GASTROINTESTINAL OBSTRUCTION

SYMPTOMS

The symptoms of gastrointestinal obstruction vary depending on the location, severity, and duration of the obstruction. Common symptoms may include:

• Abdominal Pain: Crampy, colicky abdominal pain that may come and go in waves, often localized to the site of obstruction.
• Nausea and Vomiting: Persistent nausea and vomiting, which may be bilious (green or yellow) if the obstruction is in the small intestine or gastric contents if the obstruction is in the stomach or proximal small intestine.
• Abdominal Distention: Swelling or bloating of the abdomen due to the accumulation of gas and fluid proximal to the site of obstruction.
• Constipation or Absence of Bowel Movements: Incomplete or infrequent bowel movements, or complete cessation of bowel movements (obstipation) if the obstruction is in the large intestine.
• Diarrhea: In some cases, liquid stool or diarrhea may occur as a result of intestinal secretions bypassing the site of obstruction and leaking into the colon.

DIAGNOSIS

Diagnosing gastrointestinal obstruction involves a combination of clinical evaluation, imaging studies, and laboratory tests. Diagnostic steps may include:

• Medical History and Physical Examination: A detailed history of symptoms, previous surgeries, medical conditions, and medications, along with a thorough physical examination to assess for signs of obstruction such as abdominal tenderness, distention, or palpable masses.
• Imaging Studies: Imaging modalities such as abdominal X-rays, ultrasound, computed tomography (CT) scans, or magnetic resonance imaging (MRI) may be used to visualize the location and extent of the obstruction, identify the underlying cause, and assess for complications such as bowel ischemia or perforation.
• Blood Tests: Laboratory tests such as complete blood count (CBC), electrolyte levels, and inflammatory markers may be performed to assess for signs of infection, dehydration, or electrolyte imbalances associated with gastrointestinal obstruction.

TREATMENT

Treatment of gastrointestinal obstruction aims to relieve the obstruction, manage symptoms, and address any underlying causes. Treatment options may include:

• Nasogastric Decompression: Placement of a nasogastric tube through the nose and into the stomach can help decompress the bowel by removing gastric contents and relieving abdominal distention and vomiting.
• Fluid and Electrolyte Replacement: Intravenous fluids and electrolytes may be administered to correct dehydration, electrolyte imbalances, and metabolic disturbances associated with vomiting and fluid losses.
• Surgical Intervention: In cases of complete or high-grade mechanical obstruction, or when conservative measures are ineffective, surgical intervention may be necessary to remove the obstruction, repair any structural abnormalities, or relieve adhesions.
• Medications: Depending on the underlying cause of the obstruction, medications such as antiemetics (to control nausea and vomiting), analgesics (for pain relief), or prokinetic agents (to stimulate intestinal motility) may be prescribed.