Obstipation is obstruction that occurs when there is no open passageway for food or digested food waste to move through the bowel, or intestine. It can occur anywhere in the small or large intestine, and there can be a partial or complete blockage. Obstipation usually caused by an accumulation of hardened stools due to infrequent bowel movement.
Causes of Obstipation(BowelObstruction):
Types of obstipation that could be responsible for a bowel obstruction, both mechanical and non-mechanical include:
- Mechanical bowel obstruction:
- Adhesions (scar tissue) that formed after abdominal surgery
- hernia (where part of the bowel pushes through a weak area in the abdominal wall)
- Volvulus (where the bowel becomes twisted)
- malignant tumor
- structural causes: when the rectal wall did not develop properly
- Non-mechanical bowel obstruction: Paralytic ileus (where the rhythmic muscle contractions of the intestine, known as peristalsis, stops). Condition that cause paralytic ileus:
- chest infection
- acute heart attack
- acute kidney failure
- severe hypothyroidism
- electrolyte disturbance
- complication of diabetes
- during the postnatal period
- Diseases that tend to slow down the movement of feces through the colon, rectum, or anus can cause constipation that lead to obstipation.These include the following:
- Neurological disorders: Multiple Sclerosis (MS), Parkinson’s disease, stroke, spinal cord injuries, and chronic idiopathic intestinal pseudo-obstruction.
- Endocrine and metabolic conditions: Uremia, diabetes, hypercalcemia, poor glycemic control, and hypothyroidism.
- Systemic diseases: These are diseases that affect a number of organs and tissues, or affect the body as a whole; they include lupus, scleroderma, and amyloidosis.
- Cancer: Constipation occurs in people with cancer, mainly due to pain medications and chemotherapy. Also, if a tumor blocks or squeezes the digestive system.
Other possible causes of Obstipation include:
- Impacted stools (poo) from severe constipation
- Diseases that affect the intestinal wall such as Crohn’s disease or diverticular disease
- Intussusception, where part of the intestine folds in on itself
- Congenital malformation of the bowel
- A swallowed item
- Low fiber diet
- Decrease water intake
- decreased physical activity
- Hirschsprung’s disease: A congenital defect where one of the parts of the colon is not present or is dysfunctional.
- Diverticulitis: The inflammation of pouches found protruding from the outside of the colon may lead to scarring or tissue formation that can lead to obstruction.
- Inflammatory bowel disease: A group of inflammatory conditions that can result in hypertrophy and fibrosis of the intestinal walls, leading to obstruction.
Symptoms of Obstipation
- Abdominal distension
- Bloating: enlargement or feeling of fullness
- Persistent cramping and pain
- Borborygmi: increased bowel sounds
- Foul breath odor
- Rapid pulse (tachycardia)
- Nausea and vomiting
- Fever and dehydration
- Loss of appetite
Diagnosis of obstipation
Typically, not having normal bowel moments is enough to suspect some form of constipation. A physical exam of your rectum will most likely be done to exclude foreign object obstruction. Muscle tone and the presence of bleeding from the rectum will also be assessed. Once these preliminary steps are done, your doctor will likely choose to do one of the following tests:
- Blood test: Looking for the signs of infection or checking thyroid function.
- Ultrasound: Can give a good indication of the cause and site of your obstipation.
- X-ray/CT: Imaging tests to get a picture of your obstructed bowels.
- A contrast dye enema X-ray may help in detecting a low-level obstruction or adhesions in the small bowel
- Colonoscopy: Looking directly into the colon with a camera can help see if you have tissue damage. Biopsies may also be taken to be assessed for colon cancer.
- Bowel function test: Used to check muscle tone and nerve sensitivity of the intestines and anus.
Obstipation vs constipation
The primary difference between these very similar conditions is the duration. Constipation is defined as three or fewer bowel movements per week, whereas obstipation is not having any bowel movements at all.
Cases of obstipation vary from person to person. In cases of anatomical obstruction, such as in the case of a volvulus or a hernia, surgery will be required to correct the abnormality. If your obstruction is not due to any serious condition, it may be beneficial to try natural obstipation treatments for the condition. These include:
- Eating foods that are high in fiber.
- Increase water intake to four–five liters a day.
- Exercise for at least 30 minutes a dayHelps to stimulate the bowel organs and promote gut motility.
- Practicing good toilet habits: The best time for passing stool is first thing in the morning or around half an hour after a full meal.
- Elevate your feet can help reduce constipation
- Lower consumption of processed foods.
- Decrease alcohol intake and caffeinated beverages
Herbal remediesfor severe constipation treatment:
Herbal medications should be used only if diet and exercise have failed. Herbal medications that may be useful for treating obstipation include:
- Aloe Vera
- prune juice, stewed prunes, or figs to soften hard stools
- Guava, orange, and papaya
Medication for obstipation:
- In paralytic ileus, treatment may involve inserting a flexible tube (nasogastric tube) down the throat to drain fluids from the stomach as well as correcting fluid and electrolyte imbalances.
- opioid painkillers,
- antispasmodics or antiemetic
- Surgery: complete blockage will need surgery treatment. The type of surgery depends on the type of blockage and its location. Type of surgery for obstipation:
- A laparotomy: where an incision is made into the abdomen while under general anesthesia.
- Laparoscopy or keyhole surgery: in which a laparoscope (a small tube with a light and camera on the end) is inserted into a small incision, to treating a small bowel obstruction or removing adhesions.
- Endoscopic stenting: where a self-expanding stent is inserted to help keep the passageway open, may be considered in the elderly and in palliative care of cancer patients.
- A sigmoidoscopy or colonoscopy involves inserting a thin flexible tube with a small camera and light attached on one end through the rectum into the bowel, to decompress and untwist the bowel.
- Using OTC laxatives include:
- Stimulants: These make the muscles in the intestines contract rhythmically. These include Correctol, Dulcolax, and Senokot.
- Lubricants: These help the stool move down the colon more easily. These include mineral oil and Fleet.
- Stool softeners: These moisten the stool. Stool softeners include Colace and Surfak.
- Fiber supplements: They are also called bulk laxatives. They include FiberCon, Metamucil, Konsyl, Serutan, and Citrucel and should be taken with plenty of water.
- Osmotic: These facilitate the movement of fluids through the colon. These include Cephulac, Sorbitol, and Miralax.
- Saline laxatives: These draw water into the colon and include milk of magnesia.
- Chloride channel activators: These require a prescription and include lubiprostone (Amitiza).
- 5-HT-4 agonists: They increase the secretion of fluid in the intestines and speed up the rate at which food passes through the colon. They include Prucalopride.
Complications of Obstipation
- Ischemic bowel disease will cause a lack of blood flow to the intestine as a result of a blockage caused by obstipation.
- Intestinal obstruction: condition which the normal flow in the intestine is block.
- rectal bleeding after continually straining to pass stools
- anal fissure, or a small tear around the anus
- hemorrhoids, or swollen, inflamed blood vessels of veins in the rectum
If it’s not treated immediately Obstipation can lead to severe constipation symptoms dangers:
- Peritonitis is an infection in the abdomen.
- strangulated bowel: malfunction of bowel that may cause dehydration, nausea, vomiting, low blood pressure and rapid heart rate
- body malaise
- Sepsis is a bacterial infection in the blood stream.
When to see a doctor
Following complications with your bowel movements should prompt you to visit doctor immediately:
- high fever
- Severe constipation not remedies by any kind of medication
- Having blood in stool
- Unexplained weight loss
- Low blood count
- Experiencing symptoms related to inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
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