A stenosis is the narrowing of a hollow body. In the case of intestinal stenosis, it is the intestine, which can be narrowed as a result of a variety of reasons.
What is intestinal stenosis?
As a cavity, the intestine is the most important element of the human digestive system, through which large quantities of consumed meals flow every day. Once a narrowing has occurred for whatever reason, the body itself makes attempts to break through the narrowing by increasing the natural movements of the intestines. If the body does not succeed in doing so, this is a pathological case of intestinal stenosis that requires immediate medical treatment. This is because in the case of intestinal stenosis, the continuously ingested meals accumulate, which in the worst case can lead to a complete blockage of the intestine and thus to what is known as megacolon: the swelling of the intestine to the point of rupture. Another problem that is added is the danger of an increased germ load: the meals remain at the constriction as a result of the intestinal stenosis and are decomposed by the natural intestinal flora, which leads to an excessive proliferation of the germs living there.
Causes
Intestinal stenosis can have different causes. For example, it may be congenital or it may have developed over time. Especially as a secondary disease of other major diseases, intestinal stenosis plays a significant role. Examples include the chronic inflammatory bowel diseases ulcerative colitis and Crohn’s disease. Here, those affected suffer from a chronic inflammation of the intestinal tract. The body tries to counteract the inflamed intestinal regions by increasing cell production. The inner wall of the intestine becomes thicker and thicker until intestinal stenosis occurs.
Symptoms, complaints, and signs
A variety of symptoms and complaints may occur in the setting of intestinal stenosis. Typically, gastrointestinal symptoms such as abdominal pain, constipation, and nausea and vomiting present themselves. These signs are often accompanied by intestinal colic, which is characterized by cramping pain in the abdomen, and usually also causes sweating and circulatory problems. In the worst case, intestinal stenosis can lead to intestinal obstruction. This is manifested by constipation and is life-threatening if left untreated. In extreme cases, it can lead to a rupture of the intestine, causing peritonitis. Intestinal stenosis with intestinal obstruction is accompanied by an increasing feeling of illness. Those affected are usually no longer able to get out of bed, which exacerbates the restricted bowel movement. Intestinal stenosis also leads to a number of other, mostly non-specific complaints in the area of the stomach and intestines. These include, for example, stabbing or probing pain. This is accompanied by a loss of appetite, which quickly leads to weight loss and deficiency symptoms. In addition, bad breath and a white coating on the tongue develop. Externally, intestinal stenosis can also be recognized by the pale skin and the typical trembling that occurs with a pronounced intestinal disease.
Diagnosis
As with all diseases, the medical history is the first clue for the physician to assume the presence of intestinal stenosis. Typical symptoms include abdominal pain, i.e., abdominal pain that cannot be localized, which occurs as a result of the stenosis. Furthermore, an abnormal bowel movement is part of the typical clinical picture, which in extreme cases can even be bloody-mucous. If the initial suspicion is present, the physician has the patient X-rayed. Possible stenoses can be identified on the basis of the image. The earlier intestinal stenosis is diagnosed, the lower the risks of possible complications, such as intestinal obstruction.
Complications
Intestinal stenosis causes significant discomfort and complications in the stomach and intestines. In most cases, it is then no longer possible for the patient to carry out an ordinary daily routine, as he or she constantly suffers from diarrhea or constipation. There is severe pain in the stomach region, which is associated with vomiting and nausea. Likewise, flatulence can continue to complicate daily life. Due to intestinal stenosis, the affected person often tends to reduce food intake. Likewise, constant diarrhea can lead to severe dehydration, creating a very unhealthy condition for the body. It is not uncommon to then experience a loss of appetite that can last for several days.The development of bad breath and a white coating on the tongue occurs, which is indicative of intestinal stenosis. In the worst case, rupture of the bowel may occur. As a rule, treatment in hospital is necessary for intestinal stenosis. If this is done early, no further complications occur. If parts of the intestine have been irreversibly damaged, they are usually removed surgically. Furthermore, the affected person must pay attention to a healthy diet to prevent the symptoms of intestinal stenosis.
When should one go to the doctor?
When the typical signs of intestinal stenosis occur, such as vomiting and nausea, diarrhea, constipation and stomach pain, it is advisable to consult a doctor. Patients with chronic inflammatory bowel disease such as ulcerative colitis are particularly susceptible to intestinal stenosis and should see a doctor immediately if they experience any of the above symptoms. Similarly, Crohn’s disease patients, people with gallstones, chronic diarrheal diseases or intestinal tumors, as well as pregnant women and people who regularly take certain medications such as antidepressants, are recommended. Anyone who counts themselves in one of these groups must consult a medical professional immediately if they experience symptoms of intestinal stenosis. In the case of intestinal stenosis, the chances of recovery are generally good, provided that the disease is detected and treated at an early stage. However, if intestinal stenosis remains untreated, it can lead to intestinal obstruction. This manifests itself, among other things, as painful abdominal cramps, a bloated abdomen and severe belching – warning signs that require emergency medical treatment. If circulatory shock occurs, first aid must be administered immediately. In the event of such a severe course, hospitalization is subsequently required.
Treatment and therapy
As already mentioned, an underlying disease is often responsible for the formation of intestinal stenosis. In this respect, this should be treated first, so that the stenosis in the intestinal region usually regresses on its own. For initial relief, doctors use enemas to “liquefy” the stool that may have built up, so that it can flow more easily through the stenosis and the pain is combated for the time being. Until the underlying disease has recovered, sufferers should largely avoid foods that are difficult to digest. In severe cases, sufferers are advised to switch to liquid foods to prevent congestion at the intestinal stenosis. If the narrowing has progressed so far that a blockage (Latin: ileus) has formed in the meantime, conventional treatment options can no longer be considered. If an intestinal obstruction is suspected, the patient is admitted to the nearest specialized hospital where, after further X-ray examinations, surgery is performed. Here, the abdominal wall is opened and the obstructed part of the intestine is removed if it is dead or if there is reason to believe that the obstruction will not be released. If removed, the patient is permanently cured of intestinal stenosis.
Outlook and prognosis
In the case of intestinal stenosis, self-healing does not usually occur. For this reason, those affected are dependent on medical treatment in any case to alleviate the symptoms. In the worst case, intestinal stenosis can lead to complete intestinal obstruction, which can also result in the death of the patient. Likewise, without treatment, those affected suffer from severe pain in the abdomen and likewise diarrhea or constipation. There is flatulence and nausea, often with vomiting. Due to the severe pain, many patients do not consume food or fluids, so dehydration or deficiency symptoms may occur. The patient’s quality of life is significantly reduced by intestinal stenosis. As a rule, the underlying disease of intestinal stenosis is always treated. This can alleviate the symptoms in the long term. In some cases, surgical interventions are also necessary, although there are no particular complications or other complaints. The disease can be completely cured in this process, so that the life expectancy of the patient with intestinal stenosis also usually remains unchanged.
Prevention
To what extent intestinal stenosis can be prevented cannot be said in general terms. Rather, the decisive factor is which cause has led to the narrowing of the bowel.If this is hereditary, only regular preventive examinations can help against the obstruction; recurrences, i.e. repeated occurrence after successful treatment, are conceivable in the case of congenital intestinal stenosis. As a last resort, a colectomy can be considered, in which the colon is completely removed and instead a reservoir (“pouch”) is surgically formed from the last part of the small intestine, which then takes over the task of the removed colon. The colectomy is subject to the proviso that only the colon is affected by the therapy-resistant intestinal stenosis. For the other cases of intestinal stenosis, treatment of an underlying disease is still among the best options for preventing intestinal stenosis.
Follow-up
In most cases, the measures of aftercare for intestinal stenosis depend very much on the time of diagnosis, so no general prediction can usually be made about it. The earlier the diseases are detected and treated in the process, the better the further course is usually, although self-healing cannot occur. Therefore, those affected should see a doctor at the first symptoms and signs of the disease in order to avoid further complications and complaints. In most cases, treatment is carried out by taking antibiotics. Affected persons should always pay attention to a correct dosage and also to a regular intake in order to properly alleviate the symptoms. If there are any uncertainties or questions, a doctor should always be consulted first to avoid further complications. Likewise, a balanced and healthy diet can alleviate the discomfort of the diseases. Patients are not infrequently dependent on the help and support of their own family and friends. This can also alleviate psychological upsets or depression. Whether the diseases result in a reduced life expectancy for those affected cannot be universally predicted.
Here’s what you can do yourself
People who have problems with bowel function can positively support themselves and their bodies in everyday life by adopting a healthy lifestyle. Avoiding fatty or very spicy foods is helpful to avoid unnecessarily irritating or interrupting bowel activity. All foods that have proven difficult to digest in the course of one’s life should be avoided. This should be considered on an individual basis and requires good body awareness of one’s own needs. A balanced diet rich in vitamins stabilizes the immune system and stimulates intestinal activity. Avoiding toxins such as alcohol, nicotine and non-essential medications is also beneficial for digestion. There should be enough time between meals so that the intestines are not too full or overloaded. Purification or intestinal cleansing programs can also be used to strengthen the general well-being and relieve the intestines. With sufficient exercise, metabolic activity is additionally stimulated. People who are particularly sensitive to stress should take care not to overdo it. One’s own emotional limits should not be exceeded in order to prevent stressful situations from escalating. Furthermore, a regulated daily routine, observance of rest phases and good sleep hygiene are helpful for bowel activity.