1. A Medical Emergency
Bowel obstruction is the cessation of movement of food through a person's small or large bowel. It is an absolute medical emergency that sometimes requires surgery. Because it can occur in both large and small bowel, it is divided into the two categories of small bowel obstruction and large bowl obstruction. The large bowel is made up of the colon. The small bowel is comprised of the duodenum, next to the stomach, the jejunum,the middle portion, and the ileum, the part that connects with the colon. Small bowel obstruction is more common than large bowel obstruction.
2. Mechanical or Functional
Obstruction can be mechanical or functional. Mechanical causes occur because of masses that block the bowel, areas where the bowel twists on itself, areas of bowel that have scar around them from infection or prior surgery or some congenital abnormality. Functional obstruction is caused by factors that stop the bowel from working. Functional obstruction is usually not as serious or complete as mechanical obstruction. Causes of functional obstruction include electrolyte abnormalities, medications such as narcotics and muscle relaxants and illnesses like kidney stones or blood clots to the blood supply of the bowel.
3. Obstruction Can be Complete or Partial
Obstruction is not always complete. Both large and small bowel obstruction can be complete or partial. Often, a patient can move between complete and partial obstruction as they improve or worsen. Partial bowel obstruction can sometimes be treated medically, without doing surgery. Most of the time, complete obstruction requires surgery.
4. Signs and Symptoms
The signs and symptoms of bowel obstruction are highlighted by pain, sometimes described as "the worst pain imaginable." In addition, bloating, distension, an absence of bowel sounds and absence of flatus, vomiting and nausea are common with bowel obstruction. If left untreated, complete obstruction will often lead to the death of the bowel. This can cause shock, characterized by a drop in blood pressure, loss of consciousness and death.
5. Resolving the Problem
The best way to improve bowel obstruction is to correct the condition that caused it. Obviously, the first thing done is stopping any input into the patient's system. A person with suspected bowel obstruction is placed "NPO," meaning non per os (nothing by mouth) and hydrated with intravenous fluids in an attempt to rest and decompress the bowel. In the case of partial bowel obstruction, e.g. a mechanical obstruction from an incomplete twisting of small bowel, this improves the condition to a degree where the obstruction resolves. Otherwise, direct intervention with surgery is pursued.
