GRACIOUS COLLEGE OF NURSING
ABHANPUR RAIPUR
SUBJECT:- MEDICAL SURGICAL NURSING
SEMINAR
ON
INTESTINAL OBSTRUCTION
SUBMITTED TO SUBMITTED BY
MR.OMPRAKASH VERMA MS.ANKITA MARSHLEEN PAUL
ASSOCIATE PROFESSOR M.Sc. NURSING 1 st YEAR
DEPT. OF MEDICAL-SURGICAL NURSING GRACIOUS COLLEGE OF NURSING
GRACIOUS COLLEGE OF NURSING
INTRODUCTION
Intestinal obstruction is a blockage that keeps food or liquid from passing through your small
intestine or large intestine (colon). Causes of intestinal obstruction may include fibrous bands of
tissue (adhesions) in the abdomen that form after surgery; hernias; colon cancer; certain
medications; or strictures from an inflamed intestine caused by certain conditions, such as
Crohn's disease or diverticulitis..
DEFINITION
Intestinal obstruction can cut off the blood supply to part of your intestine. Lack of blood
causes the intestinal wall to die. Tissue death can result in a tear (perforation) in the
intestinal wall, which can lead to infection. Infection. Peritonitis is the medical term for
infection in the abdominal cavity.
ETIOLOGY
Infection
Certain medications that affect muscles and nerves, including
antidepressants and opioids
Muscle and nerve disorders, such as Parkinson's disease
Intestinal adhesions — bands of fibrous tissue in the abdominal cavity that
can form after abdominal or pelvic surgery
Hernias — portions of intestine that protrude into another part of your body
Colon cancer
In children, the most common cause of intestinal obstruction is telescoping
of the intestine (intussusception).
Intussusception
Intussusception is a rare, serious disorder in which one part of the intestine slides inside
an adjacent part.
Other possible causes of intestinal obstruction include:
Inflammatory bowel diseases, such as Crohn's disease
Diverticulitis — a condition in which small, bulging pouches (diverticula) in
the digestive tract become inflamed or infected
Twisting of the colon (volvulus)
Impacted feces
Pseudo-obstruction
Symptoms
Signs and symptoms of intestinal obstruction include:
Crampy abdominal pain that comes and goes
Loss of appetite
Constipation
Vomiting
Inability to have a bowel movement or pass gas
Swelling of the abdomen
Types of bowel obstructions
Bowel obstructions can vary depending on the severity of the blockage.
Complete obstructions
Severe bowel obstruction can entirely block part of the intestine. This may stop all
solids, liquids, and gases from passing through the digestive system.
Someone with a complete obstruction will find passing a stool or gas difficult, if not
impossible.
Partial obstructions
A partial bowel obstruction is typically less severe. These obstructions block some, but
not all, of the intestine. This will slow the progress of solids, liquids, and gases through
the digestive system but will not stop them entirely.
A partial bowel obstruction may cause discomfort, bloating, and diarrhea.
Pseudo-obstruction
Intestinal pseudo-obstruction is a rare conditionTrusted Source that causes the
symptoms of bowel obstruction without the presence of a blockage.
It occurs when muscle or nerve issues prevent the normal movement of food, liquids,
and gas through the intestines.
Causes
There are many possible causes of bowel obstruction. They are either mechanical or
nonmechanical.
Mechanical obstructions
Mechanical obstructions are physical barriers that prevent or restrict the flow of matter
through the bowels. These include:
adhesionsTrusted Source, or scar tissue from surgery
foreign objects
gallstones, although this is a rarer causeTrusted Source of obstruction
hernias
infection
inflammatory bowel disease (IBD)
intussusception, which is when a segment of the bowel pushes into the next
segment, making it collapse
tumors
a twisted bowel
Nonmechanical obstructions
The large and small bowels move in coordinated contractions. If something interrupts
this process, a nonmechanical obstruction can occur.
If a doctor can detect and treat the cause, bowel obstruction is usually a short-term
issue.
Some people refer to nonmechanical obstructionsTrusted Source as adynamic or
paralytic ileus.
Causes of nonmechanical bowel obstructions include:
scarring from abdominal or pelvic surgery
diabetes
electrolyte imbalances
hypothyroidism
Hirschsprung’s disease, a condition where nerve cells are missing from the end
of the bowel
nerve and muscle disordersTrusted Source, such as Parkinson’s disease
severe infection or illness
general anesthesia
certain pain relief medications
Diagnosis
Diagnosis tends to begin with a physical examination. An obstruction can cause a hard
lump in the abdomen, which a doctor may be able to feel. During their initial
examination, the doctor will also assess a person’s medical history.
A doctor can use a stethoscope to check a person’s bowel activity. A lack of regular
bowel sounds or unusually quiet sounds can suggest a bowel obstruction.
Depending on individual cases, a doctor may recommend further tests. These can
include:
blood tests to check levels of electrolytes, liver and kidney function, and blood
counts
endoscopy, in which a doctor uses a special camera to look inside the gut
CT scans
X-rays
contrast enemas
Differential diagnosis
Some conditions may cause similar symptoms to a bowel obstruction.
These includeTrusted Source:
appendicitis
abdominal hernias
diverticulitis
colonic polyps
During their assessment, doctors will seek to eliminate all these potential causes before
diagnosing bowel obstruction.
MANAGEMENT
Treatment for bowel obstruction depends on the cause and how severe the blockage is.
A total mechanical obstruction usually requires surgery. Most cases of bowel
obstruction need some form of medical intervention.
Treatment options for bowel obstruction can include:
Medication: Opioids can lead to constipation. If this occurs, laxatives and stool
softeners can help.
Observation: Doctors will typically observe a person with partial or complete
obstructions before considering further options, such as surgery. During this time,
the individual should limit their food and drink intake to stop further buildup.
Doctors can provide fluid intravenously, meaning directly into the vein, to keep
the person hydrated.
Nasogastric tube: This is a narrow tube that goes up the nose and into the
stomach. It removes fluid and gas trapped in the stomach, relieving pressure.
This eases pain and vomiting.
Surgery: Surgeons can remove blocked or damaged sections of the bowel. In
cases of IBDs, a strictureplasty may be necessary. Here, a surgeon will widen
the narrowed section of the bowel by cutting and sewing.
Therapeutic enema: A nurse or doctor will push a medication or tap water into
the bowel to try to relieve stool impaction, which can happen in severe
constipation.
Medication may help ease discomfort due to a bowel obstruction. This can include:
antinausea medicines to prevent vomiting
pain relief medication
antibiotics to fight bacterial infection
Complications
A bowel obstruction can lead to other issues, such as:
dehydration
tissue death in the bowels
abscess within the abdomen
kidney failure
intestinal tears
pulmonary aspiration
sepsis
People who have had surgery for obstructions are also at risk of other complications,
including:
abdominal adhesions
bowel paralysisTrusted Source
nerve damage
short bowel syndrome
wound reopening
At worst, it can lead to multiple organ failure and death. That is why it is important to
treat bowel obstructions as soon as possible.
Prevention
Healthy lifestyle choices are a great way to lower the risk of bowel obstruction. Even low
levels of exercise will help keep the bowels healthy.
Dietary and lifestyle changes
Simple changes to a person’s diet and lifestyle can help them digest food more easily
and lower the impact of bowel obstructions.
Dietary changes that may help a person who has bowel obstructions include:
eating smaller portions more often
avoiding large amounts of high fiber foods, such as whole grain cereals and nuts
focusing on eating soft or liquid meals
limiting the intake of caffeine, which can irritate the bowels
avoiding tough or stringy foods, such as celery or dried meat
Exercising regularly and staying hydrated can also aid regular digestive function.
Summary
A bowel obstruction occurs when something blocks part of the small or the large
intestine. It is vital to take this condition seriously and seek immediate medical attention.
Tumors, scar tissue from surgery, and abnormalities in a person’s intestinal
development can all cause bowel obstructions.
Bowel obstructions can lead to severe complications. In extreme cases, they can cause
intestinal ruptures and be deadly if a person does not receive timely treatment.
Individuals can lower their risk of developing an obstruction by eating well, keeping
active, and staying hydrated.
The outlook for a bowel obstruction depends on its cause. In most cases, bowel
obstruction is treatable.
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