Fecal blockage: causes, symptoms and treatment. Types of constipation. Constipation. Constipation treatment. Causes and symptoms of constipation

Most often, fecal obstruction occurs in the elderly and in people with mental disabilities. This pathology is a complication of prolonged constipation. It consists in the gradual compaction of fecal masses in the intestines and the formation of fecal stones. In some cases, a gap remains between such stones and the intestinal wall, through which liquid feces pass. Because of this, the patient has diarrhea against the background of fecal obstruction.

Fecal blockage causes partial intestinal obstruction, accompanied by abdominal pain, belching, nausea and vomiting, and decreased appetite.

The reasons for the formation of fecal obstruction in the intestine can be divided into two groups: organic and functional. The latter, in turn, are divided into spastic and atonic types.

A spasm of the anal sphincter, resulting from hemorrhoids or anus fissure, can cause a fecal blockage in the intestines. Also, such consequences can lead to an ulcerative process in the sigmoid colon, accompanied by its spasm, nephrolithiasis, chronic cholecystitis, appendicitis and other diseases.

Atonic constipation, which can turn into fecal blockage in the intestines, is observed during pregnancy, as well as with toxic damage to the intestines, for example, with typhoid fever.

Organic causes of fecal obstruction are more common in practice. They consist in certain changes in the intestines and its ligaments. Such changes include deformation of the peritoneum, which affects the size of the intestinal lumen, scarring, shortening of the mesentery, the formation of spurs and kinks, and other disorders that slow down and prevent the normal movement of feces through the intestines.

In most cases, the localization of the fecal plug is the large intestine. Most often, such changes occur over the age of 40-50 years. In some cases, the formation of a blockage may be associated with the postoperative period, forced lying position. Sometimes intestinal obstruction occurs when swallowing any small objects, such as fruit seeds.

Fecal blockage: symptoms

The main symptoms of fecal blockage are: stool retention for several days, weakness, nausea, headaches, discomfort in the abdomen, bloating, vomiting and rare scant liquid feces can be observed. The onset of the disease is not acute, the development is gradual. In the first days, abdominal pains are weak, paroxysmal, in the future they become stronger and become permanent.

On palpation, the doctor can feel a dense shaft in the abdominal cavity. If a fecal stone is formed in the rectum, then it is palpated through the anus. In some cases, X-ray examination is used for diagnosis.

In cases where the formation of fecal obstruction in the intestine is caused by some disease (cholecystitis, peptic ulcer, appendicitis, volvulus, etc.), it is much more difficult to make a diagnosis.

Fecal blockage: treatment

Treatment of fecal obstruction can be conservative and surgical. The first method is used much more often, it is aimed at the evacuation of fecal stone in a natural way. If this is not possible, a surgical operation is performed, as a result of which the blockage of feces is eliminated. The complexity of the treatment lies in the fact that the stretched intestinal wall is easily damaged, which can lead to complications.

Fecal blockage - what to do?

When deciding what to do with a fecal blockage, you must strictly refuse to take laxatives, as they can lead to a worsening of the situation. Enemas in such cases should also be used with great care and only after consulting a specialist. Rash actions can lead to injuries of the intestinal walls.

With symptoms of fecal blockage, it is better to consult a doctor. As already mentioned, most often fecal stones are localized in the large intestine. In this case, the doctor carefully crushes and removes fragments of the stone through the anus. Previously, to facilitate the procedure, the patient is given sedatives and painkillers. At the end of the removal of the stone, the patient is given a siphon enema to remove all remaining elements of the fecal blockage.

After that, within 7-10 days, constipation should be prevented, which consists in following a diet and conducting cleansing enemas.

Enema and fecal blockage

One of the methods of getting rid of fecal blockage is an enema. However, it must be used with extreme caution. If the patient has pronounced symptoms of a formed fecal stone, then it is better to go to the doctor for treatment. Enema is used more often as a remedy for the prevention of fecal blockage in chronic constipation. For such cases, there are several types of this procedure:

1. Ready enema with Enimax . This procedure can be carried out with constipation and fecal blockages twice a day.
2. Introduction of Norgalax with a small enema. The procedure facilitates the act of defecation, is used for hemorrhoids, anal fissures, intestinal obstruction.
3. Enema with herbs. Soothes, relieves abdominal pain and facilitates bowel movements.
4. Oil enema. It is placed twice a day - in the morning and evening hours.

Fecal blockage in a child

The causes of fecal blockages in a child may be a violation of intestinal motility, congestion in it, accompanied by increased fluid absorption. A fecal blockage may appear against the background of some pathologies, such as chronic atonic constipation, abnormalities in the development of the intestine, and so on.

Fecal stones may not manifest themselves for some time. Then the baby has mild pain in the abdomen of a spastic nature. With a long stay in the intestine, the obstruction can grow and lead to complete or partial obstruction.

If you suspect a fecal blockage in a child, you should immediately seek medical help. If this pathology is formed against the background of congenital anomalies in the development of the intestine, then urgent hospitalization is required and, possibly, surgical removal of stones, followed by correction of the underlying pathology. Conservative treatment usually consists of an enema and medication.

Long-term constipation can cause various complications: secondary colitis, proctosigmoiditis (inflammation of the sigmoid and rectum).

With prolonged stagnation of the contents in the caecum, it may be thrown back into the small intestine with the development of enteritis (reflux enteritis). Constipation can be complicated by diseases of the biliary tract, hepatitis.

Prolonged constipation contributes to the appearance of various diseases of the rectum. Most often, hemorrhoids occur, as well as rectal fissures, inflammation of the perirectal tissue (paraproctitis).

Sometimes they cause the colon to expand and lengthen (acquired megacolon), which makes constipation even more stubborn.

The most formidable complication of prolonged constipation is cancer of the rectum and colon. There is an opinion that the stagnation of contents in the intestines caused by the use of foods poor in dietary fiber leads to a large concentration of carcinogenic (cancer-promoting) substances formed in the intestines and their long-term effect on the intestinal wall. Alarming symptoms that make it possible to suspect the possibility of a tumor of the colon are general poor health, weight loss, the recent appearance of constipation in people over 50 years old, whose stools were normal before, blood in the stool.

fecal blockage

Finally, about such a very unpleasant phenomenon as a fecal blockage. This condition occurs quite frequently in the elderly and in the mentally ill. This complication of constipation occurs when older people, especially those who are poorly groomed, forget the time of the last bowel movement and stop monitoring its regularity. The matter is complicated by the fact that around the fecal stone formed and gradually compacted in the rectum, there are long gaps between it and the walls of the intestine, through which liquid feces pass; the patient imagines that he has diarrhea, and he begins to treat it with home remedies, which, of course, only aggravates the process. Partial obstruction of the rectum sets in, abdominal pains appear, appetite disappears, belching, nausea, and vomiting appear. When examining such patients with a finger, the lower pole of the fecal lump of stony density is usually reached. Usually, the elderly patient has concomitant heart or lung failure or other serious health problems, so the treatment of fecal blockage is difficult. First of all, no laxatives; they must be used earlier, and in the described condition they can only lead to an increase in intestinal obstruction. Enemas will also not help: the enema tip usually cannot freely penetrate above the stone, they cannot be blindly used to crush the stone because of the risk of injury to the intestinal wall. It is necessary with a hand and a thick rubber glove, having well lubricated the index finger with ointment, to begin careful and gradual crushing of the distal part of the stone, removing its freed fragments. The position of the patient on his side (preferably on the left, if there are no pronounced cardiac disorders) with knees bent and legs pressed to the stomach. Usually this manipulation is possible without much difficulty, because, as a rule, in such patients, the tone of the anal sphincter is lower and the anus almost gapes. Nevertheless, this procedure is lengthy and, to put it mildly, uncomfortable for the patient, therefore, in such cases, sedatives or painkillers are preliminarily prescribed. When the most dense distal sections of the stone are crushed, the rest, its upper parts are removed much easier and at the end either an independent, very abundant bowel movement begins, or a siphon enema should be performed. Having resolved the fecal blockage, the patient or his relatives are explained the measures to prevent stool retention (weekly cleansing enemas are best), because if you limit yourself to extracting the fecal stone (stones), then everything will start all over again.

Many medical professionals do not pay due attention to this problem, especially in chronically ill and elderly people, considering this state of affairs to be quite natural, almost the norm. In fact, a violation of the excretory function of the intestine significantly worsens the patient's condition, his quality of life, leads to great complications. This is especially true for cancer patients, in whom constipation can be complicated by acute intestinal obstruction, which is not always possible to eliminate even surgically.

They call it constipation chronic delay in bowel movements (from the rectum or from a colostomy *) for more than 48 hours, which is accompanied by difficulty in the act of defecation, tension, pain and separation of a small amount of feces, increased hardness. (A.V. Frolkis, 1991; A.L. Grebenev, L.P. Myagkova, 1994).

WHAT IS CONSTIPATION?

Constipation – this is a consequence of a violation of the processes of formation of feces and their movement through the intestines.
Chronic constipation can be not only a sign of diseases of the colon and anorectal region, but also a manifestation of a number of extraintestinal diseases.
In the practice of a family doctor and a family nurse, the following types of constipation may occur:
- due to improper, malnutrition, lack of vegetable fiber in food, the use of refined foods that are completely soluble in water.

TYPES OF CONSTIPATION

♦ Neurogenic constipation associated with dysregulation of intestinal motility in duodenal ulcer, nephrolithiasis, cholelithiasis, diseases of the genital area. Neurogenic constipation occurs with multiple sclerosis, cerebrovascular accident, with tumors of the brain and spinal cord.
♦Psychogenic constipation it happens, if necessary, to perform an act of defecation in an unusual environment, in a lying position, on a ship. This type of constipation can be observed in mental illness, drug addiction.
♦Proctogenic constipation- can be with diseases of the anorectal region and rectum (hemorrhoids, anal fissures, cryptitis, paraproctitis).
♦ functional constipation with irritable bowel syndrome - due to hypertonicity (spasm) of the sphincters of the colon, especially - its distal sections.
♦ toxic constipation occurs with chronic poisoning with thallium, mercury, lead; against the background of long-term use of narcotic analgesics (codeine), diuretics (trifas, furasemide), antispasmodics (baralgin, No-shpa), etc.
♦Constipation in endocrine diseases- myxedema (slowdown of intestinal motility), diabetes mellitus (dehydration), pheochromocytoma, menopause, etc.
♦ "senile constipation" in the elderly, it is associated with hypodynamia, weakening of voluntary muscles, intestinal atony, endocrine disorders, mental inferiority.
♦ Constipation associated with an abnormal development of the colon- with Hirschsprung's disease, elongated sigmoid colon (megacolon), etc.
♦ Constipation as a manifestation of irritable bowel syndrome (IBS).
(A.V. Frolkis, 1979; N.D. Opanasyuk, 2002).

The disease of civilization, or why is it dangerous?

Constipation causes painful sensations due to intoxication. Patients suffering from constipation complain of rapid fatigue from their usual work, bad taste and smell from the mouth, loss of appetite, nausea, and bloating. Non-gastroenterological manifestations often significantly reduce the quality of life of patients: migraine-like headache, sensation of a coma in the throat when swallowing, dissatisfaction with inhalation, inability to sleep on the left side, chilliness of the hands, frequent urination, sleep disturbance. With chronic constipation, the skin becomes unhealthy, yellowish with a brownish tint, and turgor decreases. The tongue is covered with a dirty-looking coating.

With frequent and prolonged use of laxatives, signs of dehydration and hypovitaminosis are observed.
Lingering in the rectum, the feces gradually thicken and during defecation injure the mucous membrane of the anal canal. Anal fissures, ulcers, hemorrhoids are common complications of chronic constipation.
With constipation, “sheep” feces, “pencil” stools, “cork-like” stools, characterized by the release of dense, shaped feces at the beginning of defecation, and later on, mushy and even watery feces, can be noted.
With IBS, a fairly frequent complaint is the excretion of mucus with feces. The problem of constipation exists in 50% of hospitalized patients with generalized forms of cancer and 75-80% of patients observed at home (T. Orlova, 2008). Namely, patients observed at home, including oncological ones, deliver certain troubles to the family doctor and family nurse.

CAUSES OF CONSTIPATION

The causes of constipation in cancer patients are largely similar to those listed above, although they are associated with the presence of a local tumor. It:
♦ The presence in any part of the intestine of a tumor formation or adhesions that mechanically prevent the movement of feces.
♦ Immobility of the patient due to neurological disorders (paralysis), lymphostasis of the lower extremities, general weakness, cancer cachexia.
♦ Taking painkillers that depress intestinal motility (tramal, codeine, opiates, antispasmodics, antidepressants, antipsychotics, etc.).
♦ Violation of the psycho-emotional sphere - depression.
♦ Diseases of the perineum, etc.
The motor activity of the intestine has its own physiological characteristics, which should be taken into account in the prevention and treatment of constipation. Peristaltic contractions of the intestine normally have a pendulum type of movement, which contributes to better mixing of food, better contact with intestinal bacteria and digestion. Five to six times a day, a wave of longitudinal contractions occurs in the intestine, moving its contents to the exit. One of the strongest peristaltic waves occurs in the morning, the other at lunchtime. Knowing this, these periods should be used to put the patient on a ship or bedside chair, use rectal suppositories and enemas, and manually evacuate feces from the rectum.

A certain delicacy is required from the family nurse and, at the same time, sufficient certainty in clarifying some important issues, such as:
♦ What does the patient mean by “constipation”?
♦ Was there a tendency to constipation prior to the present illness?
♦ When was the last time you had a chair?
♦ What was the nature of the stool (fecal stones with fecal blockage, "ribbon" stools with tumors, "sheep feces" with chronic constipation, etc.).
♦ How hard did you have to push and was it painful to have a bowel movement?
♦ Did the patient feel the urge to defecate (in debilitated patients, the urge is absent)?
♦ Whether after a bowel movement there is a feeling of complete emptying of the bowels and satisfaction (in debilitated patients there may be a partial emptying with a feeling of dissatisfaction).
♦ Are there any pathological impurities in the feces: mucus, blood, undigested residues, etc.?
♦ If there is an admixture of blood, then when: at the beginning of defecation or at the end of it (differentiation between hemorrhoids and tumor of the rectum)?
Cancer patients have complaints indicating constipation:
♦ loose stools with a persistent feeling of incomplete emptying of the intestine is possible with a developed fecal blockage;**
♦ urinary incontinence is often the result of fecal blockage due to the anatomical proximity of the rectum and bladder;
♦ nausea and vomiting, unexplained by other causes;
♦ Pain along the colon.

When examining patients, attention should be paid to the characteristic general symptoms caused by intoxication: headache, general weakness, irritability, absent-mindedness, loss of appetite, specific fecal odor from the mouth, plaque on the mucous membrane of the oral cavity and tongue.
Nursing care for constipation aims to restore and maintain the excretory function of the intestine.
In doing so, the following steps should be taken:
♦ promote the maximum possible physical activity of the patient, using elements of physiotherapy exercises and massage;
♦ explain to the patient and his relatives the need for fluid intake at the level of 2.5–3.0 liters per day;***
♦ to develop a high-fiber diet for the patient (variety of cooked vegetables and fruits, cereals);****
♦ Anticipate constipation as a side effect of medications (opiates, etc.) by prescribing accompanying therapy in the form of laxatives;
♦ Decide together with the patient what may be acceptable to him, talking about the various ways to eliminate constipation, passing on knowledge about the physiology of the intestine;
♦ for diseases in the perineal region (anus fissures, exacerbation of hemorrhoids) to treat them promptly and thoroughly, understanding that, experiencing pain during defecation, the patient will slow it down;

♦ to give the patient the opportunity to independently cope with the problem (privacy, the creation of favorable conditions for the administration of physiological needs, etc.), which will spare his sense of shame and dignity.

Treatment for constipation

To restore and maintain the evacuation function of the intestine, it is often necessary to prescribe laxatives of various groups, cleansing and laxative enemas. In the absence of contraindications from the rectum, oil and hypertonic enemas are used as laxatives.
An oil enema coats and erodes the stool; for its setting, 100-200 ml of vaseline or vegetable oil heated to body temperature, a pear-shaped balloon and a gas outlet tube are required. Putting on rubber gloves and a protective apron, warm oil is drawn into the cylinder, and the gas outlet tube is lubricated with petroleum jelly. The patient is helped to lie on the left side with the legs bent and brought to the stomach. Having parted the buttocks, a gas outlet tube is inserted into the rectum to a depth of 15-20 cm, a cylinder of oil is attached to the tube and slowly inserted into the intestinal cavity.
An oil enema is usually given at bedtime. It is desirable that the foot end of the bed be slightly raised until morning. After a similar procedure in the morning of the next day, there is usually a stool.
Hypertonic enema designed for faster results. Its formulation is similar to the previous description, only instead of oil, 50–100 ml of a 10% solution of sodium chloride (a tablespoon per glass of water) or 20–30% magnesium sulfate (magnesia) solution is introduced. The patient is asked to force the will to keep the liquid in the intestines for 20-30 minutes, after which they lay a vessel or help to sit on the toilet.
In medical practice, laxative enemas (oil and hypertonic) are often used in debilitated patients, for whom the "classic" cleansing enema may be too tiring. However, in some cases it is necessary and can be applied with a modification of the technique applicable to a seriously ill patient. The idea is to introduce water into the intestine retrograde, proximal to the feces.
The patient is laid on a bed covered with an oilcloth hanging in a basin. Position - on the left side with legs bent at the knees. A thin polyvinyl chloride tube (Folley type urethral catheter No. 20, a tube from an infusion system) with a rounded end to avoid trauma to the mucous membrane (it can be gently burned on fire) is inserted into the rectum at least 20 cm. holes.
A tube, previously lubricated with petroleum jelly, is inserted with screwing movements without much effort. The tip of the Esmarch mug is connected to the tube by means of an adapter or adapter and the valve opens. The jet of water should not be very fast, so as not to cause pain. If water does not enter the intestines, it is necessary to raise the mug higher and move the catheter. After the introduction of water, close the valve, carefully remove the catheter and give the patient a vessel. A cleansing enema can be considered successful if, after a while, feces come out with water.
To eliminate constipation in oncological practice, the drugs of the following groups are most often used:
♦ contributing to an increase in the volume of feces (forlax);
♦ osmotic laxatives that attract liquid into the intestinal lumen (drugs based on lactulose - dufalk, normase, magnesia);
♦ stimulants of peristalsis of the large intestine (sena preparations, bisacodyl, guttalax);
♦ softening stools and stimulating peristalsis of the lower intestines (suppositories with glycerin, bisacodyl).

Forlax when taken orally, it retains the volume of fluid contained in the intestine, which leads to increased peristalsis and restoration of the defecation reflex. The laxative effect most often occurs 24-48 hours after ingestion.
Start using 2 sachets 2 times a day. The contents of the sachet should be dissolved in a glass of water, but debilitated patients, as a rule, refuse to drink four glasses of the solution a day, and therefore have to be content with two glasses (a glass in the morning and evening) of greater concentration. With the appearance of a chair, they switch to a maintenance dose (two sachets per day) with a gradual replacement with drugs from other groups of laxatives against the background of measures that promote independent intestinal motility (see above).
Osmotic laxatives mobilize water into the intestines through high osmotic pressure; fecal masses are liquefied, peristalsis is stimulated. A representative of this group, dufalk is used at a dose of 15-30 ml 2-3 times a day before meals. If necessary, the daily dose can be increased to a maximum - up to 180 ml in three divided doses. When the effect occurs, they switch to a maintenance dose - 10 ml 2 times a day before meals. The drug is not used in diabetes mellitus, in any case - in disorders of carbohydrate metabolism.
Magnesia(magnesium sulfate) or "bitter salt" is used at a dose of 10-30 g dissolved in half a glass of water at night or 20 minutes before meals. The bitterness of this remedy is offset by the expected result.
Tableted drugs based on sena leaves (senadexin, senade) stimulate intestinal motility, and therefore spastic pains in the abdomen are possible, which can cause a negative reaction from patients. Usually taken at bedtime - up to 3 tablets. The effect comes in 6-10 hours.
Bisacodyl(5 mg per tablet) when taken orally, it works after 5-7 hours. The initial single dose is 1-2 tablets at bedtime, with insufficient effect and good tolerance - up to 3 tablets.
In cases where it is difficult for patients to swallow tablets, it is convenient guttalax. It is used as a solution of 10-15 drops in a small amount of water in the morning or evening. If necessary, you can increase the dose to 25 drops. The effect comes in 6-10 hours.
Rectal sve chi (suppositories), like enemas, are best inserted into the rectum after breakfast or after dinner, adapting to the rhythm of the reflex activity of the intestine. One or two candles are advanced to a height of p the fingertips of a gloved hand; action develops within an hour.

The fight against constipation requires great patience, a certain delicacy and knowledge. The nurse should often discuss with the doctor the maximum allowable doses of laxatives and the sequence of their use.

Treatment of fecal blockage

Fecal blockage is the accumulation of dense feces in the rectum, which cannot be evacuated by the efforts of the body, despite the fact that a significant amount of fluid is released from the walls of the injured intestine into its lumen. Patients suffer from tenesmus (painful urge to defecate), but only a small amount of liquid feces, resembling diarrhea, is excreted, and normal defecation does not occur. Over time, the feces "clump" into fecal stones. With a digital examination of the rectum, the presence of a fecal blockage is established by a doctor or nurse without much difficulty.
Quite often, the only possible way to eliminate fecal obstruction may be digital (manual) removal of fecal stones from the rectum. The technique of such removal is simple: having received the patient's prior consent to the manipulation, he is placed on his left side with half-bent legs, placing a diaper under the buttocks, which then it will not be a pity to throw it away. Hands of a nurse in gloves. With the fingers of the left hand, the nurse spreads the buttocks of the patient and inserts the forefinger of the right hand, richly lubricated with vaseline, into the rectum. The movement is slow, "screwing". We must try not to hurt the patient. When fecal stones are found behind the sphincter, they put a finger behind the upper pole of the stone and, using the finger as a hook, remove the stone out.
If the fecal stone is large and cannot be divided into fragments, an oil enema should be given for several hours, after which it will be easier to remove it in parts.
With constipation, it is important to remember about intestinal obstruction, which can be acute, i.e. arising suddenly, and chronic, when it develops gradually or is manifested by repeated attacks of relative obstruction (intermittent obstruction).
The nurse must remember that chronic intestinal obstruction is manifested by periodic constipation with bloating, cramping abdominal pain. In the period of resolution of intestinal obstruction, diarrhea with copious liquid stools is observed, which is again replaced by constipation (a very characteristic syndrome in colon cancer!).
According to the mechanism of pathogenesis, intestinal obstruction can be mechanical (tumors, adhesions, volvulus, etc.) and dynamic, which is based on impaired intestinal motility, especially with asthenia in patients, the use of potent analgesics, antispasmodics, etc.
An important symptom of intestinal obstruction is the delay in the release of intestinal gases and feces. The pain, at first episodic, cramping, later becomes constant, excruciating. Patients to reduce pain take a forced position on their haunches or on all fours. There is bloating, muscle tension. The tongue becomes dryish, lined with a whitish-dirty coating, fecal smell from the mouth. Vomiting with an admixture of feces is a late and formidable sign!
If you suspect developing intestinal obstruction, you should stop taking all laxatives, cancel enemas and urgently consult a doctor!

Want to know more - read:

1. T. Orlova. Constipation in cancer patients//Nursing, M. No. 5, 2008, pp. 44-47.
2. N. Opanasyuk. Constipation: differential diagnosis, modern approaches to treatment. doctor. Journal for practicing physicians//№2, 2002. P.26-29
3. A.N. Okorokov “Treatment of diseases of internal organs. Practical hand-in 3 t. T1 - 2nd ed. revised and additional 1998, art. 400-402.
_________________________________________________________________________________________
Note.
◊ Colostomy ("kolon" - large intestine, "stoma" - passage) - an opening in the intestine, surgically formed from a part of the large intestine on the anterior abdominal wall and designed to expel intestinal contents.
** With confusion and the impossibility of productive contact with the patient, the presence of loose stools in him always requires the exclusion of fecal obstruction.
***Recommended volumes are not always achievable for debilitated patients; you should insist on at least one and a half liters per day.
**** For constipation, diet No. 3 is used, the purpose of which is to provide good nutrition and help normalize the act of defecation. For more details, see A.N. Okorokov “Treatment of diseases of internal organs: Prakt. hand-in, 3 vols., T1 - 2nd ed. revised and supplementary, 1998, pp. 400-402.

Victor DARCHINOV
Oncologist, Cherkasy Oncology Center

Bowel problems are very common these days. One of them is intestinal obstruction - a serious condition, in the acute stage of which the intervention of surgeons is necessary. The earliest harbinger of the disease is pain: it begins suddenly, at any time, for no apparent reason. Less often, the pain increases little by little, and after a certain period of time becomes intense.

What is intestinal obstruction?

Intestinal obstruction is the impossibility of the physiological nature of the passage of stool to the anus. The process of natural emptying of the rectum becomes difficult, the discharge of gases stops, and fecal blockages form. Symptoms become more pronounced as the condition worsens. The source of problems is irregular stools: it is correct if a person empties once a day. In the event that signs appear that signal obstruction, you should consult a doctor.

Causes of obstruction

Obstruction in the intestine develops under the influence of various reasons, which are divided into two categories: functional and mechanical. The development of a disease of a mechanical type is facilitated by such factors as an increase in the length of the sigmoid colon, the presence of pockets of the peritoneum, a mobile caecum, and adhesions. Functional obstruction develops against the background of overeating after fasting, a sharp increase in fresh fruits, the transfer of newborns to adapted mixtures up to a year.

Mechanical

The mechanical causes of the disease, which noticeably poisons the existence of the patient:

• hematoma;
• failures in the formation of the intestine;
• failures in the structure of the peritoneum;
• gall and fecal stones;
• vascular ailments;
• inflammation;
• neoplasms (cancer or benign);
• oncology;
• bowel obstruction;
• adhesions;
• hernia;
• cords of the peritoneum of the congenital type;
• the entry of foreign elements into the intestines;
• decrease in the intestinal lumen.

Functional

Functional reasons for the development of obstruction are also known. Their list usually depends on the associated problems, but a short version of it looks like this:

• paralytic phenomena;
• spasms;
• disruptions in intestinal motility.

Symptoms and signs of bowel obstruction

According to doctors, if an intestinal obstruction is suspected, the patient should be taken to the hospital as soon as possible. So the prognosis will be favorable. Violation can be corrected without surgical intervention in some cases. Obvious signs of the onset of the disease are the impracticability of the discharge of feces and gases. In the case of partial obstruction or obstruction of the upper intestines, scanty stools and a slight discharge of flatus are observed. There are symptoms such as repeated vomiting, irregular shape and.

There are also specific symptoms that can only be detected by a specialist, which is why the patient's early hospitalization is so important. If you do not start treating the patient on time, then the risk of developing dangerous consequences increases, including cardiac disorders, liver and kidney failure, and death. In the case of squeezing of the vessels, necrosis of the intestine develops. Even an operation (if the case is advanced) may not save the patient.

The most dangerous conditions include intestinal obstruction in infants. Therefore, it is important for moms and dads to know the symptoms that should cause concern:

• significant weight loss due to fluid loss,
• vomiting with an admixture of bile that appears after eating,
• grayish skin tone of a child,
• temperature,
• swelling of the upper abdomen.

A calm baby may refuse to eat, become restless and moody. Then you need to immediately call a doctor.

Video: How to get rid of intestinal obstruction at home?

The topic of the video below is a symptom of constipation and what it can threaten. Constipation can be indicative of many serious illnesses, including obstruction or Hirschsprung's disease.

Photo of intestinal obstruction

Fecal blockage is a condition quite often occurs in the elderly and in mental patients. This complication of constipation occurs when older people, especially those who are poorly groomed, forget the time of the last bowel movement and stop monitoring its regularity. The matter is complicated by the fact that around the fecal stone formed and gradually compacted in the rectum, there are long gaps between it and the walls of the intestine, through which liquid feces pass; the patient imagines that he has diarrhea and begins to treat it with home remedies, which, of course, only aggravates the process. Partial obstruction of the rectum sets in, abdominal pains appear, appetite disappears, belching, nausea, and vomiting appear.

When examining such patients with a finger, the lower pole of the fecal lump of stony density is usually reached. Usually in this case, the elderly patient has concomitant heart or lung failure or other serious health disorders, so that the treatment of fecal blockage is difficult.

What to do with fecal blockage

First of all - no laxatives; they had to be taken earlier, and with a fecal blockage, they can only lead to an increase in intestinal obstruction. Enemas will also not help: the enema tip usually cannot freely penetrate above the stone, they cannot be blindly used to crush the stone because of the risk of injury to the intestinal wall.

All this is known to experienced proctologists, and they know what to do. The doctor with a hand in a thick rubber glove, having well lubricated the index finger with ointment (posterized, etc.), begins a careful and gradual crushing of the distal part of the stone, removing its freed fragments. The position of the patient on his side (preferably on the left, if there are no pronounced cardiac disorders) with knees bent and legs pressed to the stomach. Usually this manipulation is possible without much difficulty, because, as a rule, in such patients, the tone of the anal sphincter is reduced and the anus almost gapes. Nevertheless, this procedure is lengthy and, to put it mildly, uncomfortable for the patient, therefore, in such cases, sedatives or painkillers are prescribed orally beforehand. When the most dense distal sections of the stone are crushed, the rest, its upper parts are removed much more easily and at the end either an independent, very abundant and fetid defecation begins, or a siphon enema should be performed.

It is necessary to observe measures to prevent stool retention (weekly cleansing enemas are best), because if you limit yourself to extracting fecal stone (stones), then everything will start all over again.

"What is a fecal blockage, what to do with a fecal blockage" - an article from the section