What is it about ?
The human intestine is constantly functioning; the muscles of the intestinal wall constantly contract (peristalsis) to move the contents of the intestine forward during the digestion process.
In the case of a bowel obstruction, a mechanical cause prevents the passage of stool through the intestine. The cause may be
- A hard stool block;
- A scar in the intestine resulting from an operation on the stomach or an inflammatory disease of the digestive tract (for example Crohn’s disease);
- A tumor of the digestive tract (eg colorectal cancer);
- The passage of part of the intestine through the wall of the stomach (hernia);
- Diverticulitis;
- The fact that part of the intestine slides inside itself (intussusception);
- The fact that the intestine turns on itself (volvulus).
In some cases, such as in volvulus, the passage of stool is blocked but also the blood flow to this part of the digestive tract.
In the case of a intestinal paralysis (paralytic ileus), the muscles of the intestinal wall are paralyzed. They are therefore no longer able to move the contents of the intestine forward. Usually, this problem is due to a serious infection, neurological condition, or serious trauma (accident or major surgery on the stomach). Certain medications and persistent constipation can also trigger paralytic ileus.
A pseudo-occlusion means that all symptoms are of an obstruction, while there is no obstacle in the gut. This phenomenon is observed in certain diseases affecting the general condition, after certain surgical procedures and after the (excessive) use of drugs which have an influence on peristalsis.
How to recognize them?
A bowel obstruction is characterized by attacks of painful cramps and numerous bowel sounds. After a while, vomiting appears. The closer the occlusion is to the mouth, the faster the vomiting occurs. The further it is from the mouth, the later they intervene. If the occlusion is in the colon, the belly is swollen.
If the blood flow is also hampered, the person experiences constant pain and their general condition quickly deteriorates.
In the case of a paralytic ileus, the intestine is at a standstill and intestinal noise is completely absent. The pains are weak or even nonexistent. On the other hand, the belly is swollen.
In the pseudo-occlusion, the intestines are also at a standstill. And the belly is swollen.
Sometimes there are signs of infection (fever).
How is the diagnosis made?
The doctor will suspect the diagnosis after a belly exam. Sometimes he will do a blood test to check for signs of infection. He may order an x-ray and / or CT scan of the belly.
What can you do ?
Watch out for the following symptoms:
- Prolonged constipation, followed by vomiting; the vomit sometimes looks like coffee grounds with pieces in it;
- Bloated stomach ;
- Lack of intestinal activity (bowel sounds).
If you have these symptoms, contact a doctor immediately. It is best not to eat or drink anything anymore, as an operation may be necessary.
What can your doctor do?
If he suspects a (pseudo-) obstruction or intestinal paralysis (paralytic ileus), the doctor will refer you systematically to the hospital, usually to the surgical department. First, you will receive an infusion of saline solution to restore the water balance. Treatment consists of medication or surgery, depending on the diagnosis and the cause. If an infection is responsible for the problem, it can be treated with antibiotics.
Want to know more?
- The radiography, here, Where to find on this page of Cliniques St Luc UCL
- Scanner (CT-scan) – Erasme Hospital
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