May be intestinal obstruction if Paroxysmal colic in the abdomen

May be intestinal obstruction if Paroxysmal colic in the abdomen.  Intestinal obstruction is a common gastrointestinal disease

Intestinal obstruction is a common gastrointestinal disease. The contents of the intestine cannot function normally, and obstacles occur through the intestinal tract, which is called intestinal obstruction.

It is more common in the elderly, with timely diagnosis and active treatment, most of which can be completely cured.

1. What is the cause of intestinal obstruction?

(1) Mechanical intestinal obstruction:

the most common, fecal stone, roundworm blockage, intestinal wall polyps, tumors, external pressure and adhesion of the intestine, these factors can cause mechanical intestinal obstruction.

For example, after abdominal surgery, it often causes intestinal adhesion obstruction, hernia or intussusception in infants and young children, and colon tumors and fecal blockage are common in the elderly.

(2) Dynamic intestinal obstruction:

Intestinal peristalsis dysfunction, problems with the motility of the intestine itself, intestinal spasm or paralysis are common causes.

(3) Blood circulation intestinal obstruction:

Intestinal wall vascular disease (mesenteric artery embolism or thrombosis), causing intestinal wall ischemia, and then leading to peristalsis, causing intestinal obstruction.

2. Types of bowel obstruction?

(1) According to the location of the obstruction, it is divided into high small bowel obstruction, low small bowel obstruction, and colon obstruction (rectum, left colon and right colon).

(2) According to the degree of disease, it is divided into complete intestinal obstruction and incomplete intestinal obstruction. If the degree of obstruction is mild, the contents of the intestinal cavity can still pass in a small amount, which is called incomplete intestinal obstruction. It can be caused by internal and external factors in the intestinal cavity, as well as factors in the intestinal wall itself. For example, constipation, intestinal adhesions, tumor compression, post-intestinal anastomosis, intestinal paralysis, etc.

Complete intestinal obstruction refers to the complete blockage of the intestinal tube and the intestinal contents cannot pass. Complete intestinal obstruction is usually caused by incomplete intestinal obstruction.

Intestinal obstruction progresses and becomes worse. The onset is rapid and the symptoms are obvious.

(3) According to whether the intestinal obstruction has caused blood flow disorder, it is divided into simple intestinal obstruction and strangulated intestinal obstruction.

Expert profile: Jia Zhenyi, Deputy Chief Physician, Doctor of Medicine, Postdoctoral in Surgery, Massachusetts General Hospital, Harvard Medical School. Deputy Chief Physician of General Surgery, the Sixth People’s Hospital Affiliated to Shanghai Jiaotong University. Good at diagnosis and treatment of intestinal dysfunction diseases such as acute and severe abdominal surgery, trauma and nutritional intervention, percutaneous gastrostomy, constipation, chronic diarrhea, short bowel, intestinal fistula, inflammatory bowel disease, postoperative intestinal adhesions, and malignant tumors Establishment of patient nutrition pathway and precise nutrition treatment.

3. Symptoms of bowel obstruction?

(1) Abdominal pain:

The pain is mostly in the middle of the abdomen, but can also be biased to the site of the obstruction. When abdominal pain occurs, it is accompanied by bowel sounds, and consciously there is a “air block” moving in the abdomen, and it is blocked in a certain part. Sometimes intestines and peristaltic waves can be seen in the abdomen.

If the intestinal obstruction affects the blood flow of the bowel and becomes a strangulated intestinal obstruction, there will be persistent severe pain.

(2) Vomiting and abdominal distension:

Vomiting of high intestinal obstruction occurs early and frequently, and will vomit when eating or drinking saliva; low intestinal obstruction and paralytic intestinal obstruction have obvious abdominal distension.

(3) Stop exhausting and defecation:

After complete intestinal obstruction, most patients stop exhausting and defecation; but in the early stage of obstruction, especially high intestinal obstruction, the feces and gas remaining in the intestine below the obstruction can still be discharged by itself.

4. What should I do if intestinal obstruction occurs?

(1) Diagnosis (looking for the cause of disease):

Blood routine (including hemoglobin, white blood cells, platelets, etc.), biochemical examination to see if there is any electrolyte imbalance. Abdominal X-ray examination is very helpful in diagnosing intestinal obstruction. It is best to take a standing abdominal plain film.

In addition to the diagnosis of intestinal obstruction, CT examination can also determine whether the site of intestinal obstruction is simple or strangulated, and whether there is blood flow disorder. CT examination can provide more evidence and help clarify the cause (whether it is caused by postoperative adhesions, volvulus, or the presence of intestinal tumors) to guide the next treatment.

(2) Conservative treatment

Fasting and no water, continuous gastrointestinal decompression. Gastrointestinal decompression is a method in which a gastric tube is inserted from the oral cavity or nasal cavity, connected to a disposable gastrointestinal pressure reducer, and the stomach contents are drawn out of the patient’s body under the action of negative pressure and siphon principle. This method can relieve or alleviate the symptoms caused by intestinal obstruction; reduce the pressure in the gastrointestinal tract, reduce the degree of gastrointestinal swelling, improve the blood circulation of the gastrointestinal wall, and promote the healing of gastric wounds and the recovery of function; in addition, the gastrointestinal Decompression aspiration judgment, observe changes in the condition and assist in diagnosis.

Most patients with intestinal obstruction are accompanied by protein-energy malnutrition, and ensuring the patient’s energy intake is of certain significance for the alleviation and recovery of the disease. Therefore, intravenous nutritional support treatment should be strengthened while fasting, and nutrients such as amino acids, sugars, and fats should be given by intravenous drip, and water and electrolytes should be added.

Antibiotics are used to prevent and treat infections. There are a lot of bacteria in the intestinal tract. When intestinal obstruction, toxins are easily absorbed into the blood through the intestine and cause infection.

Other methods, such as oral paraffin oil, acid suppression, enzyme suppression, physical therapy, Chinese medicine, etc.

(3) Surgical treatment.

When conservative treatment is ineffective, intestinal tumors are present, and the patient has complications such as intestinal ischemia, necrosis, and intestinal perforation, surgical treatment should be promptly performed. Surgical methods include lysis of intestinal adhesions and bowel resection. Surgery, enterostomy, etc. When conditions permit, laparoscopic minimally invasive surgery can be considered, which can reduce the chance of intestinal adhesions and intestinal obstruction again.

Experts remind that the history of abdominal surgery, especially laparotomy, if there are bursts of abdominal cramps, nausea and vomiting, stop defecation and gas, prompting intestinal adhesions and intestinal obstruction, you need to see a doctor in time, otherwise it may life threatening.

(source:internet, reference only)

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