How should one act?

An acute intestinal obstruction is an absolute emergency situation. If this is suspected, a hospital should be visited immediately. Especially if intestinal obstructions are already in the history of the affected person, waiting is not recommended.

During the treatment, both the diet and other activities should be discussed with the treating physician. The correct intake of medication, especially antibiotics, is important for the success of the treatment. If side effects occur, this should be discussed with the doctor and should not lead to an arbitrary discontinuation of the medication.

If there is a tendency to intestinal obstruction, adjusting the diet can have a preventive effect. In the same way, after an intestinal obstruction, a light diet should be eaten in many small meals. A sufficient amount to drink is also important for the prevention and treatment of intestinal obstructions. In the case of recurring intestinal obstructions, a more detailed examination should be carried out to discover and treat the cause.

When does the operation have to start?

In case of an acute mechanical intestinal obstruction, surgery is often the only possibility for healing, because the blockage has to be removed or the intestine has to be turned properly again. This may also be necessary in paralyzed intestinal muscles if conservative therapy is not effective. If there are complications such as a rupture of the intestinal wall, surgery is unavoidable.

In the case of diseases such as Hirschsprung’s disease, the paralysis cannot be resolved with medication. In this case too, surgery is the only way to help the affected baby in the long term. There are various surgical options for intestinal obstruction.

Usually, such an operation is a large and open operation in which an incision is made in the abdomen. The operation is performed under general anaesthesia. If the intestine is twisted as the cause, it is brought into the correct position.

In case of a blockage caused by faecal matter or adhesions, the obstacle must be removed directly. In many cases a removal of parts of the intestine is necessary. In the case of benign diseases, a piece as small as possible is clamped off and the ends are brought together again.

Sometimes an artificial bowel outlet is also necessary. In this case a part of the intestine is moved to the outside and a stoma is created. Those affected wear a bag directly on the abdominal skin, which they can empty themselves.

After these operations, tubes are placed in the wound so that wound secretion can drain away. If intestinal contents have already entered the abdominal cavity, it must be flushed thoroughly during the operation. In most cases, the abdomen is closed again after the operation, but sometimes a vacuum bandage has to be applied and then the abdomen is only completely closed after a few days.

After the operation, the anaesthesia is ended and the patient is taken to the recovery room. After an operation, the therapy of the intestinal obstruction is not yet finished. First of all, the patient must be spared, as the operation on the affected section of the intestine is a serious intervention in the body.

If an artificial bowel outlet was created during the operation, the patient must learn how to handle it. This is followed by further drug therapy with painkillers, antispasmodics and antibiotics. The antibiotics are necessary to prevent serious infections in the operation area.

The patients are closely monitored to make sure that the surgical sutures will hold. After the operation, nutrition must first be built up gradually. At the beginning, a mashed bland diet is often necessary in order not to overburden the bowel.

It is also advisable to adjust the diet later. The water and salt balance must also be monitored after the operation. In some cases, a later removal of the artificial bowel outlet is possible through further surgery. In this case the intestine is moved back and the affected person can go to the toilet normally again.