Intestinal Obstruction

A complete or partial blockage of the bowel thereby preventing intestinal content to move through is termed as intestinal obstruction. The bowel comprises the large intestine and the small intestine. When there is a block in either of them, the condition shows up. Intestinal content like fluids, food and gas do not pass through completely or partially due to this condition.

Intestinal obstruction is also known as paralytic ileus, bowel obstruction or colonic ileus. The blockage or obstruction may cause pain that is intermittent. If left untreated, intestinal obstruction may lead to death of those parts of the intestine that are blocked leading to further complications. However if treated on time, intestinal obstruction can be treated effectively.

What causes intestinal obstruction?

Common causes for intestinal obstruction:

• Inflammatory bowel diseases such as Crohn's disease
  
  
• Tumors in the small intestine
  
  
• Intestinal adhesions, bands of fibrous tissue in the abdominal cavity that are formed after the pelvic or abdomen surgery.
  
  
• Intussusception
  
  
• Volvulus i.e. twisted intestine.

Mechanical causes for intestinal obstruction arise from

• Hernia
  
• Tumor, Colon cancer
  
• Stricture, narrowing of the colon caused by inflammation or scarring.
  
• Diverticulitis
  
• Impacted stool, noticed in people who get constipated for long periods.
  
• Post surgery scar tissues or adhesions.
  
• Gallstones in a few cases
  
• Inflammatory bowel diseases such as Crohn's disease.

Paralytic ileus or pseudo-obstruction is a major cause of intestinal obstruction in children and infants. Conditions that cause paralytic ileus include:

• Complications from an abdominal surgery or pelvic surgery.
  
• Kidney or lung disease
  
• Bacteria or virus that cause intestinal infections
  
• Decreased blood supply to the intestine
  
• Abdominal infections like appendicitis
  
• Chemical, mineral or electrolyte imbalance
  
• Substance abuse like use of narcotics
  
• Muscle and nerve disorders like Parkinson's.

Symptoms include abdominal pain and cramping, distention and bloating. There is reduced appetite and vomiting. An obstruction in the intestines can lead to either constipation, diarrhea or flatulence. After physical examination, Xray or CT scan of the abdomen might be suggested as also . In some cases, an enema or stent is required to open up a partial blockage. Nasogastric tube (tube from nose to stomach) is passed so as to relieve abdominal swelling and vomiting. Volvulus of the large bowel may be treated by passing a tube into the rectum.

Potassium Gluconate

This is a potassium supplement useful in those prone to low blood potassium. Its side effects include numbness and tingling of the extremities, confusion, weakness, arrhythmia, ECG changes, nausea, vomiting, diarrhea, abdominal pain, GI ulcerations, GI bleeding, intestinal obstruction, and intestinal perforation.

Using potassium gluconate

1. Should not be used in cases of severe kidney disease, acute dehydration, or those who are using potassium sparing diuretics (e.g. spironolactone, triamterene).
2. Enteric coated potassium tablets cannot be recommended due to increased risk of GI bleeding and ulceration.
3. Minimize GI symptoms by taking this medication with food.

Adult and adolescent dose: oral, elixir, 10-20 mEq of potassium diluted in one-half glass of cold water or juice, two to four times a day; or 5-10 mEq potassium in tablet form, two to four times a day; dosage adjusted to need (up to 100 mEq potassium per day).