Small-Bowel Obstruction – Parham Doctors’ Hospital

Small-Bowel Obstruction – Parham Doctors’ Hospital

(somber music) – Hi, I’m Dr.Schroder. I’m a general surgeon with Advanced Surgical
Partners of Virginia. A small bowel obstruction is when the bowel inside
your abdomen gets kinked, kinda like the hose in
your yard gets kinked. And water will either pass
slowly through it or not at all. Small bowel obstructions
occur commonly in patients who have had previous surgery, such as gallbladder surgery, appendix, total abdominal hysterectomy,
or some type of bowel surgery. The symptoms of a bowel obstruction at first may not be very serious or even concerning to the patient. Patients may have crampy abdominal pain, but eventually everything goes through, and they have normal bowel movements. Not infrequently, though,
patients will develop crampy abdominal pain
that goes onto nausea, vomiting, and abdominal distention. These are the characteristic signs of small bowel obstruction. Once these symptoms occur, you should be seen by your
primary care physician or go immediately to the
emergency room for treatment. Most small bowel obstructions
can be treated conservatively. These are treated with an NG tube, which is a small, thin tube
that has an opening on it that is passed through
the nose into the stomach to allow contents to be
evacuated from the stomach and allow the bowel to unkink. Kinda like the hose in
your yard gets unkinked, and water then goes through it. With an NG tube in place for
approximately 24 to 48 hours, most patients will see improvement in their symptoms, less distention. Their nausea and vomiting will go away, and they will start to
have bowel movements. At that point, the NG tube
can be clamped or removed, and the patient can start a
diet, usually clear liquids, and be advanced back to regular
food without difficulty. Often the small bowel
obstruction will not reoccur, and patients can go on and live
normally without any issues. Unfortunately, sometimes the
bowel obstructive symptoms will recur, which means
they’ll get the nausea, the vomiting, and
abdominal distention back. When this occurs, even with an NG tube and decompression of the stomach, sometimes the symptoms will not go away or could even get worse. In this instance, a patient
will require surgery to unkink the bowel, which
is usually due to adhesions from the previous surgery. Often this surgery can
be done laparoscopically, using small incisions to
look inside the abdomen with a TV and a camera, find the area where the
adhesions are causing the kink, cut those adhesions, unkink the bowel, and allow the patient to
return to normal activity and a normal diet. With laparoscopic surgery,
the incisions are smaller and there is less pain. As a result, patients can go home earlier, get back to a regular diet quicker, and get back to normal activities, and even work, in a timely fashion. Unfortunately, sometimes
laparoscopic surgery cannot be done to correct
the bowel obstruction. This means that an open
incision has to be used, usually through a previous incision, if the patient has had
previous abdominal surgery. With the open technique,
we go in with our hands, and we cut the adhesions and scar tissue that may be causing the bowel obstruction. With an open procedure, however, the recovery is much longer. It’s usually a few nights in the hospital, and recovery once you go
home is a little bit longer. Instead of being able to go home earlier, have less pain, and get back
to normal activities quicker, your recovery may take two to four weeks to get back to light duty, driving, and normal activity around the house. Most patients are not able
to do any heavy lifting until six weeks, and even then, we want you to be very careful due to the risk of developing
an incisional hernia. So, in summary, patients who have had previous abdominal surgery should be aware that small bowel obstructions can occur. If you start having symptoms of belching, bloating, abdominal distention, or even nausea and vomiting, you should see your primary
care physician for evaluation. If these symptoms become worse, though, you should definitely
go to the emergency room for immediate evaluation. (somber music)

One thought on “Small-Bowel Obstruction – Parham Doctors’ Hospital

  1. Mother in hospital 75 yrs old has had small bowel obstruction for 9 days they still have the NG tube in collecting fluids. Fecal vomiting. Hallucination and confusion. She is perhaps 100 lbs not given food or water for the duration how long can this starvation/dehydration go on before they operate? Obstruction has not reduced whatsoever. History of diverticulitis, adhesions from prior surgeries.

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