American Medical Association Family Medical Guide - American Medical Association [493]
Intestinal obstruction
An intestinal obstruction is a blockage of the small or large intestine. An obstruction such as a tumor may block the flow of food or stool out of the intestine, causing the contents of the intestine to back up, which can cause the intestine to swell.
WARNING!
Intestinal Obstruction
An intestinal obstruction can be life-threatening. Call 911 or your local emergency number or go to the nearest hospital emergency department immediately if you have the following symptoms:
• Abdominal pain followed by swelling of the abdomen, especially in the lower part of the abdomen
• Constipation
• Inability to pass gas
• Nausea and vomiting
Diagnosis
If you have symptoms of an intestinal obstruction, the doctor will take an X-ray of the abdomen (while you are standing, if possible). If the doctor is unsure of what is causing the blockage, he or she may recommend a barium X-ray (see page 767) or CT scan (see page 112). If the results are still unclear, he or she will recommend a surgical procedure called exploratory laparotomy in which the abdominal cavity is opened to look for the cause of the obstruction.
Treatment
If you have symptoms of an intestinal obstruction, the doctor will pass a long tube down your nose or mouth and into your stomach and intestines to remove fluid and air, which relieves pain by relieving pressure. You may be given fluids intravenously (through a vein) if you are dehydrated. You won’t be given any food for 24 to 72 hours to see if the obstruction passes on its own.
If the obstruction does not pass through the intestines in 72 hours, your doctor will perform surgery to locate the blockage and treat it. The surgery will be done sooner if the intestine becomes completely blocked (which could cut off the blood supply to the intestine).
If the cause is a volvulus, the surgeon will try to untwist the intestine and prevent the volvulus from recurring by inserting a tube past the twisted segment. Alternatively, a surgeon may remove the twisted segment of intestine and rejoin the severed ends.
Ileus
Ileus is a serious disorder in which the intestines are paralyzed, disrupting digestion. The paralysis is caused by abnormal electrical activity of the intestinal muscles. The contractions that move food through the intestines slow down or stop entirely, causing gas, fluid, and stool to collect in the intestines. Ileus is usually the result of abdominal surgery, severe infections, or some medications. It can also result from digestive disorders such as an intestinal obstruction (see page 759), peritonitis (see page 759), pancreatitis (see page 799), or a perforated peptic ulcer (see page 755). People with some nervous system disorders such as multiple sclerosis (see page 696) or Parkinson’s disease (see page 691) are at increased risk. Ileus can be fatal if the underlying disorder is not treated.
Symptoms
The symptoms of ileus include pain and swelling in the abdomen, constipation, failure to pass gas, and vomiting. If you have these symptoms, see your doctor to determine the underlying cause. If you have these symptoms along with a fever, you could have a life-threatening infection that requires emergency medical attention.
WARNING!
Ileus
Paralysis of the intestine can be life-threatening if it causes an infection. If you have a fever with any of the following symptoms, call 911 or your local emergency number or go to the nearest hospital emergency department immediately:
• Abdominal pain and swelling
• Constipation
• Inability to pass gas
• Vomiting
Diagnosis
If you have symptoms of ileus, the doctor will examine you and will order an X-ray of your abdomen. To rule out other disorders, he or she will take a detailed health history and order blood tests to check the level of calcium and