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Obstruction is a condition in which the movement of food through the intestines is disrupted. By clinical symptoms distinguish between acute and chronic course diseases. According to the method of development of pathology, medicine also distinguishes between two types: dynamic and mechanical.

general information

In childhood(NC) accounts for about 2% of all surgical diseases. There is a distinction between congenital and acquired conditions, accounting for 25% and 75% respectively.

Among adults the disease occurs in 1.5-2 cases per 10 thousand people, which is 1.38% among all surgical pathologies.

Among acute diseases of surgical diseases, the percentage of the disease among adults is 4.50%. NK affects middle-aged people, especially men in a ratio of 3:1.

In medicine, types of disease are divided into:

• Etiologies – congenital or acquired form of the disease;
• The cause is mechanical and dynamic, which is of two types - spastic and paralytic;
• Factors of dysfunction of the mesenteric root, the vessels of which feed the intestine. They can be compressive (strangulation), non-compressive (obstructive) and combined;
• Clinical development– acute, subacute, complete, partial and chronic forms.

Causes

The causes of the mechanical form in adults include the following disorders:

The dynamic stage develops according to the following reasons:

• Reflex disorders of the gastrointestinal tract affecting motor function intestines;
• Impaired functioning of the central nervous system;
• Acid-base and electrolyte balance.

Can cause intestinal obstruction adhesions and adhesions after abdominal operations And inflammatory processes.

The disease can develop in case of poor nutrition, increased peristalsis, compression of the intestine with increased pressure inside abdominal cavity.

CI in children most often develops due to mechanical obstacles. Less commonly, this surgical disease is associated with disorders motor ability intestines.

In children, the disease can be of two types - congenital or acquired.

The causes of congenital pathology include abnormalities in the development of the esophagus.

The reasons for the acquired form are much more varied. Depending on the causes, the disease is divided into two forms - mechanical and dynamic.

The latter develops in two forms when it occurs long-term stress organ or vice versa, paralytic, when complete relaxation of the walls occurs. Key reasons development of intestinal obstruction are:

• Postoperative complications;
• Consequences and complications after taking medicines;
• Complications after inflammation of the appendix.

The main reasons for the development of the mechanical form include:

• Adhesive process;
• Compression of an organ by a tumor;
• Hit foreign body;
• Blockage with food bolus or worms;
• Prolonged fasting and intake large quantity food after;
• Integration of one intestine into another due to the underdevelopment of the peristalsis mechanism (occurs in children under 10 months).

Most common in children acute course diseases, in addition to variants of congenital pathology.

In pregnant women All forms of intestinal obstruction occur, but most often there is an acute form, expressed in volvulus small intestine. Reasons contributing to the development of intestinal obstruction include:

• Adhesive processes after abdominal operations and inflammatory processes;
• Long mesentery;
• Internal hernia;
• Pathologies in the development of the gastrointestinal tract;
• Neoplasms;
• Growing uterus.

In pregnant women, the disease develops in the second trimester or during childbirth.

Classification of the disease

The causes of CI and the variety of forms create some difficulties in diagnosing the surgical disease. Based clinical manifestations disease, in medicine there are two types of its course - acute obstruction, which is the most common form and chronic form, which is quite rare.

The mechanism of development of the disease determines all its varieties.

Dynamic intestinal obstruction often occurs in older people and patients with acute heart attack myocardium, with acute pancreatitis, after undergoing abdominal surgery.

Dynamic disease There are two types - spastic and paralytic.

CN is divided into obstructive, when the passage to the intestine is blocked by feces, gallstones or a foreign body, and strangulation, which occurs due to strangulation, volvulus, nodes and compressive vessels of the mesentery. Mechanical form has diseases mixed signs, therefore refers to the mixed form.

Intestinal obstruction is classified according to the degree of clinical manifestations:

• Full CI – expressed by the completeness of symptoms;
• Partial– with less severe symptoms, since the organ is not completely blocked and continues to function.

In addition, in the dynamics of the development of the disease, three stages are distinguished, in the event that help is not possible in the first or second stages.

• Non-reflexive stage. It lasts from 6 to 12 hours. Manifested by cramping pain, rumbling, increased peristalsis, vomiting, stool retention;
• Intoxication stage. The form is characterized by a change in symptoms - a decrease in pain, but its nature becomes constant, increased vomiting, tachycardia, decreased blood pressure;
• Stage of peritonitis. It occurs within 24 hours and manifests itself as severe intoxication of the body. The patient begins to vomit, the masses of which have the smell of feces, there is a painful bloated belly, increased heart rate contraction, sharpening of facial features.

Chronic cystitis – women at risk! Complex treatment of cystitis in women and removal acute pain- find out in.

Specific and nonspecific symptoms

Identify symptoms yourself intestinal obstruction is quite difficult, since they are the same for diseases of the abdominal organs. Specific symptoms of the disease include:

Along with classic symptoms the following may be observed additional symptoms:

• Lack of appetite;
• Aversion to food;
• Pallor;
• Increased or low temperature;
• Tongue coated with gray coating;
• Hiccups;
• Belching.

There are also a number of symptoms and signs of intestinal obstruction in adults and children, which are identified by the surgeon by palpating and listening to the abdominal cavity, and treatment of which is required immediately.

What to do: first aid, which doctor to go to

If you suspect this dangerous condition, you must immediately call " ambulance" Disease develops quite quickly and the date of admission of the patient to medical institution determines the outcome of the disease.

Treatment tactics for NK depend on the causes of the condition. Most cases do not survive without urgent abdominal intervention. But with the dynamic development of the disease, they use conservative methods treatment. Anyway If symptoms are severe, you should consult a doctor who will prescribe adequate therapy.

Diagnostic measures

The diagnosis is made based on the following criteria:

• History of the disease;
• Clinical symptoms;
• Inspection data;
• Lab tests.

Diseases that could contribute to the occurrence of obstruction are of great importance when establishing a diagnosis. These include hernias, abdominal operations, adhesions, gallbladder diseases, helminthic infestations, tumors, etc.

During the examination it is carried out rectal and vaginal examination, allowing you to identify an inflammatory area, tumor or blockage of the rectum.

A separate place is given X-ray examination of the abdominal cavity. As a rule, initial radiography is sufficient to establish a diagnosis.

In some cases they are used additional measures diagnostics, which include:

• Observation under an X-ray machine;
• X-ray contrast examination of the small intestine using barium sulfate;
• Irrigoscopy.

Surgical intervention

After confirmation of the diagnosis, the patient is transferred to the hospital. The operation is performed only when peritonitis has begun. In other cases, conservative treatment is prescribed, which is aimed at:

• Removal pain syndrome;
• Fight against intoxication;
• Restoration of electrolyte balance;
• Removal of stagnant feces.

The patient is prescribed fasting and rest, after which urgent measures :

• Inserting a flexible probe through the nose to free the upper parts of the digestive system from stagnant masses, thus stopping vomiting;
• Intravenous administration of solutions to restore electrolyte balance;
• Prescribing painkillers and antiemetics;
• With increased peristalsis, antispasmodics are prescribed;
• To stimulate intestinal motility, proserine is administered subcutaneously.

For paralytic obstruction, medications are prescribed that stimulate muscle contraction, which helps move food along. Paralytic form is a temporary condition and proper treatment her symptoms may disappear.

If conservative treatment does not bring positive result, surgery is performed. It is aimed at eliminating blockage, removing the affected section and preventing a recurrence.

If a child experiences severe pain in the abdominal area, it is necessary to immediately consult a doctor. It is dangerous to self-medicate, since wasted time will only worsen the condition and it will be much more difficult to treat intestinal obstruction. The choice of treatment method depends on the timing of contacting a medical institution.

When diagnosing congenital pathology, it is carried out surgical intervention. The operation is also performed when adhesions are detected. In case of late treatment, intestinal necrosis begins to develop, which must be urgently removed.

If peritonitis develops, it is prescribed complex treatment:

• Antiseptic drugs;
• Painkillers;
• Vitamins.

In addition, it is carried out detoxification therapy. The whole complex is aimed at eliminating symptoms.

In case of early treatment, conservative treatment of intestinal obstruction without surgery and, accordingly, consequences is prescribed. With help special device into the intestines air is pumped in to straighten the bowel bend.

If the dynamic form is diagnosed, then it is prescribed conservative treatment. To do this, the following manipulations are carried out:

• Stimulation of peristalsis;
• Enemas;
• Electrical stimulation of the intestines;
• Replenishment of potassium deficiency;
• Reducing the load on the gastrointestinal tract;
• Intestinal intubation;
• Insertion of a permanent probe.

Since acute CI is most often observed in pregnant women, treatment is carried out together with a surgeon. Therapeutic measures begin with conservative treatment:

• Stimulation of intestinal motility;
• Fighting paresis;
• Detoxification therapy.

If no improvement is observed within two hours, then an operation is performed to remove the blockage and empty the intestines.

After the operation it is prescribed antibacterial therapy , drainage is inserted. Intestinal contents are continuously sucked out and prescribed intravenous administration restorative drugs.

He talks about the symptoms of intestinal obstruction and the peculiarities of the manifestation of congenital disease in newborns. famous doctor medical sciences Elena Malysheva:

Prognosis and prevention

Favorable outcome of the disease depends on the timing of medical care.

To the question “what to do at the first symptoms of intestinal obstruction?” there is a simple answer - you need to see a doctor, since a poor prognosis is observed in cases of late diagnosis, in elderly or debilitated patients, as well as in patients with inoperable malignant tumors.

If there are adhesive processes in the abdominal cavity, relapses occur.

To preventive measures include timely detection and removal of tumors, removal of worms, prevention of adhesions and injuries. Don't forget to eat right.

Intestinal obstruction can occur for various reasons. There are mechanical and dynamic reasons its occurrence. A mechanical cause is a physical obstacle that has formed (or entered) into the lumen and clogged it. The dynamic reason is physiological state intestines, in which its walls are unable to evacuate feces out.

Let's list what can be a mechanical obstacle to the path of feces:

• Fecal stones– are formed inside the large intestine during prolonged stagnation and compaction of feces. As a rule, in old age.
• Balls of worms(more often - elongated types of helminths, for example - roundworms). Balls of worms can form in other human cavities - for example, in blood vessels or the heart.
• Hairballs- enter the esophagus through the mouth when bad habit chew or suck hair. Over time, they accumulate and form balls of various sizes.
• Foreign bodies- enter the intestines through the mouth, esophagus and stomach. In 60% of cases in children, pathology occurs precisely for this reason. Swallowing foreign objects can form obstruction of any part of the digestive tract (esophagus, thin or thick sections). The localization of the process in the intestinal cavity is determined by weakened intestinal peristalsis. Poor movement of feces occurs with excessively high-calorie and fatty foods, lack of mobility, as well as while taking certain medications. Thus, intestinal obstruction in a child after swallowing a foreign body may be a consequence of slow movement of feces.
• Tumors neighboring organs – compress the intestines inside the abdominal cavity.

The listed causes of obstruction are called obstructive. In addition to them, there are strangulation reasons. This physiological changes the location of the intestine in which acute intestinal obstruction occurs.

These include:

• Wrapping intestinal loops around yourself.
• Intertwining several loops, “tying” them with a “knot”.
• Intestinal strangulation in a hernia.
• Compression of the intestinal cavity by adhesions (which may be on neighboring abdominal organs). In this case, it is formed adhesive obstruction intestines. It can be complete or partial.
• Inflammatory processes leading to tumors and edema of the intestinal wall.

Dynamic intestinal obstruction forms without a physical obstruction (stone or lump). It is determined by the condition of the intestinal walls. Therefore, sometimes it can be cured without surgery. For example, if dynamic obstruction is caused by excessive tension (spasm of the intestinal muscles), then the movement of feces can be normalized with an antispasmodic.

In addition to those listed mechanical reasons, doctors identify dynamic causes of obstruction. There are two of them - muscle spasm in the walls or their paralysis. Intestinal obstruction in older people often occurs precisely for this reason.

Signs and symptoms of intestinal obstruction

The process of obstruction formation develops over the course of a day. Doctors identify several periods of its development, which differ characteristic symptoms. The stages of formation were called the early, middle and late periods.

Signs of intestinal obstruction in adults and children at an early stage are as follows:

• The first signs of pathology appear in the form of pain. If the intestinal lumen is blocked physical body(a stone, a ball), then the pain is paroxysmal in nature, then appears and then disappears. If a torsion of the intestinal loop has occurred, the pain will be constantly present, but will change its intensity (it hurts stronger, sometimes weaker). The localization of pain corresponds to the site of obstruction formation. At the same time, over time, the pain will intensify, getting worse every hour.
• Vomiting is possible already in the first early period, if an obstacle formed at the beginning small intestine.
• Cessation of stool and formation of gases (occurs at the beginning of the pathology - if an obstruction has formed in the lower parts of the large intestine).

The early period lasts up to 12 hours. Medium – starts 12 hours after the first signs appear and lasts until the end of the day (24 hours).

Signs of intestinal obstruction in the middle period:

• Persistence of pain. They stop strengthening and weakening and acquire a permanently sharp character. The food has stopped completely, there is no peristalsis.
• Bloating– a physical increase in the volume of the abdominal cavity, visible to the naked eye.
• Severe and frequent vomiting– is formed due to a constant flow of toxins that flows from the zone of stagnation into the blood, and then into the liver.
• Stopping stool(if the obstacle is located in upper sections intestines, the urge to defecate does not stop immediately, but only in the middle period). A blockage in the upper part is called small intestinal obstruction. It is in the small section that blockages form more often (due to the relatively small diameter of the lumen, in the human small intestine its diameter can be only 2.5 cm).

After 24 hours of appearance painful symptoms extensive pathology of the late period is formed.

It is characterized general violations vital functions of organs and systems:

• The temperature rises - this indicates the addition of a bacterial infection. Against the background of stagnation of feces, the protective function of the mucous membrane of the intestinal wall decreases. Pathogenic bacteria penetrate inside, causing extensive inflammation with a subsequent rise in temperature. A blood test at this moment shows a large number of leukocytes (more than 10 million units).
• The urge to go to the toilet gradually stops, urine stops being produced due to general dehydration of the body. The tongue becomes dry, the pressure decreases - which are also signs of dehydration.
• The breathing and heart rate increases (due to decreased blood pressure).
• Signs of damage (inflammation) of the peritoneum (the medical name for inflammation is peritonitis) - severe pain and a hard, tense abdomen.
• Sepsis develops - a purulent infection or blood poisoning.

Why is intestinal obstruction dangerous?

Intestinal obstruction in adults or children creates a number of pathological processes that lead to death. How lethal complications develop:

1. In the obstructed part of the intestine, waste products - feces - accumulate.
2. Stagnation of feces becomes a source of toxins. They penetrate the wall into the blood and spread throughout the body.
3. Severe intoxication occurs ( general poisoning organism – sepsis, peritonitis). It is accompanied by the traditional symptoms of poisoning - nausea, vomiting, headache, weakness.
4. The intestinal walls in the bend zone are deprived of normal blood supply. When the blood flow is completely blocked, they die quickly, within a few minutes. With partial overlap, toxins from their own vital activity accumulate in the cells. As a result, inflammation, swelling, and pain are formed.
5. When the intestinal wall becomes necrotic or inflamed, the absorption process stops. Toxins stop entering the blood. But at the same time, they stop entering the blood nutrients and water. Restricted water intake and vomiting lead to general dehydration of the body.

The processes described above lead to death within 24 hours after the first signs of blockage appear ( feeling unwell, nausea).

Intestinal obstruction in children

Intestinal obstruction in newborns is formed due to congenital defects in the development of the abdominal organs. In this case, the intestinal cavity can be compressed by neighboring organs, or pinched in the opening of the intestinal wall (hernia). Or intestinal asthenia or spasm (obstruction) may develop.

If such disorders are accompanied by thick, dense meconium (which is also a pathology), then the intestinal contents stop moving along the passage. A newborn baby does not pass original feces (meconium). This leads to necrosis of intestinal tissue, as well as intestinal perforation, blood poisoning, and death.

Most intestinal defects in newborns develop in the early period intrauterine development(until the 10th week). Abnormalities can cause complete bowel obstruction. In the presence of congenital pathology, the following signs of intestinal obstruction in children are formed:

• Vomiting after feeding.
• Lack of bowel movements and meconium passage within 24 hours after birth.

Intestinal obstruction in infants is accompanied by pain and crying.

Partial intestinal obstruction occurs when the intestinal lumen is not completely blocked. In this case, part of the feces may move towards the exit.

The cause of partial blockage is tumors and adhesions. They narrow the lumen of the intestine, and over time, they can block it completely.

The symptoms in this case are as follows:

• Pain (not as severe as with complete obstruction).
• Nausea, possible vomiting.
• Abdominal bloating (not as severe as with a complete blockage of the intestines).

Treatment of partial obstruction can be conservative and non-surgical.

What to do if you have intestinal obstruction

In most cases, treatment of intestinal obstruction is an emergency operation. Sometimes possible conservative therapy(if the process has just begun or the blockage of the lumen is not yet complete).

Conservative treatment and “golden” 6 hours

The first 6 hours of pathology development are called “golden”. During this period, the obstruction can be treated without surgery.

What to do if there is a partial blockage of the intestines:

• When there is spasm of the intestinal walls, antispasmodics are needed to facilitate the passage of feces.
• Colonoscopy is an examination of the colon through anus probe (endoscope). The use of colonoscopy in some cases allows you to break through an obstruction in the intestine.
• Enemas. Partial intestinal obstruction can be cleared with frequent (every 20 minutes) enemas.

In most cases " Golden time" turns out to be missed (and not always through the fault of the patient; sometimes the doctor does not understand the ongoing process and mistakenly refers the sick woman to gynecological department). Surgery is required to treat and save the life of the patient.

When is surgical treatment required?

What kind of surgery is necessary for intestinal obstruction is determined by the cause of the disease. Sometimes part of the dead intestine is removed, and the remaining edges are sewn together immediately during surgery. Sometimes the edges of the cuts are brought out, connected with a temporary tube and stitched together after a few weeks. In medical practice, such a resection is called stoma removal.

If the cause is a hernia, the intestine is reduced and the hernia is sutured. In this case, it is possible that there will be no need to remove part of the intestinal wall (if its tissue is not dead). The same is done for intestinal volvulus - the loop is straightened and the condition of the intestinal wall is assessed. If there is no tissue necrosis, the intestine is not cut.

If there is a foreign body, the intestine must be opened to remove the existing clot, lump or stone. In parallel with the surgical intervention, the person is given injections of antibiotics (if an infection process was present) and anti-inflammatory drugs.

What can be the consequences of surgery for intestinal obstruction?

The need for diet and nutrition control

The main consequence of the operation is the need for a diet and strict nutritional control for a long time after surgical treatment. This is necessary to improve digestion and restore intestinal activity.

Throughout acute period When there is a blockage in the intestine, food is generally contraindicated for a person. There is also no food for the first 24 hours after the operation. The person is fed with a drip (a glucose solution is administered through a vein). After 24 hours, the patient is allowed liquid food.

What diet is prescribed for intestinal obstruction?

• Fractional meals - up to 8 times a day, in small portions.
• All food is ground into a liquid pulp and consumed warm (it is better to abstain from hot and cold food).
• What you can: jelly, mucous decoctions, jelly, juices, low-fat broths (from poultry), ground oatmeal, curd soufflé, spoiled milk. Later (after a few days) steamed meatballs, various pureed porridges, and omelet are added.
• Calorie intake is limited to 1000 kcal per day (during the first days after surgery) and up to 1800 kcal per day (one week after surgery).

Important: every fourth case of this pathology is associated with poor nutrition. Therefore, monitoring your diet and food choices is not a whim of billionaires. This is the key to the health of every person.

The menu for intestinal obstruction after surgery should be gentle. For twelve months, a person should not eat food that causes fermentation - pickles, carbohydrates (sweets), citrus fruits, soda. Salt intake is also limited to a minimum.

Intestinal obstruction - dangerous pathology. Possibility of it successful treatment determined by the time when the patient was taken to the doctor. Medical statistics confirms the fact that surgery within the first 6 hours of blockage almost always leads to recovery. Operation in late period(one day after the appearance of the first symptoms) – has a 25% mortality rate. Therefore, at the slightest suspicion of obstruction (bloating, lack of stool, pain), immediately consult a doctor.

Obstruction is a very serious illness that is associated with severe disorder gastro- intestinal tract when the movement of intestinal contents is disrupted. This disease occurs in people of different ages - both children and adults.

Forms of obstruction

Depending on the causes of occurrence, they are formed different kinds obstruction: acute or chronic.

Concerning acute obstruction, then only surgical intervention can help here. Acute obstruction is accompanied by the appearance of a tumor (benign or malignant) that blocks the intestinal lumen, thereby preventing the movement of feces.

The cause of acute obstruction may also be intestinal volvulus. Such cases are accompanied by acute painful cramps in the abdomen, severe bloating, and absence of stool for more than 3 days. If you do not see a doctor in time, it can lead to death.

But when chronic obstruction treatment is possible, since the intestinal obstruction here is partial, no surgical intervention is required. Usually, chronic illness accompanied by constipation. But you can’t joke with such things either, since “ordinary” constipation can lead to serious complications.

In any case, if you have problems with your intestines, you should not put off going to the doctor. Only a doctor can figure out what kind of problems we have and how we can cope with them.

Causes

The formation of intestinal obstruction in humans may be due to various reasons. Here are some of them.

1. Various types of neoplasms and adhesions in the intestinal cavity.
2. The cause of the disease may be additional folds and pockets that have arisen in the peritoneum, as well as hernias that have formed on the intestinal walls.
3. The sigmoid colon, which is subject to transformation with age, can also cause intestinal obstruction.
4. One of the reasons for intestinal dysfunction may be impaired motility, which usually occurs with a sudden change in diet. For example, after a long fast, switch to normal mode you need to feed very carefully and gradually. In case of violation mandatory requirements in taking food, for example, eating it in large quantities, the formation of intestinal obstruction is possible.
5. Cleansing the intestines with an enema can also cause problems. As a rule, such problems suffer from overweight people who believe that colon cleansing helps them lose weight.
6. In infants, obstruction may occur due to improper transition of the child from breastfeeding to regular feeding.
7. The occurrence of intestinal disorders contributes to mechanical damage caused by surgical injuries, peritonitis and various kinds metabolic disorders.
8. The cause of intestinal dysfunction may be the passive lifestyle of a person leading sedentary activities.

Symptoms that indicate intestinal obstruction

1. The occurrence of abdominal pain, often cramping in nature, increasing in strength.
2. The appearance of nausea and vomiting, which may smell like feces.
3. The occurrence of constipation, bloating.
4. Decreased blood pressure, increased heart rate, dry tongue, increased body temperature.

Folk remedies in the treatment of problems associated with the gastrointestinal tract

It is impossible to treat impaired bowel function on your own. Self-medication leads to irreversible consequences. Therefore, resorting to treatment traditional methods However, you need to visit a doctor.

Chronic disease caused by partial intestinal obstruction usually involves dealing with constipation. This means that it is necessary to organize uninterrupted functioning of the intestines, which would prevent fecal congestion.

As a preventive measure, a person's diet should be changed. It is advisable to consume vegetables, fruits, as well as foods containing fiber, which promotes easy bowel movements.

In addition, before going to bed, you need to drink a tea cup of kefir with the addition of a spoonful of honey or vegetable oil. In the morning, it is advisable to drink a glass of water, which normalizes the functioning of the gastrointestinal tract.

Traditional recipes for the treatment of constipation

1. Raisins, dried apricots, prunes, figs, honey take in equal quantities. All ingredients are washed well, ground in a meat grinder, and mixed. You need to take this mixture according to Art. spoon in the morning on an empty stomach.

   

2. Fresh (seedless) plums poured water and boil for 1 hour in a ratio of 1:2. After this, hot water is added to the broth. water up to 1 l. As soon as the broth boils, it is immediately removed from the heat. You need to take it half a glass before meals.

   

3. Washed and crushed sea ​​buckthorn pour chilled boiled water water, mix and filter, squeezing the cake well. The resulting juice is taken only in the morning, 100 grams. Sea buckthorn juice not only relaxes, heals, but also relieves inflammation.

   

4. Clean and crushed sea ​​buckthorn squeeze out, separate from the cake and leave in dark place for 24 hours. During this time, the oil separates from the main mass and remains on the surface. It is collected with a spoon into a separate bowl. Accept sea ​​buckthorn oil before meals, 30 minutes before, a full teaspoon three times a day. Oil, like juice, relaxes, relieves inflammation, and restores tissue.
5. Bran(2 tbsp) boil in water(200 gr.) 10 min. Add to the cooled broth honey. Take it in the morning or evening once a day.
6. Eat a small portion every day pumpkin porridge with the addition of honey. Porridge relaxes and relieves spasms.
7. pumpkin bake in the oven in small pieces. Eat a little with honey.

   

8. Boiled beets grate, add vegetable oil and honey to taste, mix. Eat 2 spoons in the morning and evening, washed down with cold water(100 gr.).

   

9. Beetroot placed in water(1:10), bring to a boil and leave for 3 - 4 hours. Add to the strained infusion yeast And sugar(1:30), close the lid and leave for 24 hours. Drink without restrictions.
10. Fennel(3 gr.) infused in boiling water(200 gr.) for half an hour. Drink half a cup after waking up and before going to bed. The decoction normalizes intestinal motility.
11. Boiled milk(100 gr.) cool to 37 degrees and add to it butter (20 gr.). The resulting product is used as an enema shortly before bedtime. You can give an enema no more than 3 days in a row.
12. Before going to bed, it is advisable to take an infusion of one teaspoon Flaxseed, flooded boiling water(200 gr.) and infused for about 20 minutes.

    

13. Buckthorn bark pour in boiling water(500 gr.) and boil for half an hour. Strain and drink 1 spoon up to 6 times a day.
14. Finely ground sagebrush(50 gr.), saxifrage femur(100 gr.), grass arnica(75 gr.) should be mixed thoroughly. One and a half spoons of the mixture are infused in a thermos for 12 hours, after pouring a glass of boiling water.
15. Grind heather, motherwort and cudweed, mix. The collection (2 tbsp) is poured boiling water(400 gr.) and leave in a thermos for a day.
16. Grass nettle, motherwort, oregano, yarrow,shepherd's purse,knotweed and St. John's wort finely crushed. Add to the mixed ingredients (2 tbsp.) boiling water(500 gr.) and leave in the thermos overnight, after closing the lid tightly. Drink half a cup immediately before meals.
17. Eyebright(5 gr.) pour boiling water(300 g), keep in a thermos for 1 hour and drink half a cup after meals.

    

18. Chamomile, yarrow and St. John's wort, buckthorn (bark), mint leaves and fennel crushed and mixed in equal proportions. One teaspoon of the mixture is poured boiling water(200 g) and kept in a thermos for 2 hours. Drink 150 g at night.
19. Flax(1 teaspoon) pour boiling water(200 gr.). Wrap tightly in a towel, leave for 10 minutes and drink 100 grams between meals.

    

Having decided to accept folk recipes, be sure to consult your doctor. Be healthy!

Video - Treatment of intestinal obstruction with folk remedies

Do you get sick often?

Intestinal obstruction is acute illness gastrointestinal tract, in which an obstacle to the exit of feces is formed in the intestines. This is a very painful condition that can be fatal if medical attention is not sought promptly. Obstruction can occur at any age, from newborns to the elderly.

The symptoms of this disease are often mistaken for signs of other diseases of the gastrointestinal tract and people try to cope with them on their own. This is absolutely impossible to do, since only timely provided medical assistance can save the patient's life. This disease can only be treated in an inpatient surgical department.

What it is?

Intestinal obstruction consists of a partial or complete cessation of the movement of contents (chyme) through the intestines. It requires urgent medical intervention as it is a life-threatening condition.

Causes

Predisposing factors for mechanical intestinal obstruction:

• adhesions in the abdominal cavity,
• elongation of the sigmoid colon in old age,
• congenital dolichosigma
• mobile cecum,
• additional pockets and folds of the peritoneum,
• hernias of the anterior abdominal wall and internal hernias.

The causes can be benign and malignant tumors various departments intestines, leading to obstructive obstruction. Obstruction can also occur due to compression of the intestinal tube by an external tumor emanating from neighboring organs, as well as narrowing of the intestinal lumen as a result of perifocal, tumor or inflammatory infiltration. When three to five lymph nodes of the intestinal mesentery are affected and intestinal obstruction is caused by tumor, the cure rate is 99 percent. Exophytic tumors (or polyps) of the small intestine, as well as Meckel's diverticulum, can cause intussusception.

For other types of obstruction, provoking factors are often changes in intestinal motility associated with changes in diet:

• eating large amounts of high-calorie foods
• heavy food intake against the background of prolonged fasting (possible volvulus of the small intestine);
• transition from breastfeeding to artificial feeding in children of the first year of life.

Paralytic obstruction most often occurs as a result of trauma (including operating room), metabolic disorders (hypokalemia), and peritonitis.

All spicy surgical diseases abdominal organs, which can potentially lead to peritonitis, occur with symptoms of intestinal paresis. A decrease in peristaltic activity of the gastrointestinal tract is noted when physical activity(bed rest) and as a result of long-term intractable biliary or renal colic.

Spastic intestinal obstruction is caused by lesions of the brain or spinal cord(metastases malignant tumors, tabes dorsalis etc.), salt poisoning heavy metals(for example, lead), hysteria.

Signs of acute intestinal obstruction

Acute intestinal obstruction is an extremely dangerous condition in which the normal passage of gastrointestinal contents is disrupted. The symptoms of acute obstruction are quite similar to partial ones. However, it occurs more quickly, aggressively and pronouncedly.

• severe abdominal pain that occurs regardless of meal time;
• nausea;
• severe vomiting (the stronger the level of obstruction, the more severe the vomiting);
• bloating;
• no gas emissions;
• bowel disorder.

Whenever similar condition it is necessary to urgently contact an ambulance. Precious wasted time can determine a far from favorable prognosis for treatment.

Symptoms

If you suspect intestinal obstruction, it is important to know that such a disease has symptoms that develop in 3 periods:

1. Early period, first 12 hours (or less). There is bloating and a feeling of heaviness in the stomach, nausea. Then pain occurs, the nature and intensity of which depend on the cause of the pathology. If the intestine is compressed from the outside, for example, if adhesive intestinal obstruction is diagnosed, then pain symptoms are constant, but their intensity varies: from moderate to strong, leading to a state of shock. When the lumen is blocked from the inside, they are paroxysmal, last several minutes, and then disappear. Vomiting occurs when the passage of food from the stomach to the intestines is impaired.
2. Intermediate period, from 12 to 24 hours. Symptoms of intestinal obstruction become severe. Regardless of the cause of the disease, the pain is constant, the bloating increases, and vomiting is frequent and profuse. Dehydration and intestinal edema develop.
3. Late period, from 24 hours. Signs of intestinal obstruction in adults and children at this stage indicate the involvement of the whole organism in the pathological process. The respiratory rate increases, the temperature increases due to bacterial intoxication, urine production stops, and abdominal pain intensifies. Peritonitis and sepsis may develop.

How intestinal obstruction manifests itself depends in part on where it is located. Thus, vomiting in the early period of the disease is characteristic of pathology in the small intestine, especially in its upper parts, and constipation and impaired gas discharge are characteristic of the large intestine. But in the late period, when peritonitis develops, these symptoms develop with any type of obstruction.

Diagnostics

To make a diagnosis of intestinal obstruction, a number of laboratory and instrumental studies are required:

• a biochemical blood test may indicate metabolic disorders (impaired composition of microelements, decreased protein);
• general blood test - there may be an increase in leukocytes during inflammatory processes;
• colonoscopy (examination of the large intestine using a sensor with a video camera at the end) helps with colonic obstruction; irrigoscopy is used to examine the small intestine;
• An X-ray examination of the intestine is mandatory when making this diagnosis. By introducing a radiopaque substance into the intestinal lumen, the level of development of intestinal obstruction can be determined;
• Ultrasound examination is not always informative, since with intestinal obstruction, air accumulates in the abdomen, which interferes with normal assessment data.

In difficult cases, a laparoscopic examination of the abdominal cavity is performed, in which a sensor with a video camera is inserted into the abdominal cavity through a small puncture. This procedure allows you to examine the abdominal organs and diagnose accurate diagnosis, and in some cases, immediately carry out treatment (volvulus, adhesions).

It is necessary to differentiate intestinal obstruction from:

• acute appendicitis (ultrasound, localized in the right iliac region);
• perforated ulcers of the stomach and duodenum (FGDS, radiography with a contrast agent);
• renal colic (ultrasound, urography).

To clarify the diagnosis, it is always necessary to carry out additional methods research, since it is impossible to differentiate intestinal obstruction by symptoms alone.

Consequences of intestinal obstruction

This disease, if left untreated, leads to a host of serious complications. Thus, turning off part of the intestine, which becomes dead due to a disruption in its blood supply, provokes a disruption in its digestion and absorption of nutrients.

A decrease in the protective functions of the mucous membrane leads to an increase in the permeability of the intestinal wall for bacteria and their metabolic products - severe intoxication occurs, and subsequently bacterial complications: peritonitis, sepsis, multiple organ failure. The cessation of absorption in the dead intestine also applies to water. Insufficient intake into the blood, coupled with frequent vomiting, leads to rapid dehydration of the body.

All these phenomena develop relatively quickly and lead to inevitable death within a few days if the patient is not promptly transported to a surgical hospital.

Treatment of intestinal obstruction

Treatment of acute intestinal obstruction begins with conservative measures. Regardless of the cause of this condition, all patients are shown hunger and rest. A nasogastric tube is passed through the nose into the stomach. It is necessary to empty the stomach, which helps stop vomiting. Intravenous administration of solutions and medications (antispasmodics, analgesics and antiemetics) is started.

Stimulation of intestinal motility is carried out by subcutaneous administration of proserin. If a hernia is strangulated, it is necessary to perform emergency surgery– it is impossible to relieve intestinal obstruction in such a situation without surgical intervention. In other cases, if conservative treatment is ineffective, surgical intervention is also necessary.

Elastic bandaging is required before surgery lower limbs for the prevention of thrombus formation in the veins of the legs.

Surgery for intestinal obstruction is performed under general anesthesia(intubation endotracheal anesthesia with muscle relaxants). For this pathology, it is necessary to perform a wide median laparotomy - a median incision on the anterior abdominal wall. Such an incision is necessary for an adequate examination of the abdominal organs and search for the disease that caused intestinal obstruction. Depending on the established cause carry out the appropriate operational assistance.

Nutrition

After treatment of any form of intestinal obstruction, it is necessary to strictly monitor nutrition and adhere to a diet.

In case of intestinal obstruction, products that promote flatulence and constipation are strictly prohibited:

• smoked, salted, hot, spicy foods;
• soda, coffee, alcohol;
• sweets and chocolate;
• fatty meat, fish;
• cereals that are difficult to digest (millet, pearl barley);
• legumes, mushrooms;
• fresh bread and pastries;
• white cabbage;
• apples;
• kefir, sour cream, cheese, cream, milk.

In the first month after surgery, eat pureed food. The following products are allowed:

• vegetables after heat treatment, Not causing bloating belly;
• fruits that do not cause bloating, ground or baked;
• low-fat cottage cheese, acidophilus;
• cereals (semolina, buckwheat, rice, oatmeal);
• lean meats and fish;
• compotes and jelly from fruits and berries.

As with any intestinal disease, with CI it is recommended to eat often and in small portions. This reduces the load on the gastrointestinal tract, regulates the secretion of gastric juices and bile acids, facilitates the work of the small and large intestines. Avoid eating things that are too hot or too cold food. Also don't eat rough food which is difficult to digest. Minimize your salt intake. Drink plenty of water.

Prognosis and prevention

A favorable prognosis for the treatment of intestinal obstruction depends on the timeliness of medical care. You can’t delay seeing a doctor, otherwise there is a high risk if severe complications develop fatal outcome. An unfavorable outcome may occur with late diagnosis, in weakened and elderly patients, in the presence of inoperable malignant tumors. If adhesions occur in the abdominal cavity, relapses of intestinal obstruction are possible.

TO preventive measures prevention of intestinal obstruction includes timely detection and removal of intestinal tumors, treatment helminthic infestations, prevention of adhesions and abdominal injuries, proper nutrition.

Intestinal obstruction called a syndrome that is characterized by a violation motor function intestines, as a result of which the movement of food stops, followed by blockage of a certain section of the intestine. Obstruction does not protrude separate disease, but is a consequence of other gastrointestinal diseases. However, the clinical picture is similar despite its different etiologies.

Statistics show that this pathological condition most often occurs in older people, as well as in those who have suffered in the past. surgical interventions on the gastrointestinal tract.

The intestinal tract can be thought of as a long tube that can contract its sections to move food through them. Lumps of food move along the “tube”, but suddenly a moment comes when an obstacle appears in front of them or the intestines simply refuse to contract, allowing the intestinal contents to pass forward. Then food accumulates in one place, bloating the intestines. What are the reasons for this? We need to figure it out further.

The causes of such gastrointestinal disorders are quite varied. Based on the etiological characteristics, mechanical and dynamic obstruction are distinguished.

The causes of mechanical obstruction are considered to be:

• appearance adhesive process;
• the appearance of folds and pockets in the peritoneum;
• increased mobility of the cecum;
• the appearance of internal hernias;
• presence of polyps;
• tumor processes;
• the presence of a diverticulum.

A similar pathological condition can also occur in infants as a result of a sharp transition to artificial feeding.

Dynamic (functional) obstruction can occur:

• against the background of surgical interventions;
• with prolonged colic and the absence of its relief (renal, hepatic);
• in case of metabolic disorders;
• due to the development of peritonitis (inflammation of the peritoneum);
• stress, hysteria;
• against the background of tumor diseases of the brain;
• lead poisoning;
• due to injuries.

Pathogenesis

The disorders that develop in the body are directly related to the appearance of dehydration and loss of proteins and electrolytes. Dehydration occurs against the background of vomiting. This leads to a decrease in pressure and disruption of microcirculation in tissues.

A decrease in circulating blood volume and a lack of fluid lead to the production of aldosterone, a hormone that reduces diuresis and largely removes potassium from the body. The result of these processes is a violation of the amount of electrolytes.

In parallel with the above, rapid decomposition and decay of food contents that linger in the intestines occurs. The proliferation of pathological microflora and the release of toxic substances leads to the development of intoxication of the body. Under pathological conditions, the intestinal barrier function is disrupted, which increases the entry of toxins into the human blood. The proliferation of microbes causes inflammation in the intestinal walls and the appearance of tissue death, followed by the development of purulent peritonitis.

At the stage of intestinal obstruction, the intestinal walls begin to contract more often, trying to overcome the obstacle in order to move the chyme (food contents) further. Subsequently, a phase occurs when weakening occurs contractile function, and peristalsis becomes weak, up to absolute disappearance. This condition is called intestinal paresis.

If you explain in simple words, and not in scientific terms, then mechanical obstruction appears when there is a mechanical obstruction. This barrier can be located inside the intestine itself (intraorgan) or outside it (extraorgan). When an obstruction is located in the intestine, the lumen is blocked, which prevents food from moving further. If the obstruction is outside the intestine, it is compressed from the outside.

Depending on the state of the mesentery at the time of development of the pathological condition, several types of obstruction are distinguished.

• Obstructive - there is no impairment of vascular functionality.
• Strangulation - compression of the mesenteric vessels occurs with disruption of microcirculation.
• Combined - a combination of the previous types.

If we take into account the rate of development of symptoms, acute intestinal obstruction is distinguished, subacute and chronic. Acute is the most severe, since the clinic develops in a matter of hours, and the patient enters a medical facility already in critical condition.

Mechanical obstruction is also divided into:

1. According to the form of localization pathological process:
   • colonic;
   • small intestine.
2. Congenital and acquired.
3. Partial and complete - depending on the completeness of the lumen closure and the possibility of chyme advancement.

Symptoms of mechanical intestinal obstruction

The clinical picture develops quite quickly. Within a few hours, signs of dehydration appear in the form of chapped lips, sunken eyes, and dry skin. Blood pressure increases with sharp drop subsequently, the pulse becomes weak and rapid. Breathing becomes weak and frequent.

Abdominal pain of a cramping nature and vomiting appear. When vomiting, the patient spits out large lumps of undigested food, and may appear bad smell. If the obstruction is localized in the large intestine, then vomiting may be absent. Then the first place of symptoms comes to the appearance of flatulence and intestinal colic.

The development of acute obstruction occurs in several stages:

1. initial stage- characterized by the appearance of severe abdominal pain, up to a state of shock.
2. Intoxication- stage of development of all possible symptoms with their full manifestation.
3. Stage of development of peritonitis- appears on the second day of the disease and requires urgent surgical intervention.

Features of dynamic intestinal obstruction

Distinguish the following types functional intestinal obstruction - spastic and paralytic. The cause of spastic obstruction is most often the presence of helminthiasis. It develops quite rarely.

The clinical picture is characterized by dull symptoms compared to the mechanical version of obstruction. Appears low-grade fever or it may be absent. Abdominal pain is spastic and short-lived. May appear one-time vomiting. The abdomen is soft on palpation, without swelling. Put this diagnosis is possible only with the help of x-ray examination.

The paralytic variant of obstruction has great importance in surgery, since it often occurs after surgical interventions. This pathological condition often occurs in children. A variant of intestinal paresis after surgery occurs as a protective reaction of the body to irritation of the nerve endings of the peritoneum.

The symptoms of this condition also develop in several periods:

1. Initial period- Occurs immediately after surgery. Spasm of intestinal vessels is not very pronounced and is compensatory in nature. The patient's condition is satisfactory and the changes that have begun to occur in the intestines are not life-threatening.
2. Organic Change Stage- changes at the microcirculatory level intensify. Condition requires medical intervention. Shortness of breath, increased heart rate, and slight hypertension appear. Hypovolemia appears - BCC (blood circulation volume) decreases by about a quarter.
3. Stage of morphological changes - serious condition, blood pressure drops sharply, rapid and shallow breathing, tachycardia. Patients are inhibited or very excited. Hypovolemia - up to 40%. The abdomen is distended and intestinal peristalsis cannot be heard.

Diagnosis of intestinal obstruction

Making the correct diagnosis as quickly as possible short time is a very important factor for a favorable prognosis. It is important to start solving the problem from the moment symptoms appear, and not two days later, when the patient is already in a state of shock.

History taking

The first thing the doctor does is collect an anamnesis. Since the appearance of obstruction often occurs against the background of other diseases, it is imperative to clarify their presence (if the patient is aware of the existence of problems). Find out whether the patient has undergone surgery in the past, inflammatory diseases abdominal or pelvic organs (in women). Next, the nature of the food that the sick person usually takes, the presence of physical activity, which could provoke an increase in intra-abdominal pressure. Sometimes the patient may report exact time the appearance of symptoms. This indicates acute obstruction.

Next, the clinician checks the data from palpation, percussion and auscultation. When tapping on the anterior abdominal wall, a dull sound is detected in the place where the obstruction has formed. When listening with a stethoscope, the disappearance of bowel sounds is noted - a symptom of impaired intestinal motility, or the sound of a splash of water appears due to the accumulation of liquid and gases.

X-ray

The next diagnostic method is x-ray. This is a fairly indicative instrumental method, since in the X-ray picture, the doctor can see “Kloiber cups”. The intestinal loops, which are located above the blockage, swell, and gases and liquid accumulate in them in the form of horizontal levels of different heights. This symptom is called “Kloiber's cups”. Also when x-ray examination it is impossible to see the fluid fluctuations in the intestines.

It is important to diagnose the presence of ischemia of a specific area - this will help arteriography. This is an instrumental study of the patency of the arteries of the intestinal tract. When the latter are blocked or squeezed, blood circulation is disrupted and areas of tissue necrosis develop.

Ultrasound of the abdominal organs makes it possible to differentiate this diagnosis with 100% accuracy from other gastrointestinal diseases that have a similar clinical picture. At an early stage the picture ultrasound examination more sensitive than x-ray method. Laboratory methods studies include general tests and blood biochemistry.

There are so-called specific symptoms , which allow us to further verify the correctness of the diagnosis. Among them are the following:

1. Schlange's sign- increased peristalsis during palpation of the abdominal wall;
2. Mathieu-Sklyarov's sign- during a concussion of the abdominal wall, a splashing noise can be heard.
3. Chugaev's symptom- the patient lies on his back and pulls up his legs. A visible transverse stripe appears on the abdomen.
4. Gold's symptom- palpation reveals a swollen loop of the small intestine.
5. Babuk's sign- characteristic of intussusception. The patient is given an enema. The rinsing waters after it have normal color. Next, the abdomen is palpated for several minutes and the enema is administered again. This time the washing water has brownish-brown impurities.

Treatment of intestinal obstruction

Providing assistance for such a pathology is emergency. The patient is hospitalized in a hospital.

What to do in case of intestinal obstruction:

• If necessary, urgent surgical intervention is performed. Since, most often, there is no time to postpone the operation, the preparation of the patient lasts no more than 2 hours.
• Functional obstruction cannot be treated operative method, only conservative, so that the situation does not worsen.
• Placement of a nasogastric tube for aspiration of contents to relieve pressure on the gastrointestinal tract.
• Giving an enema makes stool more liquid and, in some cases, helps remove the obstruction.
• Infusion therapy to replenish blood volume and restore microcirculation. The volume of injected liquid should reach 4 liters - saline, rheosorbilact, neohemodez, gekodez.
• Potassium preparations - so that intestinal paralysis does not worsen - potassium chloride.
• In severe cases, blood plasma transfusion is performed to restore the lost amount of albumin.
• Antispasmodic drugs for pain relief - no-spa, atropine, platifillin.
• For intestinal paresis - prozerin, sodium chloride in the form of a hypertonic solution (into the rectum), ubretide.
• To prevent bacterial complications, such as peritonitis or wound suppuration, antibiotics are prescribed.

How to prevent intestinal obstruction

• The first piece of advice, which, unfortunately, not everyone uses, is timely treatment of gastrointestinal diseases, since they may cause obstruction in the future. This includes a clinical examination, treatment of abdominal wall hernias, treatment of adhesions that arose after previous operations.
• It is necessary to normalize the nutrition process. Food should be supplied to the body in small portions 4 to 5 times, and not in the evening before bed once a day, and even in huge quantities. It is necessary to reduce the amount of spices consumed in your diet, fried, pickled, fatty foods. Use sufficient quantity liquids.
• If constipation occurs, it is necessary for a doctor to prescribe adequate treatment, since chronic forms of constipation significantly increase the risk of obstruction.

The prognosis is favorable in case of timely seeking of help, correct diagnosis and treatment.