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Bowel obstruction a very serious matter

Dr. Jim Surrell

All of us health care providers have encountered numerous patients with the serious medical condition known as a bowel obstruction.

First, let me give you the medical definition of a bowel obstruction. Bowel obstruction is a very serious medical condition when the food or drink we have consumed cannot pass through our digestive system.

Of course, our digestive system starts with swallowing our food or drink, and it goes from our esophagus at the beginning of our digestive system, into our stomach, and then passes through our small bowel (about 10 feet long inside our abdomen), then into our colon (about 4 to 6 feet long inside our abdomen), then into our rectum, as the last part of our digestive system. A blockage may occur in the esophagus or in the stomach, but today I will focus on obstruction in our small bowel (small intestine) or in our large bowel (colon and rectum), since these are our internal structures medically defined as bowels.

What causes a bowel obstruction? There are many causes, and the most common causes of bowel obstruction are abdominal adhesions (scar tissue, usually from previous abdominal or pelvic surgery), hernias in the abdomen, the pelvis, or in the groin, cancers, and various medicines that can cause severe constipation. By far, adhesions are the most common cause of small bowel obstruction.

The most common symptoms of bowel obstruction are as follows. Severe abdominal pain and cramping, nausea and vomiting, abdominal bloating with moderate to severe swelling of the abdomen, loud bowel sounds, inability to pass gas out of the rectum, and severe constipation. A bowel obstruction can be complete or partial. A complete bowel obstruction means that nothing can pass by the blockage. A partial bowel obstruction means that some fluids and perhaps some very small sized food substances may be able to pass by the site of the obstruction.

If a person has any suspicion that they are experiencing the symptoms of a bowel obstruction, they need to seek professional medical care without delay, usually by going to the nearest emergency department. As you might expect, a person with a bowel obstruction will become dehydrated very quickly.

This may also lead to electrolyte imbalances, and the inability to take and/or absorb their usual medications may lead to additional serious problems such as uncontrolled blood pressure, diabetes out of control, and others. If a person presents to their primary health care provider, and the provider suspects bowel obstruction, this person will likely be sent to the emergency department without delay.

A major part of making the diagnosis of a bowel obstruction will be based on the current symptoms, the patient’s medical and surgical history, the physical examination, along with various abdominal x-rays, and often a C.T. scan as well. Laboratory studies will also be done to check for electrolyte abnormalities anemia, infection, and other abnormal laboratory results.

When a partial bowel obstruction is diagnosed early in its course, this may be initially treated with non-surgical intervention with I.V. fluids, bowel rest, and very close professional observation. This may be done initially in an emergency department, but if it does not resolve in a reasonably short time frame, the patient will likely be admitted to the hospital for continued care and observation.

A complete bowel obstruction is a true medical emergency, and very often requires prompt surgical intervention. The x-rays and laboratory studies will help the surgical team prepare for the much needed surgery. These patients need to be rapidly rehydrated, laboratory abnormalities corrected as can be promptly done, and then taken to surgery to relieve the bowel obstruction. During the surgical procedure, the surgeon will determine the cause of the obstruction, and treat it accordingly.

Again, the most common cause will be from abdominal or pelvic adhesions, but the obstruction may also be from other abnormalities, such as an internal hernia, cancer, the small bowel twisting upon itself, and other causes. Bottom line… never ignore the symptoms of a bowel obstruction, and seek professional help without any delay. Yes, these are definitely “Doctor’s Orders”!

EDITOR’S NOTE: Dr. Jim Surrell is the author of “The ABC’s For Success In All We Do” and the “SOS (Stop Only Sugar) Diet” books. Requests for health topics for this column are encouraged. Contact Dr. Surrell by email at sosdietdoc@gmail.com.