Intestinal obstruction: Causes, Symptoms, Treatment and Cost

Intestinal obstruction is a serious intestinal condition in which the intestines are completely or partially blocked, preventing the contents of the intestines from passing through.

Intestinal obstruction can be classified into two main types – partial and complete.

• Partial Obstruction: Partial intestinal obstruction is caused by a blockage that is located in one specific part of the intestine, allowing partially digested food to pass around it. Symptoms of partial intestinal obstruction may include abdominal cramping, nausea and vomiting, constipation, bloating and abdominal distention, and lack of appetite.
• Complete Obstruction: Complete intestinal obstruction is caused by a blockage that prevents any food from passing through the intestines at all. Symptoms of complete intestinal obstruction may include intense abdominal cramping and pain that gets worse when moving or lying down; vomiting that does not improve over time; bloating; swollen abdomen; faintness; fatigue; dizziness; and loss of appetite.

• Intestinal obstruction can be caused by a variety of conditions, including hernias, tumours, Crohn's disease, bowel adhesions, and intestinal volvulus.
• Other causes include ingested foreign bodies, impacted faeces, narrowing of the intestines due to inflammation of the tissue walls, and strictures due to various other causes.

• Abdominal pain, cramps, and tenderness: Localised to the area of the blockage.
• Nausea and vomiting: Usually faecal in appearance if caused by a mechanical obstructive lesion.
• Bloating and distention of the abdomen: Due to build-up of intestinal gases or fluids behind the blockage.
• Changes in stool or inability to pass gas: Stools often appear darker with a foul smell due to bacteria accumulation if an obstruction is present.
• Inability to pass food/liquid: As peristalsis is blocked, nothing gets through the obstruction point in the intestine causing constipation or diarrhoea depending on severity of blockage.
• Constipation and decreased bowel movements: Due to decreased transit time of faecal matter through the intestines.

• Maintain a healthy lifestyle.
• Exercise regularly.
• Avoid smoking and/or drinking.
• Eat a balanced diet with high-fibre foods.
• Avoid constipation by increasing water and fibre intake.
• Prevent infectious diseases by proper vaccinations, hand washing and following proper hygiene.

• Physical exam:During physical exam, the doctor will perform an evaluation of the abdominal area, including palpating and listening to bowel sounds using a stethoscope.
• Abdominal imaging:Abdominal imaging is a form of diagnostic imaging that uses imaging such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) and fluoroscopy to visualise the organs and structures within the abdomen. It can assist in diagnosing conditions such as intestinal obstruction, which occurs when a part of the intestines becomes blocked.
• Endoscopy:Endoscopy involves inserting a flexible tube with a small camera and light at its tip into the stomach or intestine to view its interior. The scope can be used in conjunction with specialised instruments to help diagnose, monitor, or perform treatments for various conditions such as intestinal obstruction.
• Barium enema:A barium enema is a test often used for diagnosing intestinal obstructions. This test involves taking x-ray images after a patient ingests a solution containing barium sulphate, which coats their insides and makes it easier to spot abnormalities on scans.
• CBC:CBC can reveal anaemia or low red blood cell count consistent with intestinal obstruction.
• Liver function tests:Liver function tests may show signs that your body is having difficulty processing what it's ingested due to the blockage.

• Fluid and electrolyte imbalance:Imbalances can occur due to inadequate fluid intake or excessive loss of ions from the gastrointestinal tract.
• Uremia:Uremia results when toxic waste products, which are normally removed by your kidneys, are trapped in your body if urine output is decreased or isn’t present.
• Peritonitis:Bacterial infection of the lining of the abdominal cavity (peritoneum).
• Bowel necrosis:Death of a part of the wall of the intestine due to lack of oxygen supply, leading to gangrenous changes in the affected area.
• Respiratory compromise:bowel distension causing decreased lung capacity and possible pneumonia or atelectasis (collapsed lung).
• Skin breakdown:Because some individuals may be subject to prolonged bed rest due to their condition, pressure sores may form where skin comes into contact with beds and other surfaces for extended periods.

• Take one teaspoon of Triphala (Haritaki, Bibhitaki and Amla) mixed with honey twice daily for quick relief from constipation caused by Intestinal Obstruction.
• Prepare a decoction of Castor oil (Arandi) mixed with dry ginger powder and drink this decoction regularly to cure Intestinal Obstruction.
• Boil 5-10 Grams of jeera (cumin seeds) in 250 ml water until the quantity reduces to half and drink it 2-3 times daily for adequate relief.
• Soak 4-5 tulsi leaves in boiling water, strain it and consume the decoction on an empty stomach every morning to get rid of constipation caused by Intestinal Obstruction.
• Drink Barley water prepared by boiling 5 Grams Barley in 500 ml water every day or include sprouted green gram in your diet every day as both these methods have proven to be beneficial for curing constipation associated with Intestinal Obstruction naturally at home itself.

• Clear liquids only: Drink plenty of clear fluids such as water, apple juice, chicken broth or weak tea. Avoid anything that is red or purple in colour.
• Bland diet: When you are able to tolerate clear liquids and your bowel movements return to normal, transition to a bland diet of cooked cereals, plain toast, mashed potatoes, saltines and other soft items.
• Low-residue diet: Once your doctor approves, move on to a low-residue diet which consists of foods that are low in fibre and residue like boiled vegetables without skins or seeds; white breads; tender lean meats; eggs; poultry; strained soup broths; and ice cream and custards without nuts or fruits added.

• High-fibre foods:Foods that are high in fibre, such as raw fruits and vegetables, whole grains, legumes, and nuts, should be avoided as they can cause further blockage in the intestines.
• Greasy or Fried Foods:These types of foods can make the symptoms of obstruction worse due to their fatty nature.
• Dairy Products:Dairy products like milk and cheese should be avoided as they can cause uncomfortable symptoms such as diarrhoea and bloating due to lactose intolerance.
• Spicy Foods:Spicy foods should also be avoided as they can irritate the digestive tract and worsen abdominal pain caused by obstruction.
• Caffeinated Beverages:Caffeinated beverages such as coffee, tea, sodas, and energy drinks should be avoided due to their diuretic effects which can lead to dehydration and electrolyte imbalances.

• Medications:Intestinal obstruction can be treated with medications such as prokinetics, antibiotics, etc.
• Lifestyle changes:Lifestyle changes are essential for people with intestinal obstruction. These include eating smaller meals more often and avoiding certain foods that can be hard to digest or cause discomfort. Additionally, physical activity should be increased gradually to improve overall fitness and wellbeing.
• Manual extraction of the obstructing lesion:This procedure involves using instruments to remove the object or tissue causing the blockage.
• Surgical Dissection:In this procedure, a surgeon creates an incision and manually separates the obstructed organ from surrounding tissues and structures.
• Laparoscopy:During this minimally invasive procedure, several small incisions are made and a laparoscope is inserted into one of them to guide the dissection process.
• Enterostomy:This is a procedure that involves creating an opening in the skin to surgically insert a tube, typically to divert material away from the blocked area in order to relieve pressure and reduce risk of further adhesions or scarring.

A person experiencing intestinal obstruction should consult a gastroenterologist or a general surgeon for treatment.

A gastroenterologist specialises in treating diseases of the digestive system, including intestine and abdominal problems, while a general surgeon has advanced knowledge of the abdomen, intestines and related organs.

Before consultation with either specialist, it can be helpful to seek treatment from a primary care physician. The primary care physician may decide to refer the patient to a specialist based on the symptoms experienced and medical tests results.

• Antibiotics:These drugs are used to treat infection and reduce inflammation in the intestines, such as ciprofloxacin, metronidazole, and amoxicillin.
• Laxatives:These medications are used to soften stool and promote faecal evacuation, such as senna and lactulose.
• Opioids:These drugs are prescribed to relieve severe pain associated with intestinal obstruction, such as codeine and morphine.
• Antiemetics:These medications help control nausea or vomiting due to intestinal obstruction, such as prochlorperazine and ondansetron.
• Prokinetic Agents:These drugs work to help accelerate digestive motility so that food can pass through the intestine more easily, such as domperidone and metoclopramide.
• Enemas/Glycerin Suppositories:Enemas can be used for manual evacuation of stool when fluid comes out around it or if a partial obstruction is present; the same is true for glycerin suppositories which soften up stool so that it passes more easily through an area of narrowing in your intestines.

Generally, patients can expect to take at least several days of rest in combination with medications to help alleviate symptoms and promote healing. After this period of rest, it may take weeks or even months to fully recover from an intestinal obstruction depending on the extent of the damage and how well treatment has been managed.

No, the results of treatment for intestinal obstruction are not permanent. Treatments for intestinal obstruction, such as surgical intervention, can provide relief and help restore normal functioning of the intestine. However, intestinal obstruction can recur if the underlying cause is not addressed.

• Patients should avoid eating solid foods or drinking carbonated beverages for 24 hours after the operation.
• If the patient is able to pass gas and their abdominal pain has decreased, they can start a clear liquid diet slowly with small amounts of liquids at a time.
• As their stools become less frequent, a regular diet can be reintroduced over a period of 1–2 weeks.
• Over-the-counter medications like antacids, fibre supplements and probiotics may be taken as recommended by the doctor but care should be taken to not take any medications that could worsen the obstruction or further irritate the stomach lining.
• The patient should also keep activity levels low to prevent straining or hurting their abdominal muscles and should report back to their doctor if there is any worsening of symptoms such as nausea, vomiting or abdominal pain, unusual stool characteristics (such as blood in its content) or signs of infection (such as fever).

The cost of Intestinal Obstruction treatments in India depends on a variety of factors including the severity of the condition, the hospital chosen for treatment, and the type of treatment required.

Generally, costs can range from ₹20,000- 4 lakhs ($275- 5550 USD) depending on these factors. This cost typically covers hospitalisation charges, medications or surgeries needed to address the obstruction.

• Nausea and vomiting
• Abdominal pain
• Diarrhoea
• Bloating
• Swelling in the abdomen.
• Constipation
• Loss of appetite
• Changes in heart rate and blood pressure.

If you are suffering from any complications relating to intestinal obstruction then you should consult a doctor nearby as they can cause complications like 'fluid and electrolyte imbalance, uremia, peritonitis' in which treatment courses can range from a few months to years depending on the severity of the situation.