What is an intestinal obstruction?

In the case of intestinal obstruction (ileus), the food pulp is no longer transported through the intestine and accumulates. This creates an ideal breeding ground for bacteria. These release gases that inflate and stretch the intestines. This can cause cracks in the intestinal wall. If germs enter the abdomen, there is a risk of peritonitis. If the pathogens get into the blood, however, there is a risk of blood poisoning (sepsis) - this is a life-threatening condition.

In addition, with intestinal obstruction there is the risk that fluids and electrolytes no longer pass into the bloodstream, which creates a life-threatening deficiency. If a section of the intestine is no longer supplied with sufficient blood, the tissue ultimately dies. Thus, an intestinal obstruction can be life-threatening.

There are several causes of intestinal obstruction:

• Most often, the small intestine or large intestine is blocked by an obstacle (mechanical ileus). Depending on the affected section of the intestine, doctors speak of a small intestinal ileus or the large intestinal ileus.
• Another reason for intestinal obstruction is intestinal paralysis (paralytic ileus). The intestinal muscles no longer work and an intestinal arrest occurs. In around 80 percent of cases, the intestinal paralysis occurs in the small intestine.

Typical symptoms of an intestinal obstruction are abdominal pain , nausea, and vomiting of stomach contents. With colon ileus, some also vomit liquid stool.

The earlier a doctor diagnoses and treats the intestinal obstruction or paralysis, the more favorable the prognosis. If discovered in good time, conservative medication therapy often helps. However, sometimes surgery is unavoidable. Without treatment, an intestinal obstruction can be fatal - two to 20 percent of those affected do not survive it.

Intestinal obstruction: causes

A bowel obstruction can have various causes. Doctors differentiate between mechanical and functional ileus (paralytic or spastic ileus). Without treatment, a mechanical intestinal obstruction can develop into a functional intestinal obstruction.

A bowel obstruction in old people is more common than in younger people. That is because they are more likely to suffer from underlying diseases like diabetesSuffer from diabetes mellitus or adhesions in the abdomen. They also take pain medication more often. However, bowel obstruction symptoms in the elderly are no different from those experienced by younger people. 

Mechanical ileus

If an obstacle such as a scarring growth in the intestine after an operation, a fecal stone or a tumor interrupts the intestinal passage, doctors refer to this as mechanical ileus. In newborns, bowel malformation or the meconium can cause bowel obstruction. Meconium is the newborn's first tough stool. It consists of hair, skin and mucous membrane cells that the unborn child has swallowed in the uterus.

Functional ileus

There are two variants:

• Paralytic ileus : bowel function is interrupted due to intestinal paralysis. This type of bowel obstruction often occurs after surgery. Inflammation or poisoning can also be the cause.
• Spastic ileus : This type of intestinal obstruction is much less common. The spastic ileus is characterized by an intestinal cramp, for example due to a metabolic disorder or an infection with roundworms.

 

Intestinal obstruction: symptoms and signs

A bowel obstruction can manifest itself through various signs and symptoms. The signs depend on the cause: If an obstacle blocks the intestinal passage, severe abdominal pain suddenly occurs. With intestinal paralysis, the pain is less severe and occurs more slowly.

Ileus symptoms: How to recognize an intestinal obstruction

Signs that suggest a mechanical ileus include:

• severe, cramp-like pain in the abdomen, which alternately increases and decreases
• Constipation - the stool remains in the intestine, even the winds no longer go away
• Nausea and gushing vomiting with intestinal obstruction - there is a risk that the body will dry out
• The stomach puffs up
• Eructation
• If bacteria get into the bloodstream, there may be a fever , noticeable paleness, weakness and a high pulse (the heart beats faster).

Intestinal obstruction symptoms that speak for the paralytic form are:

• The pain is less severe , but persists. Usually they are diffuse and show up in different places in the abdomen. Affected people find it difficult to locate the pain.
• The abdomen swells up a lot, can be hard and extremely sensitive to pressure - for example as a result of peritonitis.
• Nausea : Those affected have to vomit the contents of their stomach and spit out greenish to yellow contents of the small intestine. In the case of colon occlusion at an advanced stage, those affected also vomit liquid stool (vomiting of excrement).

Depending on the location of the intestinal obstruction, the symptoms vary in severity. If it has formed in the small intestine, acute nausea with vomiting, cramps or a distended stomach are more typical.

Although pain is typical in this condition, there is also an intestinal obstruction without pain. A colon ileus initially only causes minor symptoms. Only after a while does alarming pain set in. Therefore, there is a risk that doctors will discover the colon obstruction late. 

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