How to relieve intestinal obstruction

Written by Zhang Peng
General Surgery
Updated on September 17, 2024
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How to alleviate intestinal obstruction, which means how to treat intestinal obstruction. After the occurrence of intestinal obstruction, it is first important to clarify what intestinal obstruction is. Intestinal obstruction is characterized by cessation of gas and stool passage from the anus, and is usually accompanied by symptoms such as abdominal distension, nausea, vomiting, and even fever. If intestinal obstruction occurs, firstly, do not eat or drink, and then carry out appropriate examinations to identify the cause of the obstruction. If it is adhesive obstruction, treatment generally includes fasting, gastrointestinal decompression, anti-inflammatory treatment, fluid replenishment, and enemas as symptomatic treatment measures, trying to keep the treatment as conservative as possible. If the obstruction is caused by a tumor, it is preferable to perform surgery to remove the obstruction based on a clear diagnosis, as this is the only effective treatment.

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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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Principles of Intestinal Obstruction Treatment

In the treatment principles of intestinal obstruction, the basic treatment methods apply to both partial and complete intestinal obstructions. Firstly, gastrointestinal decompression is required based on the situation. Gastrointestinal decompression involves the insertion of a gastric tube, which is determined by whether the patient has symptoms of nausea and vomiting. If these symptoms are prominent, a gastric tube should be placed to drain the stomach contents, thus alleviating the burden and swelling of the intestines and aiding in the treatment of the disease. Another aspect is fluid replenishment and anti-inflammation, as intestinal obstruction will definitely lead to changes in intestinal flora and concurrent infections, making anti-infection measures very important. Fluid replenishment involves administering nutrient solutions to provide nutrition and prevent electrolyte imbalances. Additionally, enemas or traditional Chinese medicine may be used to facilitate intestinal motility. During this treatment process, it is crucial to closely monitor the condition to assess if exploratory surgery is indicated. As the condition can either improve or worsen, close observation is extremely important.

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General Surgery
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Causes of intestinal obstruction

Generally, the basic causes of intestinal obstruction can be divided into three categories. The most common is mechanical intestinal obstruction, which mainly includes blockage of the intestinal lumen, such as large fecal masses or corresponding foreign objects, and even parasites. The second type is compression of the intestinal tube, which can be caused by adhesions leading to torsion of the intestine or compression by tumors, and congenital inflammatory strictures and tumors can cause mechanical intestinal obstruction. The second major category is dynamic intestinal obstruction, which is primarily due to weakened peristaltic ability of the intestine, resulting in paralytic intestinal obstruction. This condition can be improved by adjusting intestinal function disorders or treating intestinal spasms. The third type is intestinal obstruction caused by vascular issues in the intestines, most commonly thrombosis of the mesentery or compression causing vascular disorders of the intestines.

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General Surgery
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Is intestinal obstruction dangerous?

Whether intestinal obstruction is dangerous depends on the actual individualized level. If the obstruction has progressed to symptoms of peritonitis, and if intestinal necrosis cannot be ruled out, not performing timely exploratory laparotomy surgery could potentially endanger the patient's life. However, if it is just a mild incomplete obstruction, with signs of passing gas and stools, and the patient’s abdominal symptoms are not pronounced, and related examinations are not concerning, then the risk to the patient might be relatively smaller. Therefore, in such cases, it is not possible to generalize, and decisions need to be made based on the individual situation.

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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.