The causes of intestinal obstruction
A mechanical ileus (intestinal obstruction) has as its cause a spatial obstruction to the transport of food, as can occur in a hernia (hernia), because an intestinal loop pressed into the hernial sac is pinched off and the passage of food can be hindered. The same problem can also occur if the intestinal loops are twisted, kinked or pushed into themselves. After operations in the abdominal cavity, a so-called obstructive ileus can develop because external adhesions of the intestinal loops develop, which hinder the free movement of the intestine during its work.
Within the intestine, chronic inflammatory processes (Crohn’s disease) can lead to adhesions, which also lead to a mechanical handicap. In addition, a tumour that constricts the intestinal lumen and originates from the intestine itself or neighbouring organs, as well as larger foreign bodies or large gallstones that have come loose in the intestine, can represent an obstacle to passage. Finally, difficult to deform or tough stool such as excrement bales, meconium (child’s spittle), or viscous body secretions in the context of cystic fibrosis can also lead to a mechanical ileus.
In older people, faeces bales are mainly caused by insufficient fluid intake or generally by a diet that is too rich in fibre, whereas meconium, the first baby stool, contains many tough components that can sometimes cause intestinal obstruction. Paralytic ileus (intestinal obstruction) is caused, for example, by circulatory disorders such as those that occur in a mesenteric infarction. In the case of a mesenteric infarction, the blood vessels supplying the bowel may be undersupplied with blood due to infiltration or the formation of a blood clot on site (similar to heart attack or stroke).
Various types of injuries or inflammation in the abdominal cavity can lead to a reflex stoppage of intestinal movements. Possible causes are an operation, an accident with injury to the abdominal cavity, a (subsequent) inflammation of the abdominal cavity and its organs, or biliary and renal colic. Likewise, a mechanical ileus that has existed for a longer period of time inevitably leads to a paralytic ileus due to the inflammatory reaction.
In addition, electrolyte shifts (hypokalemia), an excessive concentration of uric acid in the blood due to renal insufficiency (uremia), as well as poisoning with opiates or lead, lead to paralysis of the intestinal muscles. Cancer is one of many possible causes of intestinal obstruction. This is either caused by the relocation of the intestinal tube due to the growth of a cancerous tumour from the inside, or a tumour grows in the abdominal cavity, which pushes in the intestine from the outside.
In both cases, the result can ultimately be a complete passenger disruption of the intestine and thus mechanical intestinal obstruction. If cancer is the cause of intestinal obstruction, however, this is often already indicated by stool irregularities such as an alternation of constipation and diarrhoea. In the case of a sudden and unsigned intestinal obstruction, cancer is rarely the cause.
This topic might also be of interest to you: End-stage colon cancer adhesions are one of the most common causes of so-called mechanical bowel obstruction. A previous operation in the abdominal cavity, which can also be decades in the past, can cause adhesions to form. These can lead to a narrowing and ultimately to the closure of the raw intestine from the outside.
In such a case, surgical removal of the causative adhesions as quickly as possible and the associated restoration of intestinal passage is crucial. In younger and otherwise healthy patients, this can often lead to a healing without consequences. In patients who are already seriously ill or elderly, or if the operation is too late, intestinal obstruction caused by adhesions can be fatal.
In extreme cases, constipation can lead to intestinal obstruction. Due to an ever increasing thickening of the faeces in the intestine, a backlog occurs against which the intestine presses unsuccessfully, which is usually expressed by colicky abdominal pain as well as nausea and vomiting (possibly also vomiting of faeces). In such a case a doctor must be consulted urgently.
Constipation alone, however, is a very common symptom, with intestinal obstruction occurring only very rarely and can be treated initially by sufficient fluid intake, a high-fibre diet and physical exercise. The ingestion and especially the misuse of laxatives can trigger an intestinal obstruction or promote its development. Among other things, the drugs cause a loss of salts such as potassium.
A potassium deficiency can lead to paralysis of the intestinal muscles and thus cause intestinal obstruction. Laxatives should therefore only be taken as prescribed by a doctor. Non-drug measures such as sufficient drinking, a high-fibre diet and physical activity should have been exhausted beforehand.
