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{{Bowel obstruction}}
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==Overview==
The hallmark of bowel obstruction is [[abdominal distension]] with waxing and waning pain and [[Constipation|obstipation]]. A positive history of previous abdominal surgery and abdominal adhesion is suggestive of bowel obstruction. The most common symptoms of bowel symptoms include [[abdominal pain]] with [[Nausea and vomiting|nausea]] and [[Nausea and vomiting|vomiting]], [[abdominal distension]], and [[Constipation|obstipation]]. Common symptoms of bowel obstruction include episodic [[pain]], [[abdominal distension]], and [[constipation]]. Less common symptoms of bowel obstruction include constant severe pain, sudden severe [[pain]], and [[postprandial]] abdominal discomfort.


==History and Symptoms==
==History and Symptoms==
Depending on the level of obstruction, bowel obstruction can present with [[abdominal pain]], [[abdominal distension]], [[vomiting]], [[fecal vomiting]], and [[constipation]].
===History===
Patients with bowel obstruction may have a positive history of:<ref name="pmid3296252">{{cite journal |vauthors=Mucha P |title=Small intestinal obstruction |journal=Surg. Clin. North Am. |volume=67 |issue=3 |pages=597–620 |year=1987 |pmid=3296252 |doi= |url=}}</ref><ref name="pmid11036136">{{cite journal |vauthors=Miller G, Boman J, Shrier I, Gordon PH |title=Etiology of small bowel obstruction |journal=Am. J. Surg. |volume=180 |issue=1 |pages=33–6 |year=2000 |pmid=11036136 |doi= |url=}}</ref>
*Previous abdominal surgery
*[[Crohn's disease]]
*[[Hernia]]
*Foreign body ingestion
*[[Colorectal cancer]]
 
===Common Symptoms===
Common symptoms of bowel obstruction include:<ref name="pmid23758299">{{cite journal |vauthors=Taylor MR, Lalani N |title=Adult small bowel obstruction |journal=Acad Emerg Med |volume=20 |issue=6 |pages=528–44 |year=2013 |pmid=23758299 |doi=10.1111/acem.12150 |url=}}</ref><ref name="pmid3415100">{{cite journal |vauthors=Cheadle WG, Garr EE, Richardson JD |title=The importance of early diagnosis of small bowel obstruction |journal=Am Surg |volume=54 |issue=9 |pages=565–9 |year=1988 |pmid=3415100 |doi= |url=}}</ref>
*Paroxysmal [[abdominal pain]]
*[[Abdominal distension]]
*[[Nausea and vomiting|Nausea]]
*[[Nausea and vomiting|Vomiting]]
*[[Constipation|Obstipation]]
*[[Constipation]]


Obstruction may be due to causes within the bowel lumen, within the wall of the bowel, or external to the bowel (such as compression, entrapment or [[volvulus]]).
===Less Common Symptoms===
Less common symptoms of bowel obstruction include:<ref name="pmid11084840">{{cite journal |vauthors=Tamijmarane A, Chandra S, Smile SR |title=Clinical aspects of adhesive intestinal obstruction |journal=Trop Gastroenterol |volume=21 |issue=3 |pages=141–3 |year=2000 |pmid=11084840 |doi= |url=}}</ref>
*Constant severe pain - indicates [[Peritonitis|peritoneal irritation]]
*Sudden severe pain - indicates [[Gastrointestinal perforation|bowel perforation]]
*[[Postprandial]] abdominal discomfort - may suggest chronic bowel obstruction


In small bowel obstruction the pain tends to be colicky (cramping and intermittent) in nature, with spasms lasting a few minutes. The pain tends to be central and mid-abdominal. Vomiting occurs before constipation.
===Nature of pain in bowel obstruction===
====Small bowel obstruction====
*In small bowel obstruction the pain tends to be [[Colicky flank pain|colicky]] ([[cramping]] and intermittent) in nature, with [[spasms]] lasting a few minutes.  
*The [[pain]] tends to be central and mid-abdominal.  
====Large bowel obstruction====
*In large bowel obstruction the [[pain]] is felt lower in the abdomen and the [[spasms]] last longer.  


In large bowel obstruction the pain is felt lower in the abdomen and the spasms last longer. Constipation occurs earlier and vomiting may be less prominent. Proximal obstruction of the large bowel may present as small bowel obstruction.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 15:52, 27 February 2018

Bowel obstruction Microchapters

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Overview

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Natural History, Complications and Prognosis

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History and Symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

The hallmark of bowel obstruction is abdominal distension with waxing and waning pain and obstipation. A positive history of previous abdominal surgery and abdominal adhesion is suggestive of bowel obstruction. The most common symptoms of bowel symptoms include abdominal pain with nausea and vomiting, abdominal distension, and obstipation. Common symptoms of bowel obstruction include episodic pain, abdominal distension, and constipation. Less common symptoms of bowel obstruction include constant severe pain, sudden severe pain, and postprandial abdominal discomfort.

History and Symptoms

History

Patients with bowel obstruction may have a positive history of:[1][2]

Common Symptoms

Common symptoms of bowel obstruction include:[3][4]

Less Common Symptoms

Less common symptoms of bowel obstruction include:[5]

Nature of pain in bowel obstruction

Small bowel obstruction

  • In small bowel obstruction the pain tends to be colicky (cramping and intermittent) in nature, with spasms lasting a few minutes.
  • The pain tends to be central and mid-abdominal.

Large bowel obstruction

  • In large bowel obstruction the pain is felt lower in the abdomen and the spasms last longer.


References

  1. Mucha P (1987). "Small intestinal obstruction". Surg. Clin. North Am. 67 (3): 597–620. PMID 3296252.
  2. Miller G, Boman J, Shrier I, Gordon PH (2000). "Etiology of small bowel obstruction". Am. J. Surg. 180 (1): 33–6. PMID 11036136.
  3. Taylor MR, Lalani N (2013). "Adult small bowel obstruction". Acad Emerg Med. 20 (6): 528–44. doi:10.1111/acem.12150. PMID 23758299.
  4. Cheadle WG, Garr EE, Richardson JD (1988). "The importance of early diagnosis of small bowel obstruction". Am Surg. 54 (9): 565–9. PMID 3415100.
  5. Tamijmarane A, Chandra S, Smile SR (2000). "Clinical aspects of adhesive intestinal obstruction". Trop Gastroenterol. 21 (3): 141–3. PMID 11084840.

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