When the natural movement of foodstuffs, liquids, or gas within the colon is obstructed, it is called a bowel blockage (intestines). Blockages can be full or partial, with partial blockages allowing some water and gas to move but not solids, and complete blockages preventing nothing from passing through the bowel. A blockage of the intestine is found in around 20% of individuals brought to the clinic with an acute abdomen (or an abdomen that suddenly becomes hard, sensitive to touch, and irritable). Most (80%) of this 20% will have a minor bowel blockage, Bowel obstructions can develop for a variety of causes, but adhesions (scar tissue) and food blockage are the two most frequent with your kind of surgery and stoma. Below, we’ll go through each of these points.
Adhesions are bands of fibrous connective tissue that can unnaturally link or join adjacent portions of the intestine together, tie the intestine to other components in the abdomen, or attach the bowel to the interior of the abdominal wall, similar to scar tissue. Such scar tissue can then obstruct regular food, water, and gas passage through the intestine. The majority of scar tissue is caused by an activity that disturbs normal tissues. Scar tissue is formed when the body attempts to heal the damage. The operation, an illness in the abdomen, injury, or radiation therapy is all examples of events that might cause this condition. Adhesions are the most frequent postoperative complication, happening in more than 90 percent of patients who have surgery. After days of surgery, adhesions start developing. Adhesions, for the most part, do not cause discomfort or problems, and most individuals are unaware of their existence. Adhesions, on the other hand, may not create difficulties for months or even years following surgery. If adhesions caused your intestinal blockage, it’s possible that it’ll happen again.
Food that becomes blocked while attempting to pass through your ileostomy is another form of blockage that can develop. This is a bigger risk in the first 6-8 weeks following surgery, when the intestine is bloated from the procedure. Although the swelling is very temporary, it narrows the lumen (inner part of your intestine), which is especially important because the intestines passes through multiple layers of your abdominal wall. Several foods may be difficult to pass through your stoma due to a small opening. Diet rich in cellulose (fruits, vegetables, nuts, cereals) or with shells (such as sausages and cold cuts) or hard meats, such as beef, are generally of significance. Small quantities are insufficient to cause issues, but higher quantities or improperly chewed/cooked fruits and vegetables could be a risk. While previously stated, this sort of obstruction is generally just a problem for the first 6-8 weeks following surgery, as the swelling reduces. You must be able to consume most meals without fear beyond this stage.
A bowel obstruction can cause a number of different symptoms. People may have periods of cramp stomach discomfort and bloating. The discomfort can be severe and unrelenting at times. There might be some nausea and/or vomiting, as well as a lack of appetite. It’s possible that the output from your ileostomy will vary. The output from a partial small bowel blockage may be extremely liquid (no solids will be seen) and quite powerful and loud. There’ll be no liquid, solid, or gas outflow if the obstruction is severe. If you detect a bowel obstruction, get medical help immediately rather than attempting to identify the problem by yourself. You can aid yourself by enlarging the opening of your ostomy appliance/flange to allow any probable stomal swelling while you seek care. If you aren’t vomiting, you must stop eating solid foods and attempt to drink some water.
If you’re vomiting, have severe/constant discomfort, or haven’t had any output from your stoma in twelve hours, you should seek immediate medical attention. In these cases, you must go to the nearest emergency room for evaluation and treatment. The specialist will examine you regarding your surgical and medical history, do a physical exam, and prescribe tests such as blood tests and an abdominal x-ray or CT scan. Primary treatment may involve discontinuing any oral food, providing intravenous hydration support, and prescribing medicines to alleviate some of your problems.
A nasogastric tube, a tiny tube that runs into your nostrils and into your stomach to enable drain fluid from your stomach and alleviate vomiting, may be placed. The blockage may take several days to clear, after which a regular food will be gradually reintroduced. You’ll be examined for any symptoms of unresolved issues. You may need surgery to address the condition depending on the degree of the blockage or if it does not improve with conservative medicinal treatment.