What is Intestinal Obstruction? Causes and Symptoms

by Abbas Jahangir · June 22, 2024

Intestinal knotting refers to the abnormal twisting and folding of the intestines around themselves. Care should be taken as intestinal obstruction resulting from intestinal obstruction can cause very serious complications. Intestinal obstruction is a condition that requires urgent medical attention. You can follow the rest of the article to get information about your questions about intestinal obstruction, such as how to relieve intestinal obstruction, how intestinal obstruction occurs, what nutrition is like in intestinal obstruction.

What is Intestinal Obstruction?

The medical term for intestinal obstruction is volvulus. When volvulus occurs, a part of the intestines turns around itself and blocks both nutrition and conduction within the intestine, creating an intestinal obstruction. Symptoms that occur when this condition occurs include complaints such as bloating, tension, pain, nausea, vomiting, constipation and bloody stools in the abdominal area. Symptoms of intestinal obstruction may occur suddenly or gradually. The knotting of the mesentery, which is responsible for feeding the intestines, disrupts the blood flow to this area and causes serious pain. Impaired nutrition of the intestinal tissue can cause tissue loss called necrosis, and this very dangerous condition can also have a severe course because it cannot be reversed.

What Causes Intestinal Obstruction?

The actual cause of intestinal knotting has not yet been fully revealed. This condition is generally more common in older individuals. Some studies on intestinal obstruction have found that men are more prone to this condition than women. The susceptibility to intestinal obstruction is especially high in people suffering from neurological and psychiatric conditions accompanied by constipation. Although the underlying cause has not been fully revealed, various diseases and anatomical reasons are among the causes of intestinal obstruction.

Intestinal knotting in newborn babies is caused by orientation defects of the small intestine called malrotation. Malrotation refers to the intestine following a different path within the abdomen due to a problem in the normal path of the intestines. This can cause the intestines to become twisted, knotted, or blocked. Abnormal orientation of the intestines of babies is a condition that occurs while the baby is still in the womb and can be detected in approximately 1 in every 6000 live births.

Knotting of the small intestine is a condition usually seen in newborn babies and young children. In adults, knotting in the small intestine is a rare phenomenon. In this age group, the area where knotting occurs is usually the large intestine and is called sigmoid volvulus.

Causes of intestinal obstruction in adults are as follows:

growth of the colon,
Abdominal adhesions (intra-abdominal adhesions) occurring due to previous surgery, injuries or infections,
Diseases that affect the large intestine, such as Hirschsprung disease,
Narrow transition zones in some parts of the colon,
Chronic (long-term) constipation,

Apart from these situations, there are other risk factors such as male gender, being over 60 years of age, and living in institutions such as nursing homes, among the causes of intestinal obstruction. Intestinal obstruction usually occurs due to another health problem or physical problem. However, caution should be exercised as volvulus may develop in some cases without any underlying problem.

What are the Symptoms of Intestinal Obstruction?

Symptoms of intestinal obstruction may occur suddenly and with intense onset. In this case, people usually go directly to hospital emergency departments. The symptoms that may occur with the development of volvulus can be summarized as follows:

Pain and tenderness in the abdominal area,
Green bile vomiting,
Nausea,
Tension in the abdominal area,
bloody defecation,
Constipation,

Care should be taken as hemodynamic instability (circulatory disorders) may occur in both children and adults due to the development of intestinal obstruction, inadequate fluid intake or septic shock.

Some other symptoms may also occur if intestinal obstruction develops in newborn babies:

Sudden onset of intense and high-pitched crying,
Pulling the legs towards oneself as if there is abdominal pain,
predisposition to sleep,
Increased breathing rate and heart rate.

Sometimes knot formation occurs in children at various periods and symptoms appear during these periods, while at other times children do not have any complaints. In these cases, temporary knotting tends to recur and go away on its own.

How is Intestinal Knotting (Intestinal Obstruction) Treated?

Intestinal obstruction is a condition that requires urgent intervention, and this intervention is usually provided surgically.

Intestinal Knot Surgery:

In order to correct the knot during the operation, an incision is made in the abdominal wall, usually in the midline, and the rotating part is corrected. By intervening in the knotted area, blood flow is restored. If the blood flow to the relevant intestinal segment has not been provided for a long time and this intestinal section has lost its vitality, the affected intestinal segment must be removed. In some cases, due to the size of the removed intestinal segment, it may be impossible to connect the remaining healthy ends. In such cases, intestinal flow is carried out from the holes opened in the abdominal area to the outside of the body through openings called stomas. There are various surgical procedures that can be performed within the scope of intestinal obstruction surgery. Colectomy operations are surgeries that involve the removal of all or part of the intestine. In people where intestinal knotting occurs in the lower segments, the damaged intestinal section is removed by operation and then the healthy intestinal segments are connected together. It is very unlikely that the knot will occur again after this operation. If the knot occurs in the region of the intestine called the cecum, the initial part of the large intestine, the cecum and the ascending colon segments are surgically removed. The operation is then completed by connecting the remaining intestinal sections to the small intestine. In colostomy, which is another operation for intestinal knotting, the affected knotted bowel segment is surgically removed from the body, as in colectomy. However, in the colostomy operation, the intestinal segments are not connected to each other and the end of the intestines is opened outwards from the abdominal area. Then, the colostomy bag is connected to this opening and digestive residues are collected in this bag.

What is Good for Intestinal Obstruction?

Treatment of intestinal obstruction is generally provided by surgical intervention. However, in some cases, these operations may not be needed. In cases of knots occurring in the sigmoid colon, physicians may first use the imaging method called sigmoidoscopy as a corrective procedure. Sigmoidoscopy examination is performed through a thin tube inserted through the rectum. Introducing a small amount of air through this tube, which is advanced into the lower parts of the large intestine, may help correct the intestinal segment that rotates around itself. However, knots corrected in this way can usually recur after a while. In this case, permanent surgical correction of intestinal obstruction is necessary.

Nutrition After Intestinal Loop Surgery

The most common complaints that may occur after colectomy surgery include diarrhea and dehydration. These complaints arise from the fact that the intestines do not yet function as they did before the operation. For this reason, after surgery, foods such as easy-to-digest fruits such as bananas, apricots, peaches and melons, boiled rice, pasta, potatoes, spinach, white bread and yoghurt can be preferred.

Is Intestinal Knot Fatal?

Volvulus should be treated urgently to prevent the development of intestinal complications. In cases of intestinal obstruction where necessary medical intervention cannot be provided, problems such as blood infection called sepsis, nutrient absorption problems called short bowel syndrome, and infection of the peritoneal membrane covering the organs in the abdominal area may occur. The outcome of treatment for bowel obstruction depends on the size of the intestinal segment affected by the condition and how quickly treatment is carried out. With early diagnosis and intervention, the likelihood of developing serious complications is greatly reduced. For this reason, if you observe signs and symptoms of intestinal obstruction in yourself or those around you, it is recommended that you contact healthcare institutions and get support from specialist physicians as soon as possible.