What is intestinal obstruction?

Written by Li Jin Quan
General Surgery
Updated on September 27, 2024
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Intestinal obstruction refers to a blockage condition caused by various factors leading to intestinal obstruction, compression, and torsion, which prevents the normal passage of intestinal contents through the intestine. This is collectively referred to as intestinal obstruction. Intestinal obstruction can be divided into three categories based on the cause: first, mechanical intestinal obstruction; second, dynamic intestinal obstruction; and third, vascular intestinal obstruction. The main clinical symptoms of intestinal obstruction are abdominal pain, abdominal distension, vomiting, and cessation of gas and feces from the anus. Clinically, intestinal obstruction can be treated conservatively or surgically.

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Early symptoms of intestinal obstruction

What are the early symptoms of intestinal obstruction? For intestinal obstruction, the symptoms that appear in the early stages vary depending on the location of the obstruction. If it is a high-level obstruction, the main early symptoms are nausea and vomiting. If it is a low-level obstruction, abdominal distension is more prominent early on, and nausea and vomiting are less common. Additionally, the cause of the obstruction also leads to different symptoms. For instance, if the obstruction is simply due to adhesions in the abdominal cavity, the early symptoms may include poor appetite or nausea and vomiting. If it is caused by tumors in the digestive tract, early symptoms might include abdominal bloating, difficulty defecating, bloody stools, or changes in the characteristics of the stool, among others.

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Methods for examining intestinal obstruction

The simplest test for intestinal obstruction is an upright abdominal X-ray, which can diagnose intestinal obstruction if dilated bowel loops and fluid levels are seen. Diagnosis can also be based on the patient's history and physical signs, such as nausea, vomiting, cessation of passing gas or stool, etc. Currently, abdominal CT can also diagnose intestinal obstruction, with the simplest method being the upright abdominal X-ray. Different types of intestinal obstruction require different treatments. For obstructions caused by tumors or volvulus, prompt surgical treatment is necessary. For general intestinal obstructions, such as those caused by adhesions or intestinal dysmotility, the preferred treatment includes fasting, hydration, anti-inflammatory medications, and other supportive measures. For elderly patients with obstipation-induced obstruction, enema treatment can be initiated first.

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How long to fast for intestinal obstruction

Intestinal obstruction and the barrier to the passage of intestinal contents can lead to intestinal obstruction, typically characterized by abdominal pain, bloating, cessation of passing gas and stools, and in cases of high intestinal obstruction, it may also involve nausea and vomiting. How long fasting should be continued in the case of intestinal obstruction depends on whether the patient has resumed passing gas and stools, as well as whether symptoms such as abdominal pain, bloating, nausea, and vomiting have subsided. If the patient's abdominal pain and bloating have mostly subsided, passing gas and stools have resumed, and there is no bloody stool or symptoms of nausea and vomiting, then a gradual reintroduction of a liquid diet can be started. If abdominal pain and bloating do not worsen, and there is passing gas and stools, then a transition to a semi-liquid diet until a normal diet is resumed can be made. Therefore, the duration of fasting for intestinal obstruction should be determined based on the effectiveness of the treatment for the obstruction.

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How is intestinal obstruction treated?

Patients with intestinal obstruction primarily receive the following treatments: First, basic treatment, which includes gastrointestinal decompression, where patients need to refrain from eating and drinking, meaning they cannot consume food or water. Additionally, a gastric tube may be inserted. Second, frequent vomiting combined with the prohibition of food and drink can lead to disturbances in electrolyte and acid-base balance, so intravenous fluid supplementation is used to correct these imbalances. Third, appropriate antibiotics are used to prevent infection. Further, in cases of intestinal obstruction, abdominal distension can cause a sensation of bloating in the stomach, and somatostatin may be used to reduce the secretion of gastrointestinal fluids and alleviate abdominal distension. Alongside basic treatment, it’s essential to monitor the abdominal condition to see if it worsens, and surgical intervention should be considered when necessary.

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Causes of intestinal obstruction

The causes of intestinal obstruction include factors external to the intestine and those originating from the intestine itself. External factors are mainly adhesions and bands of adhesions that cause intussusception or volvulus, thereby leading to intestinal obstruction. Congenital adhesive bands are common in children. Adhesions resulting from abdominal surgery or intra-abdominal inflammatory lesions are the most common causes of adult intestinal obstruction, although a minority of patients may have no history of abdominal surgery or inflammation. Additionally, incarcerated external or internal hernias may also cause intestinal obstruction. Furthermore, tumors external to the intestine or abdominal compression can also lead to obstruction.