruction develops rapidly, and its three periods total up to 36 hours.

1. The early period of obstruction of the digestive tract begins from the moment the first symptoms appear and lasts up to 12 hours. At this time, a person experiences paroxysmal pain: in the first hours it appears and then disappears, by the end of the early period it is constantly present, only its intensity changes.
2. The intermediate period of intestinal obstruction begins after the end of the early period and lasts another 12 hours, that is, at the end of the intermediate period, the day ends from the onset of the first symptoms.
   During these 12 hours, the pain in the abdomen is constant and unbearable, the abdomen swells, and vomiting appears. Due to pain, a person is exhausted and practically unable to move; due to vomiting, a person is dehydrated and may lose consciousness.
3. Late period - the time after the end of the intermediate period, the beginning of the second day after the first signals of the disease. At this time, the danger of death without promptly taken measures is at its maximum level: the patient breathes quickly, his body temperature rises, and there is a complete absence of urination. By this point, peritonitis and sepsis, as well as multiple organ failure, usually develop.

Thus, the patient’s main task is to assess the seriousness of the situation as early as possible and call an ambulance service, which will admit him to the hospital and perform surgery.

What danger does the disease pose?

The main danger of intestinal obstruction is the high risk of death.

Important! If a person is admitted to the hospital after a day from the onset of abdominal pain, even modern medical technologies and the professionalism of doctors cannot guarantee saving the patient’s life.

Considering the stages of the disease and its development, you can see the main complications that intestinal obstruction causes:

• intoxication – poisoning of the body with poisons, in this case, its own toxins;
• peritonitis - an inflammatory process localized in the abdominal region;
• sepsis - blood poisoning when pathogenic microbes enter it;
• dehydration of the body - disturbance of water and electrolyte balance, loss of fluid and salts necessary for life;
• multiple organ failure - cessation of functioning of two or more body systems.

All complications are life-threatening, so intestinal obstruction is dangerous at any stage.

Diagnostic methods

Once a patient enters a medical facility, doctors must quickly diagnose and confirm the disease. It is also important to detect the place, part of the intestine where the obstruction has occurred.

Laboratory diagnostic methods include blood sampling and testing:

• general (clinical) blood test - intestinal obstruction will be indicated by an increased level of hemoglobin and red blood cells, as a result of dehydration, and an increased level of leukocytes, as a signal of the presence of an inflammatory process.
• biochemical blood test - pathological confirmation will be a decreasing level of potassium and total protein and an increasing level of urea and creatinine from intoxication.

The main task of diagnosis lies on functional studies:

• An x-ray of the abdominal cavity allows you to see where the obstruction is localized; in the early stages, a contract x-ray method can be used, when a person drinks a liquid that passes through the digestive tract to the site of the barrier, and its path can be tracked on an x-ray - it will be noticeable due to its contrast;
• Ultrasound during diagnosis is used to exclude the possibility of tumors in the intestine that caused obstruction;
• Colonoscopy is a research method in which a probe is inserted into the intestines through the anus, and the image is taken from a camera. located at its tip, visualized on the device monitor;
• Laparoscopy is a method that combines both diagnosis and treatment: it involves surgical intervention performed through small incisions not exceeding one and a half centimeters.

Traditional treatment

The main method of treating intestinal obstruction is surgery and removal of the obstruction that interferes with the normal functioning of the organ.

In exceptional cases, if the pathology lasts less than 6 hours, you can try using traditional treatment methods, for example:

• pumping out contents from the stomach;
• siphon enemas;
• taking antispasmodics.

All three techniques are used simultaneously. If doctors do not see the effectiveness of reproducible actions, the patient is sent to the operating room.

Medical fact! There are cases when, during diagnostics - colonoscopy, doctors were able to “break through” a barrier in the intestines, thereby curing the patient and saving him from the need for surgical intervention.

Treatment with traditional medicine

Intestinal obstruction is that rare case when the use of traditional medicine is not only useless, but also dangerous. Every person who cares about their health should know the symptoms of intestinal obstruction and consult a doctor, bypassing any other methods of help.

It is also important to understand that any, even the most effective, folk recipes can be used only after consultation with your doctor.

Prevention

The best way to prevent intestinal obstruction is a proper, healthy, balanced diet. When a person gets the right amount of protein, fat, carbohydrates, fiber and fluid, his body functions correctly. The widespread use of medically questionable diets has increased the number of people hospitalized due to intestinal obstruction. For example, a popular way to lose weight by making fiber the basis of your diet may well cause a “congestion” in the intestinal tube.

Nutrition should not only be correct, but also moderate. You need to eat in small portions, but every 3-4 hours. There is a good way to check whether the portion size is normal: a side dish should fit in the palm of one hand, a light vegetable salad should fit in two palms joined together. The size of a piece of fish, meat or chicken should not be larger than a cigarette pack.

Moderate physical activity, especially walking, is very important for intestinal motility. By spending 20-30 minutes a day walking, you can reduce the risk of pathology several times.

Regular medical examination is necessary for every person interested in living long and being healthy. For example, if the cause of intestinal obstruction is a tumor, then it could well be detected until it began to cause physical discomfort.
For this purpose, in hospitals there is a medical examination - a step-by-step examination method, in which each person can undergo a minimum list of tests, and, if deviations from the norm are detected in the indicators, undergo additional examinations.

According to statistics, 9 out of 10 cases of intestinal obstruction could be prevented with proper nutrition, a healthy lifestyle and regular, at least once a year, visiting a doctor.