Archive for the ‘Gastrointestinal’ Category

TUMMY TROUBLES: BOWEL OBSTRUCTION

Wednesday, April 29th, 2009

Q. I imagine bowel obstruction means what it says — there is a blockage along the intestinal system.

A. True, and this may be serious. It often presents as a surgical emergency and often prompt surgery is life saving. It may occur anywhere along the bowel but probably the most common site is the large bowel.

In older people, a sinister and serious cause is an obstruction caused by a cancer. Sometimes a loop of bowel may be blocked by bands and adhesions from previous surgery or inflammation. A loop of bowel being caught in a hernia in the groin is a common cause. Generally this will show up as an obvious tender swelling making diagnosis easier.

In children and infants, obstruction may occur if the bowel telescopes in itself, a condition called intussusception, or it may twist, causing a volvulus. Ulcers near the pylorus of the stomach may contract as they heal, causing scarring and narrowing of the canal, also blocking the free flow of food. An obstruction may occur suddenly, causing abdominal pain, followed by vomiting. After a time, this may become faecal. Babies are sometimes born with a very narrow pyloric canal called pyloric stenosis.

Q. What is the treatment?

A. Treatment is invariably surgical and often as an emergency measure. The source of the blockage must be found and relieved. In older people, if a cancer is found, the surgery may be extensive for the effects of the obstruction plus the cancer must be dealt with at the same time. The risks are high.

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