Bowel obstruction

Diagnosis

The following examinations and techniques are used to identify intestinal obstruction:

• Physical exam. Your medical history and current symptoms will be discussed with your doctor. To evaluate your case, the doctor will perform a physical examination. If your belly is large, tender, or if a lump is present, the doctor may suspect intestinal obstruction and use a stethoscope to listen for bowel noises.
• X-ray. Your doctor might suggest an abdominal X-ray to confirm the diagnosis of intestinal obstruction. Nevertheless, certain intestinal blockages are invisible to normal X-rays.
• Computerized Tomography (CT).  A CT scan creates cross-sectional images by combining a number of X-ray images obtained at various angles. These images are more accurate and more likely to reveal an intestinal obstruction than a typical X-ray.
• Ultrasound.  In cases of intestinal obstruction in children, ultrasonography is frequently the chosen imaging modality. An ultrasound generally reveals a “bull’s-eye,” or the intestine coiling inside the gut, in children with an intussusception.
• Air or barium enema. An air or barium enema enables improved colon imaging. For some alleged blockage causes, this may be done. During the operation, the doctor will use the rectum to introduce air or liquid barium into the colon. An air or barium enema can usually solve the issue with intussusception in children, and no additional treatment is required.

Treatment

Depending on the underlying cause of your problem, treatment for intestinal obstruction usually requires hospitalization.

Hospitalization

As soon as you get to the hospital, the medical staff stabilizes you so that you can start receiving treatment. This procedure might involve:

• Inserting an intravenous (IV) line into your arm’s vein so that fluids can be administered.
• Insertion of a nasogastric tube via the nose into the stomach to remove air and fluid and reduce abdominal edema.
• Inserting a small, flexible tube (catheter) into your bladder in order to empty urine and collect it for testing.

Intussusception treatment

For kids with intussusception, a barium or air enema is utilized as a diagnostic procedure as well as a form of treatment. In most cases, additional therapy is not required if an enema is effective.

Partial obstruction treatment

After you’ve been stabilized, you might not require any treatment if you have a partial obstruction, which allows some food and liquid to pass through. A special low-fiber diet that is simpler for your partially obstructed bowel to process may be suggested by your doctor. The impediment may need to be removed surgically if it does not go away on its own.

Complete obstruction treatment

If nothing can flow through your gut, surgery is typically required to remove the obstruction. The cause of the obstruction and the damaged area of your intestine will determine the procedure you have. Surgery often entails the removal of the obstruction as well as any dead or damaged intestinal tissue.
As an alternative, your doctor can advise using a self-expanding metal stent to clear the clog. An endoscope is put into your intestine through your mouth or colon before the wire mesh tube is placed inside of you. In order for the obstruction to be cleared, it forces the intestines to open.
Stents are typically used to treat colon cancer or to temporarily relieve symptoms in patients for whom immediate surgery would be too dangerous. Once your health is stable, you might still require surgery.

Pseudo-obstruction treatment

If your doctor determines that the signs and symptoms you are experiencing are due to pseudo-obstruction (paralytic ileus), they may decide to keep you in the hospital for a day or two while they monitor your condition and, if necessary, administer treatment. Ileus with paralysis can recover on its own. To prevent malnutrition in the interim, food will probably be administered to you via an IV or nasogastric tube.
If your paralytic ileus doesn’t get better on its own, your doctor can recommend a drug that makes your muscles contract, which can assist move food and liquids through your intestines. The doctor will treat the underlying condition or cease the drug if paralytic ileus is brought on by a disease or medicine. Surgery is a rare necessity.
An approach known as decompression may be helpful when the colon is enlarged. Colonoscopy, a process in which a tiny tube is introduced into the anus and guided into the colon, this can be used to help in decompression. Surgical decompression is another option.