A large bowel obstruction is when the large intestine, which is also known as the colon or large bowel, is partially or completely blocked. When this occurs, waste isn’t able to properly move through the bowels and exit the body. Immediate treatment becomes necessary to treat this blockage and relieve painful symptoms. It also works to prevent serious complications, like rupture of a person’s large bowel or tissue death. If it is not treated, a large bowel obstruction may be fatal. It is much more common for small bowel obstructions to occur, with obstructions of the large bowel only accounting for 20 percent of bowel obstructions. That being said, it is still useful to be aware of the symptoms and causes of the blockage so you can recognize them and receive prompt treatment.
What Are the Symptoms of Large Bowel Obstruction?
Some possible symptoms include the following:
- Diarrhea from a liquid stool which is leaking around partial obstructions
- Constipation during obstruction with possible bouts of constipation intermittently occurring for a few months before
- Abdominal pain which is mild and vague or severe and sharp based on the obstruction cause
- Bloated abdomen
- In the case of a colon tumor causing the obstruction, there may be a history involvingrectal bleeding
What Causes Large Bowel Obstruction?
The underlying causes of a large bowel obstruction vary greatly by age, but among adults, the most common factor is colonic cancer, which accounts for 50 to 60 percent of cases and typically occurs in the sigmoid 1 to 4. Among adults, the second most common cause is acute diverticulitis which involves the sigmoid colon. These two causes together account for 90 percent of cases of obstruction.
Colorectal cancer accounts for around half of large bowel obstructions. When undiagnosed, this cancer may lead to the large intestine’s inner passageway gradually narrowing. In most cases, patients with an obstruction due to this cause will notice intermittent constipation before the obstruction occurs.
This is when a segment of the bowel twists abnormally around itself. In the typical case, this twisting will produce a closed bowel loop featuring a pinched base and this in turn leads to intestinal obstruction. Among Western countries, those over 65 are more likely to notice volvulus, particularly those with a history of chronic constipation.
The diverticula are balloon-shaped, small pouches that extend from the intestinal wall in the large bowel. Diverticulitis refers to the infection of these diverticula. While healing from an infection, scars might begin to form along the colon wall. When a scar encircles the colon, it is known as a colon stricture. When these strictures age and tighten, they may gradually narrow the intestine, leading to a blocked colon.
Just some risk factors associated with a large bowel obstruction include:
- Cancer of the colon, breast, lung, ovary, or stomach
- Abdominal radiation
- Abdominal surgery
Those at risk of an obstruction of the large bowel include people who:
- Have or have had any type of cancer
- Have had radiation therapy on their abdomen
- Have had surgery on their abdomen
- Although anyone can develop this issue, it is more common among those over 70
- Keep in mind that less than a third of colorectal cancer patients will develop a large bowel obstruction.
How to Treat Large Bowel Obstruction
There are different treatments depending on the type of bowel obstruction you have. If you have a sudden and short-term bowel obstruction, the treatment including:
- Fluid replacement therapy
This treatment involves providing intravenous fluids or various medications as a way to bring body fluid levels back to normal.
- Electrolyte correction
This treatment aims to achieve the proper quantities of chemicals within the blood, specifically focusing on chloride, potassium, and sodium. The treatment may involve giving an infusion of fluids containing electrolytes.
In cases where other treatment doesn’t relieve serious symptoms, surgery may be necessary. It may also take place in the case of a long-term bowel obstruction. The surgery will remove the obstruction as a way to improve the patient’s quality of life and relieve pain.
For long-term obstructions, your doctor may insert a metal tube into the bowel as a way to open up the blocked area.
Various medicines may be given to relieve various symptoms. They are typically designed to treat fullness of bowel, pain, nausea, or multiple symptoms.
Prognosis of Large Bowel Obstruction
The prognosis for someone with a large bowel obstruction depends on many factors, including the timing of treatment, the patient’s age, the cause of the obstruction, and the presence of other illnesses, particularly kidney, lung, or heart problems. In people who are otherwise healthy, an obstruction that is not linked to cancer tends to have a prognosis that is very good.
How to Prevent Large Bowel Obstruction
To prevent a large bowel obstruction, you should live a healthy lifestyle. This involves exercising every day and making sure that your diet is low in cholesterol and fat while containing a high amount of fiber. If your diet is currently low in fiber, then work to slowly increase your fiber intake to avoid negative side effects. You should also aim to drink lots of water as this ensures your intestines will work smoothly.
Those who are 50 years old or older should talk to the healthcare provider about how frequent they will need colorectal cancer screenings as this is an excellent preventative measure.
You should also be aware of when you will need to talk to your doctor about troublesome symptoms. Let your healthcare provider know if you notice a change to your bowel habits or see blood in any movements. If you have already experienced a blockage in the past and it was due to a health problem, take the time to make sure you have that health concern under control and know how to manage it. Doing so will reduce your risk of a repeat blockage.