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Intestinal obstruction
How to deal with intestinal obstruction?
Patients with intestinal obstruction commonly present with abdominal pain, bloating, vomiting, and cessation of passing gas or stool. Treatment for intestinal obstruction primarily includes conservative management and surgical intervention. Conservative treatment firstly involves gastrointestinal decompression, abstaining from food and drink, and, if necessary, the insertion of a gastric tube. The second step is to enhance anti-inflammatory measures to prevent infections within the abdominal cavity. The third step is proactive fluid replenishment to prevent disorders of water and electrolyte balance. Along with aggressive conservative treatment, the patient's overall condition should be monitored. If a pseudo-obstruction occurs, surgical treatment should be actively pursued.
Enema method for intestinal obstruction
Enemas are an effective treatment measure in the management of intestinal obstruction. An enema involves a nurse using an enema bag to introduce about 500 milliliters of soapy water through a rounded-tip catheter into the rectum via the anus. Typically, the catheter is inserted about 30 centimeters deep. The purpose of injecting soapy water into the rectum is to stimulate intestinal peristalsis, leading to the expulsion of intestinal contents. During this process, it is important to avoid damage to the intestinal mucosa and consider the patient's tolerance. Generally, it is preferable to retain the soapy water for an extended period for better results.
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.
Is intestinal obstruction serious?
When the contents of the intestine cannot be normally expelled through the intestinal tract, it is called intestinal obstruction. Its clinical manifestations mainly include abdominal pain, bloating, vomiting, cessation of defecation and flatulence from the anus. The treatment of intestinal obstruction mainly includes conservative treatment and surgical treatment, with the vast majority of patients receiving conservative treatment. This includes gastrointestinal decompression, abstinence from drinking and eating, enhanced anti-inflammatory therapy, and maintenance of electrolyte balance. Only a small portion of patients require surgical treatment. After treatment, the vast majority of patients with intestinal obstruction can recover normally, which means that intestinal obstruction is not a very serious illness.
Symptoms of intestinal obstruction
Intestinal obstruction is caused by any factor that causes blockage of the intestinal tube. Compression and twisting cause the intestinal contents to not pass normally, leading to obstructive symptoms. Clinically, intestinal obstruction mainly presents with four major symptoms: first, intermittent abdominal pain; second, vomiting, where the higher the location of the obstruction, the earlier and more frequent the vomiting, consisting mainly of food or gastric fluid. If the location of the obstruction is lower, the vomiting is delayed and less frequent and may include fecal matter; third, abdominal distension, which generally occurs after the obstruction has been present for some time, and its severity is related to the location of the obstruction; fourth, cessation of gas and feces discharge through the anus.
Does intestinal obstruction cause fever?
It is possible, as the primary pathophysiological change in intestinal obstruction is the translocation of intestinal flora causing infection, which can lead to symptoms such as fever. Therefore, fever is also a factor in assessing the condition. If a patient has persistent high fever, they may even develop septic shock, which could necessitate surgical intervention such as exploratory laparotomy. Thus, fever is a common factor in intestinal obstruction, but it is not a mandatory one.
How is intestinal obstruction diagnosed?
The main clinical manifestations of intestinal obstruction include abdominal pain, abdominal distension, vomiting, and cessation of gas and bowel movements from the anus. During the physical examination, tenderness in the abdomen can be observed, as well as hyperactive bowel sounds. Laboratory tests may reveal increased red and white blood cell counts, and electrolyte imbalances. Supplementary examinations, such as abdominal X-ray films, can show dilation of the intestinal tube, air and fluid accumulation within the abdominal cavity, and the presence of fluid-air levels. Abdominal ultrasound can also reveal air and fluid accumulation in the intestinal tube. Through the above examinations, intestinal obstruction can be diagnosed.
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.
How is intestinal obstruction treated?
The treatment methods for intestinal obstruction can be divided into non-surgical and surgical treatments in clinical practice. In our clinic, most cases of intestinal obstruction, such as adhesive obstruction or parasitic obstruction, can be alleviated through gastrointestinal decompression, enemas, and rapid expulsion of gas and stools, achieving the therapeutic goal. However, a small portion of intestinal obstructions do not respond to non-surgical treatments, and vital signs cannot be maintained; such cases require active surgical intervention.