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Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. [2] [5] Either the small bowel or large bowel may be affected. [1] Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas. [1]
However, instances with symptoms and signs of a bowel obstruction occur, but with the absence of a mechanical obstruction, mainly in acute colonic pseudo-obstruction, Ogilvie's syndrome. [3] In 2023 the US FDA reported gastrointestinal ileus as an adverse effect of the medication semaglutide , with frequency and causal relationship unknown.
Volvulus causes severe pain and progressive injury to the intestinal wall, with accumulation of gas and fluid in the portion of the bowel obstructed. [11] Ultimately, this can result in necrosis of the affected intestinal wall, acidosis, and death. This is known as a closed-loop obstruction because there exists an isolated ("closed") loop of bowel.
It is a common cause of bowel obstruction [1] and constipation. It is common in Asia, India (7% of intestinal obstruction) and especially South India because of the high fibre diet. It is a very common cause of large bowel obstruction in Peru and Bolivia due to high altitude. [2]
Bowel obstruction is most often caused by intestinal adhesions, which frequently form after abdominal surgeries, or by chronic infections such as diverticulitis, hepatitis, and inflammatory bowel disease. The condition may be difficult to diagnose, as the symptoms may resemble those of other bowel disorders. [5]
In one large report on over 2000 patients who underwent STARR found that there was improvement in obstructed defecation symptoms and quality of life 12 months after the procedure. [ 15 ] 36% of patients had complications, such as defecatory urgency, bleeding, infections, pain, and fecal incontinence.
Stercoral ulcer is an ulcer of the colon due to pressure and irritation resulting from severe, prolonged constipation due to a large bowel obstruction, damage to the autonomic nervous system, or stercoral colitis. It is most commonly located in the sigmoid colon and rectum.
Cecal bascule is a cause of large bowel obstruction where there is folding of the cecum anteriorly over the ascending colon. It is one of two types of cecal volvulus, the other being axial ileocolic. It is caused by rotational torsion of the cecum or ascending colon along its own axis.