Bowel obstruction is a rare but very dangerous pathology
Bowel obstruction refers to quite serious conditions: usually acute obstruction requires the need for the earliest possible surgical intervention. Acute intestinal obstruction generally refers to the most severe cases of GIT organs - this is due to a high percentage of postoperative mortality (up to 20%). But among the total number of surgical diseases, the obstruction is only 2-3% (according to statistics, 1.6 cases per 10 000 population).
What is an intestinal obstruction
In general, the obstruction of the intestine is a pathology in which the normal movement of the contents of the intestines (half-digested food masses) is somehow broken (completely or only partially). This can be due to mechanical or functional reasons, depending on this, distinguish between dynamic and mechanical obstruction (and, based on the course of the disease, diagnose its acute or chronic form). The types of disease are still divided into subspecies: thus, the dynamic is subdivided into a paralytic (when the walls of the intestine relax and the peristalsis stops) and the spastic (when the peristalsis, on the contrary, is excessively increased, provoking a spasm of the intestine). Mechanical type of obstruction is further subdivided into obturation (when the walls of the intestine are simply squeezed) and strangulation (when, in addition to squeezing the walls of the intestine, the nutrition of its vessels is also disturbed).
Causes and Symptoms
The causes of dynamic obstruction are usually attributed to unsuccessful consequences of surgical interventions and acute conditions in the digestive tract (such as peritonitis, acute appendicitis, inflammation in gynecology, pancreatitis, etc.). Mechanical obstruction in adults often causes tumors, foreign bodies in the gut, gallstones (if they lead to pressure ulcers in the walls of the gut), tangles of parasites (ascaris), adhesions (they are attributed to the most common causes of the disease).
Symptoms of intestinal obstruction primarily include a sudden sharp pain - as a rule, the pain is cramped in character, each fight lasts about ten minutes. With a strangulation variety of obstruction (or with exhaustion of the muscles of the intestine) the pain can be constant and not pass. In most cases, the pain syndrome disappears in two or three days, but this is not a sign that the disease is gone - on the contrary, it signals that the motor function of the intestine is completely out of order.
Signs of intestinal obstruction
Doctors say that the faster the person is taken to the hospital if there is a suspicion of an intestinal obstruction, the more he has the chances of an amendment (sometimes even everything can be solved with conservative methods, without surgery). Other obvious signs of intestinal obstruction include the impossibility of gas and feces leaving it (in rare cases, with partial obstruction or obstruction localized in the upper part of the intestine, there may be a slight separation of gases, along with a meager stool). Also, bloating and visible "skewness" of the abdomen are observed, often there is multiple vomiting (if the congestion is high - this symptom is manifested more quickly).
In addition to the described features, more specific ones can also be observed, which can be identified only by a specialist, that is, once again it is important to emphasize the importance of prompt hospitalization of a patient suspected of obstruction. It is important to remember that before the patient is examined by a doctor, he should not take painkillers, do enemas or rinsing the stomach, give laxatives. If you do not immediately consult a doctor in the presence of obstruction, dangerous consequences may develop, the most serious of them are renal and hepatic insufficiency, violations in the activity of the heart. When squeezing the vessels may develop necrosis (necrosis) of the intestine. In addition, in advanced stages, even the operation does not guarantee that the patient will survive.
Especially dangerous (and severe) conditions include intestinal obstruction in newborns. Among the reasons are also distinguished mechanical (congenital or acquired character) and neurohumoral. Congenital mechanical disorders are detected immediately after birth or a little later, the disease itself can occur in acute, recurrent or chronic forms. Parents should be aware of the dangerous symptoms of intestinal obstruction in children: vomiting with bile, appearing after eating (can begin with the first days of life), significant weight loss due to fluid loss (one day to three hundred grams), bloating of the upper part of the tummy, greyish skin tone. Behavioral characteristics change gradually - a fairly quiet baby with time becomes capricious, refuses to eat. Calling a doctor for the manifestation of such symptoms in children is urgent and necessary (there is a high probability that surgery will be required).
Diagnosis and treatment of the disease
Methods of diagnosis of intestinal obstruction are combined - the disease is determined based on the collection of anamnesis and comprehensive examination of the patient with clarification of clinical symptoms, and then (if urgent surgery is not required or more detailed study of the disease is required) and using hardware techniques. To determine the levels of liquids and gas in the loops of the intestines, as well as transverse striation of the intestine, X-rays are used (sometimes with the introduction of contrast medium). The most commonly used method of apparatus research for intestinal obstruction is ultrasound - it allows you to clarify the clinical state in both mechanical and dynamic obstruction. Irrigography is usually contraindicated, but occasionally it can be used in the presence of obstruction, localized in the large intestine.
With established and confirmed diagnosis, or if the patient is still suspected of the disease - hospitalization (in a surgical hospital) is urgent and mandatory (remember - the faster the patient gets into the reliable hands of doctors, the more he has the chance to survive). Another thing is that if the intestine is obstructed, the operation is not always appointed immediately, in an emergency (that is, after two to four hours of preparation), this is necessary only if the patient develops peritonitis. In other cases, the treatment of intestinal obstruction begins with conservative methods that combine with the refinement of the diagnosis (if necessary).
Conservative treatment methods include enemas, drainage of the stomach, administration of drug solutions that will help relieve pain and eliminate toxins (they will be prescribed by a doctor). These measures are quite effective if there is a dynamic type of obstruction, but sometimes gives a result and with separate forms of mechanical. But if there is no improvement after twelve hours, an operation is prescribed. Effective treatment is considered if the patient's pain goes along with swelling and vomiting. Together with this, the waste gases and stool from the intestine must begin to flow. In this case, an x-ray is usually given that will show whether there are really significant improvements in the patient's condition.
During surgery, an obstacle is usually removed to promote the contents of the intestine. If the obstruction is localized in the small intestine, resection is often used, it completely restores patency. In complex cases, a series of several operations can be applied. An unfavorable prognosis may be with late circulation or late recognition of intestinal obstruction, as well as in weakened and elderly patients, or in the presence of a tumor in an inoperable form or stage. If there are pronounced adhesions in the abdominal cavity - the obstruction can recur even if the treatment is successful.
Diet and prevention of intestinal obstruction
The diet plays an important role in the presence of the disease, with intestinal obstruction it aims to rid the intestines of complex work. Diet should certainly be developed by your doctor (especially if there was an operative intervention), but about its main signs - the speech is further. First of all, nutrition in case of obstruction should not be excessive - any overeating (especially after a break in eating) leads to an exacerbation of the symptoms of the disease. It should be removed from the diet products that contribute to gassing - it's cabbage, legumes, whole milk, etc. To not feel hunger, due to reduced portions, you should eat more often.
If the intestinal obstruction required surgery - for twelve hours, food (like drinking) for the patient is completely banned. At this time, the food is injected intravenously or through a probe - the basis is a special nutritional mixture. Then (only when the doctor approves and appoints!) The patient is transferred to "zero" food. During this period, the food is extremely easily digestible products with a sharp restriction of salt (1-2 grams per day maximum). Portions are made very small, caloric content is reduced to 1020 kcal, but food is six- and even eight-oz. All dishes are served in a wiped or jelly-like condition, warm (hot and cold dishes are not allowed). The basis of such nutrition is mucous broths (with the addition of low-fat cream), home-made fruit and berry jelly, juices and broths, low-fat, unconcentrated broths (from meat).
Separately, a diet can be prescribed for chronic intestinal obstruction - it helps to reduce the formation of putrefactive processes and to establish proper digestion. With this diet, fast carbohydrates and fats are limited, irritants (in the form of solid, hot or over-processed food) are completely excluded. Caloric content of such nutrition within 1800-1900 kilocalories. Here is the approximate menu (it should be discussed with the doctor): the wiped oatmeal cooked on water, tea and curd soufflé. For the second breakfast, a quince/blueberry broth. At lunch, it will be good to eat low-fat broth, semolina porridge or mashed rice, steamed croquettes, squeezed everything with a kissel. For a mid-morning snack a warm broth of dog rose, and for dinner, an omelet cooked for a couple, mashed buckwheat (cook on the water - you can not consume whole milk!) And tea. Before going to bed, you can drink fruit jelly.
The sad medical statistics only emphasizes the importance of nutrition in case of intestinal obstruction: the death of almost one in four patients with obstruction is caused by illiterate diet.
To avoid dangerous pathology, much attention should be paid to the prevention of intestinal obstruction. It includes such actions as: timely detection (and, if possible, removal) of intestinal tumors, treatment of acute infections in the intestines, prevention of adhesions in it, familiarization with a healthy lifestyle (more movement, especially in old age), getting rid of intestinal Parasites (worms), as well as correct (full and regular) nutrition. We remember that with the slightest suspicion of obstruction, you should contact the hospital as quickly as possible.
Folk methods of treating the disease
Treatment with folk remedies for existing intestinal obstruction can be deadly - after all, delay in going to the doctor can cause death. Only after the beginning of treatment in a medical institution (if it turns out that the obstruction is not complete, but partial, or if a diagnosis of chronic intestinal obstruction is established), you can discuss with your doctor the possibility of using such methods and - with their approval by your specialist - carefully combine with the prescribed medical Procedures. Remember that self-treatment in the presence of complete intestinal obstruction (without going to the hospital) can mean a death sentence imposed on oneself.
Speaking about the recipes of folk methods that can be used in case of intestinal obstruction under the supervision of a treating specialist, it should be emphasized that good results are obtained by such a drink: to clean several tubers of raw beet (so that a half-kilo of the product is obtained in purified form), cut and pour Five liters of just boiling water. Seal the mixture with a lid and insist three hours, then remove the beet slices, and in return add a spoonful of dried yeast granules together with one hundred and fifty grams of sugar. All is aged for exactly 24 hours and then drunk like a normal drink.
Another drink can be made from sand sedge and St. John's wort - mix them and measure three spoons, steaming them in six hundred grams of boiling water. After eight hours, strain through a sieve, squeezing the thick. All you need to drink in 24 hours, dividing the drink into four portions.
Within three days with intestinal obstruction, it is possible to do an oil-and-milk enema (it is impossible with acute obstruction and without consultation!). Enema should be done an hour before bedtime, it is prepared as follows: in a half cup of warm milk to dissolve a twenty-gram piece of butter, injected as usual enema, in a recumbent position, preferably on the left side.
Such a collection can also be useful in case of intestinal obstruction: in dry condition it is necessary to take a bitter wormwood (50 grams), stone-thresher (underground part, in a sliced condition, 100 grams) and bitter arnica (75 grams). Take three tablespoons of the resulting mixture, fill in a thermos with 400 grams of boiling water, stand twelve hours and squeeze through a sieve. Drink a hundred gram portions, slowly, twenty minutes before eating. To drink completely all the received volume of the collection.
Remember that when intestinal obstruction occurs, there is only one right choice - to go to the hospital (therefore it is important to know the symptoms of the disease and respond quickly to their onset), but if you take care of bowel health, preventive maintenance and healthy lifestyle in advance With this severe pathology can safely be avoided.