Causes of Intestinal obstruction
List of causes of Intestinal obstruction
Following is a list of causes or underlying conditions
(see also Misdiagnosis of underlying causes of Intestinal obstruction)
that could possibly cause Intestinal obstruction includes:
More causes:
see full list of causes for Intestinal obstruction
Intestinal obstruction Causes: Book Excerpts
Intestinal obstruction as a complication of other conditions:
Other conditions that might have
Intestinal obstruction as a complication may,
potentially, be an underlying cause of Intestinal obstruction.
Our database lists the following as having
Intestinal obstruction as a complication of that condition:
Intestinal obstruction as a symptom:
Conditions listing Intestinal obstruction
as a symptom may also be potential underlying causes of Intestinal obstruction.
Our database lists the following as having
Intestinal obstruction as a symptom of that condition:
Medications or substances causing Intestinal obstruction:
The following drugs, medications, substances or toxins are some of the possible
causes of Intestinal obstruction as a symptom.
This list is incomplete and various other drugs or substances
may cause your symptoms.
Always advise your doctor of any medications or treatments you are using,
including prescription, over-the-counter, supplements, herbal or alternative treatments.
See full list of 37
medications causing Intestinal obstruction
Drug interactions causing Intestinal obstruction:
When combined, certain drugs, medications, substances or toxins may react
causing Intestinal obstruction as a symptom.
The list below is incomplete and various other drugs or substances may cause your symptoms.
Always advise your doctor of any medications or treatments you are using,
including prescription, over-the-counter, supplements, herbal or alternative treatments.
- Diphenhydramine and Phenothiazine interaction
- Acetaminophen-PM and Phenothiazine interaction
- AID to Sleep and Phenothiazine interaction
- Allerdryl and Phenothiazine interaction
- Allergy Capsules and Phenothiazine interaction
- more interactions...»
See full list of 72
drug interactions causing Intestinal obstruction
Related information on causes of Intestinal obstruction:
As with all medical conditions,
there may be many causal factors.
Further relevant information on causes of Intestinal obstruction may be found in:
Causes of Intestinal obstruction: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the causes of Intestinal obstruction.
Constipation:
Differential Diagnosis
(In a Page: Signs and Symptoms)
-
Medications
–Narcotic analgesics
–Antihypertensives (e.g., calcium channel blockers)
–Tricyclic antidepressants
–Aluminum hydroxide in antacids
–Iron supplements
-
Inadequate dietary fiber or liquid intake
-
Neurological dysfunction
–Diabetes mellitus
–Multiple sclerosis
–Hirschsprung's disease
-
Mechanical difficulties
–Colorectal cancer
–Hernia
–Diverticulitis
–Inflammatory bowel syndrome
–Adhesion
–Stricture
–Torsion
–Volvulus
-
Metabolic and endocrine
–Hypothyroidism
–Hypercalcemia
–Hypokalemia
-
Chronic laxative abuse
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Constipation:
Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)
- Functional constipation
–By far the most common etiology
–Rome II criteria define chronic functional constipation in infants and young children as at least 2 weeks of scybalous, pebble-like, hard stools for the majority of stools, or firm stools two or fewer times per week
–Presents with stool-withholding behavior
–Often due to inadequate fluid/fiber intake
-
Drugs: Antacids (with aluminium and calcium), anticholinergics, antidepressants, bismuth, calcium antagonists, cough suppressants, opioid analgesics, phenobarbitol
-
Irritable bowel syndrome
-
Endocrine disorders
–Hypercalcemia
–Hypothyroidism
–Hyperparathyroidism
–Pregnancy
–Reduction of steroid hormones in luteal and follicular phases of menstrual cycle
-
Hirschsprung disease
–1/5,000 births, male to female ratio 4:1
–94% do not pass meconium within 24 hours of birth
–61% diagnosed by 12 months of life
-
Neurologic disease
–Myelomeningoce
–Hypotonia (e.g., Down, myopathies, prune-belly syndrome)
–Cerebral palsy
-
Celiac disease
-
Cystic fibrosis
-
Inflammatory bowel disease
-
Lead toxicity
- Structural abnormalities
–Anal disorders (imperforate anus, anteriorly displaced anus, perianal fissures, strep infection, anal stenosis)
–Colonic strictures (primary or secondary)
–Pelvic masses (sacral teratoma)
-
Infectious disease
–Infantile botulism
–Chagas disease
-
Metabolic disorders
–Uremia
–Hypokalemia
–Amyloid neuropathy
-
Ogilvie syndrome
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Bowel sounds, hypoactive:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
❑ Mechanical intestinal obstruction. Bowel sounds may become hypoactive after a period of hyperactivity. The patient may also have acute colicky abdominal pain in the quadrant of obstruction, possibly radiating to the flank or lumbar region; nausea and vomiting (the higher the obstruction, the earlier and more severe the vomiting); constipation; and abdominal distention and bloating. If the obstruction becomes complete, signs of shock may occur.
❑ Mesenteric artery occlusion. After a brief period of hyperactivity, bowel sounds become hypoactive and then quickly disappear, signifying a life-threatening crisis. Associated signs and symptoms include fever; a history of colicky abdominal pain leading to sudden and severe midepigastric or periumbilical pain, followed by abdominal distention and possible bruits; vomiting; constipation; and signs of shock. Abdominal rigidity may appear late.
❑ Paralytic (adynamic) ileus. Bowel sounds are hypoactive and may become absent. Associated signs and symptoms include abdominal distention, generalized discomfort, and constipation or passage of small, liquid stools and flatus. If the disorder follows acute abdominal infection, fever and abdominal pain may occur.
Other causes
❑ Drugs. Certain classes of drugs reduce intestinal motility and thus produce hypoactive bowel sounds. These include opiates, such as codeine; anticholinergics, such as propantheline bromide; phenothiazines, such as chlorpromazine; and vinca alkaloids such as vincristine. General or spinal anesthetics produce transient hypoactive sounds.
❑ Radiation therapy. Hypoactive bowel sounds and abdominal tenderness may occur after irradiation of the abdomen.
❑ Surgery. Hypoactive bowel sounds may occur after manipulation of the bowel. Motility and bowel sounds in the small intestine usually resume within 24 hours; colonic bowel sounds, in 3 to 5 days.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Breath with fecal odor:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
❑ Distal small-bowel obstruction. With late obstruction, nausea is present although vomiting may be delayed. Vomitus initially consists of gastric contents, then changes to bilious contents, followed by fecal contents with resultant fecal breath odor. Accompanying symptoms include achiness, malaise, drowsiness, and polydipsia. Bowel changes (ranging from diarrhea to constipation) are accompanied by abdominal distention, persistent epigastric or periumbilical colicky pain, and hyperactive bowel sounds and borborygmi. As the obstruction becomes complete, bowel sounds become hypoactive or absent. Fever, hypotension, tachycardia, and rebound tenderness may indicate strangulation or perforation.
❑ Gastrojejunocolic fistula. With gastrojejunocolic fistula, symptoms may be variable and intermittent because of temporary plugging of the fistula. Fecal vomiting with resulting fecal breath odor may occur, but the most common chief complaint is diarrhea, accompanied by abdominal pain. Related GI findings include anorexia, weight loss, abdominal distention and, possibly, marked malabsorption.
❑ Large-bowel obstruction. Vomiting is usually absent initially, but fecal vomiting with resultant fecal breath odor occurs as a late sign. Typically, symptoms develop more slowly than in small-bowel obstruction. Colicky abdominal pain appears suddenly, followed by continuous hypogastric pain. Marked abdominal distention and tenderness occur, and loops of large bowel may be visible through the abdominal wall. Although constipation develops, defecation may continue for up to 3 days after complete obstruction because of stool remaining in the bowel below the obstruction. Leakage of stool is common with partial obstruction.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Constipation:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Anal fissure.
A crack or laceration in the lining of the anal wall can cause acute constipation, usually due to the patient's fear of the severe tearing or burning pain associated with bowel movements. He may notice a few drops of blood streaking toilet tissue or his underwear.
Anorectal abscess.
In anorectal abscess, constipation occurs together with severe, throbbing, localized pain and tenderness at the abscess site. The patient may also have localized inflammation, swelling, and purulent drainage and may complain of fever and malaise.
Cirrhosis.
In the early stages of cirrhosis, the patient experiences constipation along with nausea and vomiting and a dull pain in the right upper quadrant. Other early findings include indigestion, anorexia, fatigue, malaise, flatulence, hepatomegaly and, possibly, splenomegaly and diarrhea.
Diabetic neuropathy.
Diabetic neuropathy produces episodic constipation or diarrhea. Other signs and symptoms include dysphagia, orthostatic hypotension, syncope, and painless bladder distention with overflow incontinence. A male patient may also experience impotence and retrograde ejaculation.
Diverticulitis.
In diverticulitis, constipation or diarrhea occurs with left lower quadrant pain and tenderness and possibly a palpable, tender, firm, fixed abdominal mass. The patient may develop mild nausea, flatulence, or a low-grade fever.
Hemorrhoids.
Thrombosed hemorrhoids cause constipation as the patient tries to avoid the severe pain of defecation. The hemorrhoids may bleed during defecation.
Hepatic porphyria.
Abdominal pain, which may be severe, colicky, localized, or generalized, precedes constipation in hepatic porphyria. The patient may also have a fever, sinus tachycardia, labile hypertension, excessive diaphoresis, severe vomiting, photophobia, urine retention, nervousness or restlessness, disorientation and, possibly, visual hallucinations. Deep tendon reflexes may be diminished or absent. He may also have skin lesions causing itching, burning, erythema, altered pigmentation, and edema in areas exposed to light. Severe hepatic porphyria can produce delirium, coma, seizures, paraplegia, or complete flaccid quadriplegia.
Hypercalcemia.
With hypercalcemia, constipation usually occurs along with anorexia, nausea, vomiting, polyuria, and polydipsia. The patient may also display arrhythmias, bone pain, muscle weakness and atrophy, hypoactive deep tendon reflexes, and personality changes.
Hypothyroidism.
Constipation occurs early and insidiously in patients with hypothyroidism, in addition to fatigue, sensitivity to cold, anorexia with weight gain, menorrhagia in women, decreased memory, hearing impairment, muscle cramps, and paresthesia.
Intestinal obstruction.
Constipation associated with an intestinal obstruction varies in severity and onset, depending on the location and extent of the obstruction. With partial obstruction, constipation may alternate with leakage of liquid stools. With complete obstruction, obstipation may occur. Constipation can be the earliest sign of partial colon obstruction, but it usually occurs later if the level of the obstruction is more proximal. Associated findings include episodes of colicky abdominal pain, abdominal distention, nausea, or vomiting. The patient may also develop hyperactive bowel sounds, visible peristaltic waves, a palpable abdominal mass, and abdominal tenderness.
Irritable bowel syndrome (IBS).
IBS commonly produces chronic constipation, although some patients have intermittent, watery diarrhea and others complain of alternating constipation and diarrhea. Stress may trigger nausea and abdominal distention and tenderness, but defecation usually relieves these signs and symptoms. Patients typically have an intense urge to defecate and feelings of incomplete evacuation. Typically, the stools are scybalous and contain visible mucus.
Mesenteric artery ischemia.
Mesenteric artery ischemia is a life-threatening disorder that produces sudden constipation with failure to expel stool or flatus. Initially, the abdomen is soft and nontender, but soon severe abdominal pain, tenderness, vomiting, and anorexia occur. Later, the patient may develop abdominal guarding, rigidity, and distention; tachycardia; syncope; tachypnea; a fever; and signs of shock, such as cool, clammy skin and hypotension. A bruit may be heard.
Spinal cord lesion.
Constipation may occur with a spinal cord lesion, in addition to urine retention, sexual dysfunction, pain and, possibly, motor weakness, paralysis, or sensory impairment below the level of the lesion.
Other causes
Diagnostic tests.
Constipation can result from the retention of barium given during certain GI studies.
Drugs.
Patients commonly experience constipation when taking an opioid analgesic or other drugs, including vinca alkaloids, calcium channel blockers, antacids containing aluminum or calcium, anticholinergics, and drugs with anticholinergic effects (such as tricyclic antidepressants). Patients may also experience constipation from excessive use of laxatives or enemas.
Surgery and radiation therapy.
Constipation can result from rectoanal surgery, which may traumatize nerves, and abdominal irradiation, which may cause intestinal stricture.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Bowel sounds, hypoactive:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Mechanical intestinal obstruction
Bowel sounds may become hypoactive after a period of hyperactivity. The patient may also have acute colicky abdominal pain in the quadrant of obstruction, possibly radiating to the flank or lumbar region; nausea and vomiting (the higher the obstruction, the earlier and more severe the vomiting); constipation; and abdominal distention and bloating. If the obstruction becomes complete, signs of shock may occur.
Mesenteric artery occlusion
After a brief period of hyperactivity, bowel sounds become hypoactive and then quickly disappear, signifying a life-threatening crisis. Associated signs and symptoms include fever; a history of colicky abdominal pain leading to sudden and severe midepigastric or periumbilical pain, followed by abdominal distention and possibly bruits; vomiting; constipation; and signs of shock. Abdominal rigidity may appear late.
Paralytic (adynamic) ileus
Bowel sounds are hypoactive and may become absent in this disorder. Associated signs and symptoms include abdominal distention, generalized discomfort, and constipation or passage of small, liquid stools and flatus. If the disorder follows acute abdominal infection, fever and abdominal pain may occur.
Other causes
Drugs
Certain classes of drugs reduce intestinal motility and thus produce hypoactive bowel sounds. These include opiates such as codeine, anticholinergics such as propantheline bromide, phenothiazines such as chlorpromazine, and vinca alkaloids such as vincristine. General or spinal anesthetics produce transient hypoactive sounds.
Radiation therapy
Hypoactive bowel sounds and abdominal tenderness may occur after irradiation of the abdomen.
Surgery
Hypoactive bowel sounds may occur after manipulation of the bowel. Motility and bowel sounds in the small intestine usually resume within 24 hours; colonic bowel sounds, in 3 to 5 days.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Breath with fecal odor:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Gastrojejunocolic fistula
Symptoms of gastrojejunocolic fistula may be variable and intermittent because of temporary plugging of the fistula. They may include fecal vomiting with resulting fecal breath odor, but the chief complaint is usually diarrhea accompanied by abdominal pain. Related GI findings include anorexia, weight loss, abdominal distention, and possibly marked malabsorption.
Large-bowel obstruction
Vomiting is usually absent at first, but fecal vomiting with resulting fecal breath odor occurs as a late sign. Typically, symptoms develop more slowly than in small-bowel obstruction. Colicky abdominal pain appears suddenly, followed by continuous hypogastric pain. Marked abdominal distention and tenderness occur, and loops of large bowel may be visible through the abdominal wall. Although constipation develops, defecation may continue for up to 3 days after a complete obstruction because of stool remaining in the bowel below the obstruction. Leakage of stool is common in a partial obstruction.
Small-bowel obstruction, distal
In late obstruction, nausea is present but vomiting may be delayed. Vomitus initially consists of gastric contents, then changes to bilious contents, followed by fecal contents with resulting fecal breath odor. Accompanying symptoms include achiness, malaise, drowsiness, and polydipsia. Bowel changes (ranging from diarrhea to constipation) are accompanied by abdominal distention, persistent epigastric or periumbilical colicky pain, hyperactive bowel sounds, and borborygmus. As the obstruction becomes complete, bowel sounds become hypoactive or absent. Fever, hypotension, tachycardia, and rebound tenderness may indicate strangulation or perforation.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Constipation:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Anal fissure
A crack or laceration in the lining of the anal wall can cause acute constipation, usually due to the patient’s fear of the severe tearing or burning pain associated with bowel movements. He may notice a few drops of blood streaking toilet tissue or his underwear.
Anorectal abscess
In this disorder, constipation occurs together with severe, throbbing, localized pain and tenderness at the abscess site. The patient may also have localized inflammation, swelling, and purulent drainage and may complain of fever and malaise.
Cirrhosis
In the early stages of cirrhosis, the patient experiences constipation along with nausea and vomiting, and a dull pain in the right upper quadrant. Other early findings include indigestion, anorexia, fatigue, malaise, flatulence, hepatomegaly and, possibly, splenomegaly and diarrhea.
Diabetic neuropathy
This type of neuropathy produces episodic constipation or diarrhea. Other signs and symptoms include dysphagia, orthostatic hypotension, syncope, and painless bladder distention with overflow incontinence. A male patient may also experience impotence and retrograde ejaculation.
Diverticulitis
In this disorder, constipation or diarrhea occurs with left-lower-quadrant pain and tenderness and possibly a palpable, tender, firm, fixed abdominal mass. The patient may develop mild nausea, flatulence, or a low-grade fever.
Hemorrhoids
Thrombosed hemorrhoids cause constipation as the patient tries to avoid the severe pain of defecation. The hemorrhoids may bleed during defecation.
Hepatic porphyria
Abdominal pain, which may be severe, colicky, and localized or generalized, precedes constipation in hepatic porphyria. The patient may also have a fever, sinus tachycardia, labile hypertension, diaphoresis, severe vomiting, photophobia, urine retention, nervousness or restlessness, disorientation and, possibly, visual hallucinations. Deep tendon reflexes may be diminished or absent. Some patients have skin lesions causing itching, burning, erythema, altered pigmentation, and edema in areas exposed to light. Severe hepatic porphyria can produce delirium, coma, seizures, paraplegia, or complete flaccid quadriplegia.
Hypercalcemia
In hypercalcemia, constipation usually is accompanied by anorexia, nausea, vomiting, polyuria, and polydipsia. The patient may also display arrhythmias, bone pain, muscle weakness and atrophy, hypoactive deep tendon reflexes, and personality changes.
Hypothyroidism
Constipation occurs early and insidiously in patients with hypothyroidism; it may be accompanied by fatigue, sensitivity to cold, anorexia with weight gain, menorrhagia, decreased memory, hearing impairment, muscle cramps, and paresthesia.
Intestinal obstruction
Constipation associated with this disorder varies in severity and onset, depending on the location and extent of the obstruction. In a partial obstruction, constipation may alternate with leakage of liquid stools. In a complete obstruction, obstipation may occur. Constipation can be the earliest sign of partial colon obstruction, but it usually occurs later if the level of the obstruction is more proximal. Associated findings include episodes of colicky abdominal pain, abdominal distention, nausea, and vomiting. The patient may also develop hyperactive bowel sounds, visible peristaltic waves, a palpable abdominal mass, and abdominal tenderness.
Irritable bowel syndrome
This common syndrome usually produces chronic constipation, although some patients have intermittent watery diarrhea and others complain of alternating constipation and diarrhea. Stress may trigger nausea and abdominal distention and tenderness, but defecation usually relieves these signs and symptoms. Many patients have an intense urge to defecate and feelings of incomplete evacuation. Typically, the stools are scybalous and contain visible mucus.
Mesenteric artery ischemia
This life-threatening disorder produces sudden constipation with failure to expel stool or flatus. Initially, the abdomen is soft and nontender but soon severe abdominal pain, tenderness, vomiting, and anorexia occur. Later, the patient may develop abdominal guarding, rigidity, and distention; tachycardia; syncope; tachypnea; fever; and signs of shock, such as cool, clammy skin and hypotension. A bruit may be heard.
Multiple sclerosis (MS)
This disorder can produce constipation in addition to ocular disturbances, such as nystagmus, blurred vision, and diplopia; vertigo; and sensory disturbances. The patient may also have motor weakness, seizures, paralysis, muscle spasticity, gait ataxia, intention tremor, hyperreflexia, dysarthria, or dysphagia. MS can also produce urinary urgency, frequency, and incontinence as well as emotional instability. A male patient may experience impotence.
Spinal cord lesion
Constipation may occur in this disorder along with urine retention, sexual dysfunction, pain, and possibly motor weakness, paralysis, or sensory impairment below the level of the lesion.
Tabes dorsalis
In tabes dorsalis, constipation is accompanied by an ataxic gait; paresthesia; loss of sensation of body position, deep pain, and temperature; Charcot’s joints; Argyll Robertson pupils; diminished deep tendon reflexes; and possibly impotence.
Ulcerative colitis
Constipation may occur in patients with chronic ulcerative colitis, but bloody diarrhea with pus, mucus, or both is the hallmark of this disorder. Other signs and symptoms include cramping lower abdominal pain, tenesmus, anorexia, low-grade fever and, occasionally, nausea and vomiting. Bowel sounds may be hyperactive. Later, weight loss, weakness, and arthralgias occur.
Ulcerative proctitis
This disorder produces acute constipation with tenesmus. The patient feels an intense urge to defecate but is unable to do so. Instead, he may eliminate mucus, pus, or blood.
Other causes
Diagnostic tests
Constipation can result from the retention of barium given during certain GI studies.
Drugs
Many patients experience constipation when taking an opioid analgesic or other drugs, including vinca alkaloids, calcium channel blockers, antacids containing aluminum or calcium, anticholinergics, and drugs with anticholinergic effects (such as tricyclic antidepressants). Patients may also experience constipation from excessive use of laxatives or enemas.
Surgery and radiation therapy
Constipation can result from rectoanal surgery, which may traumatize nerves, and abdominal irradiation, which may cause intestinal stricture.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Constipation:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑ Lifestyle
❑ Drugs
❑ Depression
❑ Irritable bowel syndrome
❑ Pelvic floor dysfunction
❑ Hypothyroidism
❑ Hypokalemia
❑ Colon cancer
❑ Anorectal pathology
❑ Voluntary retention
❑ Megacolon
❑ Mechanical obstruction
❑ Spinal cord pathology
❑ Hypercalcemia
❑ Scleroderma
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Intestinal obstruction:
Causes
(Handbook of Diseases)
Adhesions and strangulated hernias usually cause small-bowel obstructions; carcinomas usually cause large-bowel obstructions. A mechanical intestinal obstruction results from a foreign body (fruit pits, gallstones, or worms) or compression of the bowel wall due to stenosis, intussusception, volvulus of the sigmoid or cecum, tumors, or atresia.
A nonmechanical obstruction results from a physiologic disturbance, such as paralytic ileus (see Paralytic ileus), electrolyte imbalance, toxicity (uremia or generalized infection), a neurogenic abnormality (spinal cord lesions), or thrombosis or embolism of mesenteric vessels.
The three forms of intestinal obstruction are:
❑ simple — blockage prevents intestinal contents from passing with no other complications
❑ strangulated — blood supply to part or all of the obstructed section is cut off in addition to blockage of the lumen
❑ close looped — both ends of a bowel section are occluded, isolating it from the rest of the intestine.
In all three forms, the physiologic effects are similar. When intestinal obstruction occurs, fluid, air, and gas collect near the site. Peristalsis increases temporarily as the bowel tries to force its contents through the obstruction, injuring intestinal mucosa and causing distention at and above the site of the obstruction. This distention blocks the flow of venous blood and halts normal absorptive processes. As a result, the bowel begins to secrete water, sodium, and potassium into the fluid pooled in the lumen. This results in distention and enormous amounts of fluid in the gut.
An obstruction in the upper intestine results in metabolic alkalosis from dehydration and loss of gastric hydrochloric acid; a lower obstruction causes slower dehydration and loss of intestinal alkaline fluids, resulting in metabolic acidosis. Ultimately, an intestinal obstruction may lead to ischemia, necrosis, and death.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Chronic constipation:
Causes
(Handbook of Diseases)
Chronic constipation usually results from some deficiency in the three elements necessary for normal bowel activity: dietary bulk, fluid intake, and exercise. Other possible causes can include habitual disregard of the impulse to defecate, emotional conflicts, overuse of laxatives, or prolonged dependence on enemas, which dull rectal sensitivity to the presence of stool. Certain medications (tranquilizers, anticholinergics, opioids, antacids) can cause it, and patients with certain disorders (Parkinson’s disease, multiple sclerosis, hypothyroidism, scleroderma, lupus erythematosus) are more prone to develop it.
Clinical tip Anal fissure can also precipitate chronic constipation.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Breath odor, fecal:
Medical causes
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Distal small-bowel obstruction
With late obstruction, nausea is present although vomiting may be delayed. Vomitus initially consists of gastric contents, then changes to bilious contents, followed by fecal contents with resultant fecal breath odor. Accompanying symptoms include achiness, malaise, drowsiness, and polydipsia. Bowel changes (ranging from diarrhea to constipation) are accompanied by abdominal distention, persistent epigastric or periumbilical colicky pain, and hyperactive bowel sounds and borborygmi. As the obstruction becomes complete, bowel sounds become hypoactive or absent. Fever, hypotension, tachycardia, and rebound tenderness may indicate strangulation or perforation.
Gastrojejunocolic fistula
With gastrojejunocolic fistula, symptoms may be variable and intermittent because of temporary plugging of the fistula. Fecal vomiting with resulting fecal breath odor may occur, but the most common chief complaint is diarrhea, accompanied by abdominal pain. Related GI findings include anorexia, weight loss, abdominal distention, and possibly marked malabsorption.
Large-bowel obstruction
Vomiting is usually absent at first, but fecal vomiting with resultant fecal breath odor occurs as a late sign. Typically, symptoms develop more slowly than in small-bowel obstruction. Colicky abdominal pain appears suddenly, followed by continuous hypogastric pain. Marked abdominal distention and tenderness occur, and loops of large bowel may be visible through the abdominal wall. Although constipation develops, defecation may continue for up to 3 days after complete obstruction because of stool remaining in the bowel below the obstruction. Leakage of stool is common with partial obstruction.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Bowel sounds, hypoactive:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Mechanical intestinal obstruction
In a patient with a mechanical intestinal obstruction, bowel sounds may become hypoactive after a period of hyperactivity. The patient may also have acute colicky abdominal pain in the quadrant of obstruction, possibly radiating to the flank or lumbar region; nausea and vomiting (the higher the obstruction, the earlier and more severe the vomiting); constipation; and abdominal distention and bloating. If the obstruction becomes complete, signs of shock may occur.
Mesenteric artery occlusion
In cases of mesenteric artery occlusion, bowel sounds become hypoactive after a brief period of hyperactivity and then quickly disappear, signifying a life-threatening crisis. Associated signs and symptoms include fever; a history of colicky abdominal pain leading to sudden and severe midepigastric or periumbilical pain, followed by abdominal distention and possible bruits; vomiting; constipation; and signs of shock. Abdominal rigidity may appear late.
Paralytic ileus
With paralytic (adynamic) ileus, bowel sounds are hypoactive and may become absent. Associated signs and symptoms include abdominal distention, generalized discomfort, and constipation or passage of small, liquid stools and flatus. If the disorder follows acute abdominal infection, fever and abdominal pain may occur.
Other causes
Drugs
Certain classes of drugs reduce intestinal motility and thus produce hypoactive bowel sounds. These include opiates such as codeine, anticholinergics such as propantheline, phenothiazines such as chlorpromazine, and vinca alkaloids such as vincristine. General or spinal anesthetics produce transient hypoactive sounds.
Surgery
Hypoactive bowel sounds may occur after surgical manipulation of the bowel. Motility and bowel sounds in the small intestine usually resume within 24 hours; colonic bowel sounds, in 3 to 5 days.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Breath with fecal odor:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Distal small-bowel obstruction
With late small-bowel obstruction, nausea is present although vomiting may be delayed. Vomitus initially consists of gastric contents, then changes to bilious contents, followed by fecal contents with resultant fecal breath odor. Accompanying symptoms include achiness, malaise, drowsiness, and polydipsia. Bowel changes (ranging from diarrhea to constipation) are accompanied by abdominal distention, persistent epigastric or periumbilical colicky pain, and hyperactive bowel sounds and borborygmi. As the obstruction becomes complete, bowel sounds become hypoactive or absent. Fever, hypotension, tachycardia, and rebound tenderness may indicate strangulation or perforation.
Gastrojejunocolic fistula
With gastrojejunocolic fistula, symptoms may be variable and intermittent because of temporary plugging of the fistula. Fecal vomiting with resulting fecal breath odor may occur, but the most common chief complaint is diarrhea, accompanied by abdominal pain. Related GI findings include anorexia, weight loss, abdominal distention and, possibly, marked malabsorption.
Large-bowel obstruction
Vomiting is usually absent at first, but fecal vomiting with resultant fecal breath odor occurs as a late sign of large-bowel obstruction. Typically, symptoms develop more slowly than in small-bowel obstruction. Colicky abdominal pain appears suddenly, followed by continuous hypogastric pain. Marked abdominal distention and tenderness occur, and loops of large bowel may be visible through the abdominal wall. Although constipation develops, defecation may continue for up to 3 days after complete obstruction because of stool remaining in the bowel below the obstruction. Leakage of stool is common with partial obstruction. Explain all procedures and treatments.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Constipation:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Anal fissure
An anal fissure, a crack or laceration in the lining of the anal wall, can cause acute constipation, usually due to the patient’s fear of the severe tearing or burning pain associated with bowel movements. He may notice a few drops of blood streaking toilet tissue or his underwear.
Anorectal abscess
With an anorectal abscess, constipation occurs with severe, throbbing, localized pain and tenderness at the abscess site. The patient may also have localized inflammation, swelling, and purulent drainage and may complain of fever and malaise.
Diverticulitis
With diverticulitis, constipation or diarrhea occurs with left-lower-quadrant pain and tenderness and possibly a palpable, tender, firm, fixed abdominal mass. The patient may develop mild nausea, flatulence, or a low-grade fever.
Hemorrhoids
Thrombosed hemorrhoids cause constipation as the patient tries to avoid the severe pain of defecation. The hemorrhoids may bleed during defecation. The patient may notice bright red blood on stools or toilet tissue.
Hepatic porphyria
Abdominal pain, which may be severe, colicky, localized, or generalized, precedes constipation in hepatic porphyria. The patient may also have fever, sinus tachycardia, labile hypertension, excessive diaphoresis, severe vomiting, photophobia, urine retention, nervousness or restlessness, disorientation and, possibly, visual hallucinations. Deep tendon reflexes may be diminished or absent. Some patients have skin lesions causing itching, burning, erythema, altered pigmentation, and edema in areas exposed to light. Severe hepatic porphyria can produce delirium, coma, seizures, paraplegia, or complete flaccid quadriplegia.
Hypercalcemia
With hypercalcemia, constipation usually occurs along with anorexia, nausea, vomiting, polyuria, and polydipsia. The patient may also display arrhythmias, bone pain, muscle weakness and atrophy, hypoactive deep tendon reflexes, and personality changes.
Hypothyroidism
Constipation occurs early and insidiously in patients with hypothyroidism, in addition to fatigue, sensitivity to cold, anorexia with weight gain, menorrhagia, decreased memory, hearing impairment, muscle cramps, and paresthesia.
Intestinal obstruction
Constipation associated with intestinal obstruction varies in severity and onset, depending on the location and extent of the obstruction. With partial obstruction, constipation may alternate with leakage of liquid stools. With complete obstruction, obstipation may occur. Constipation can be the earliest sign of partial colon obstruction, but it usually occurs later if the level of the obstruction is more proximal. Associated findings include episodes of colicky abdominal pain, abdominal distention, nausea, or vomiting. The patient may also develop hyperactive bowel sounds, visible peristaltic waves, a palpable abdominal mass, and abdominal tenderness.
Irritable bowel syndrome
Irritable bowel syndrome, a common disorder, usually produces chronic constipation, although some patients have intermittent, watery diarrhea and others complain of alternating constipation and diarrhea. Stress may trigger nausea and abdominal distention and tenderness, but defecation usually relieves these signs and symptoms. Patients with irritable bowel syndrome commonly have an intense urge to defecate and feelings of incomplete evacuation. Typically, the stools are scybalous and contain visible mucus.
Mesenteric artery ischemia
Mesenteric artery ischemia, a life-threatening disorder, produces sudden constipation with failure to expel stools or flatus. Initially, the abdomen is soft and nontender but soon severe abdominal pain, tenderness, vomiting, and anorexia occur. Later, the patient may develop abdominal guarding, rigidity, and distention; tachycardia; syncope; tachypnea; fever; and signs of shock, such as cool, clammy skin and hypotension. A bruit may be heard.
Multiple sclerosis
Multiple sclerosis (MS) can produce constipation in addition to ocular disturbances, such as nystagmus, blurred vision, and diplopia; vertigo; and sensory disturbances. The patient may also have motor weakness, seizures, paralysis, muscle spasticity, gait ataxia, intention tremor, hyperreflexia, dysarthria, or dysphagia. MS can also produce urinary urgency, frequency, and incontinence as well as emotional instability. A male patient may experience impotence.
Spinal cord lesion
Constipation may occur with a spinal cord lesion, in addition to urine retention, sexual dysfunction, pain and, possibly, motor weakness, paralysis, or sensory impairment below the level of the lesion.
Ulcerative colitis
Constipation may occur in patients with chronic ulcerative colitis, but bloody diarrhea with pus, mucus, or both is the hallmark of this disorder. Other signs and symptoms include cramping lower abdominal pain, tenesmus, anorexia, low-grade fever and, occasionally, nausea and vomiting. Bowel sounds may be hyperactive. Later, weight loss, weakness, and arthralgia occur.
Other causes
Diagnostic tests
Constipation can result from the retention of barium given during certain GI studies.
Drugs
Patients often experience constipation when taking an opioid analgesic or other drugs, including vinca alkaloids, calcium channel blockers, antacids containing aluminum or calcium, anticholinergics, and drugs with anticholinergic effects (such as tricyclic antidepressants). Patients may also experience constipation from excessive use of laxatives or enemas.
Surgery and radiation therapy
Constipation can result from rectoanal surgery, which may traumatize nerves, and abdominal irradiation, which may cause intestinal stricture.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Constipation:
Principal Causes of Constipation
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
- Constitutional
- Geneticpredisposition
- Colonic inertia
- Dietary factors
- Developmental, situational, and psychologicdisturbances
- Gastrointestinal disorders
- Anal fissure
- Anal stenosis
- Anterior location of the anus
- Proctitis
- Congenital aganglionic megacolon
- Cystic fibrosis
- Celiac disease
- Chronic intestinal pseudoobstruction
- Abdominal, pelvic, and sacral masses
- Neurologic disorders
- Mentalretardation
- Spinal dysraphism
- Spinal cord injury
- Spinal tumor
- Neuromuscular disorders
- Metabolic disorders
- Drugs
» READ BOOK EXCERPT ONLINE »
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
Bowel sounds, hypoactive:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Mechanical intestinal obstruction.Bowel sounds may become hypoactive after a period of hyperactivity. The patient may also have acute colicky abdominal pain in the quadrant of obstruction, possibly radiating to the flank or lumbar region; nausea and vomiting (the higher the obstruction, the earlier and more severe the vomiting); constipation; and abdominal distention and bloating. If the obstruction becomes complete, signs of shock may occur.
Mesenteric artery occlusion.After a brief period of hyperactivity, bowel sounds become hypoactive and then quickly disappear, signifying a life-threatening crisis. Associated signs and symptoms include fever; a history of colicky abdominal pain leading to sudden and severe midepigastric or periumbilical pain, followed by abdominal distention and possible bruits; vomiting; constipation; and signs of shock. Abdominal rigidity may appear late.
Paralytic (adynamic) ileus.Bowel sounds are hypoactive and may become absent. Associated signs and symptoms include abdominal distention, generalized discomfort, and constipation or passage of small, liquid stools and flatus. If the disorder follows acute abdominal infection, fever and abdominal pain may occur.
Other causes
Drugs.Certain classes of drugs reduce intestinal motility and thus produce hypoactive bowel sounds. These include opiates, such as codeine; anticholinergics, such as propantheline bromide; phenothiazines, such as chlorpromazine; and vinca alkaloids such as vincristine. General or spinal anesthetics produce transient hypoactive sounds.
Radiation therapy.Hypoactive bowel sounds and abdominal tenderness may occur after irradiation of the abdomen.
Surgery.Hypoactive bowel sounds may occur after manipulation of the bowel. Motility and bowel sounds in the small intestine usually resume within 24 hours; colonic bowel sounds, in 3 to 5 days.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Breath with fecal odor:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Distal small-bowel obstruction.With late small-bowel obstruction, nausea is present although vomiting may be delayed. Vomitus initially consists of gastric contents, then changes to bilious contents, followed by fecal contents with resultant fecal breath odor. Accompanying symptoms include achiness, malaise, drowsiness, and polydipsia. Bowel changes (ranging from diarrhea to constipation) are accompanied by abdominal distention, persistent epigastric or periumbilical colicky pain, and hyperactive bowel sounds and borborygmi. As the obstruction becomes complete, bowel sounds become hypoactive or absent. Fever, hypotension, tachycardia, and rebound tenderness may indicate strangulation or perforation.
Gastrojejunocolic fistula.With gastrojejunocolic fistula, symptoms may be variable and intermittent because of temporary plugging of the fistula. Fecal vomiting with resulting fecal breath odor may occur, but the most common chief complaint is diarrhea, accompanied by abdominal pain. Related GI findings include anorexia, weight loss, abdominal distention and, possibly, marked malabsorption.
Large-bowel obstruction.Vomiting is usually absent initially with a large-bowel obstruction, but fecal vomiting with resultant fecal breath odor occurs as a late sign. Typically, symptoms develop more slowly than in small-bowel obstruction. Colicky abdominal pain appears suddenly, followed by continuous hypogastric pain. Marked abdominal distention and tenderness occur, and loops of large bowel may be visible through the abdominal wall. Although constipation develops, defecation may continue for up to 3 days after complete obstruction because of stool remaining in the bowel below the obstruction. Leakage of stool is common with partial obstruction.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Constipation:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Anal fissure.A crack or laceration in the lining of the anal wall can cause acute constipation, usually due to the patient's fear of the severe tearing or burning pain associated with bowel movements. He may notice a few drops of blood streaking toilet tissue or his underwear.
Anorectal abscess.In anorectal abscess, constipation occurs together with severe, throbbing, localized pain and tenderness at the abscess site. The patient may also have localized inflammation, swelling, and purulent drainage and may complain of fever and malaise.
Cirrhosis.In the early stages of cirrhosis, the patient experiences constipation along with nausea and vomiting and a dull pain in the right upper quadrant. Other early findings include indigestion, anorexia, fatigue, malaise, flatulence, hepatomegaly and, possibly, splenomegaly and diarrhea.
Diabetic neuropathy.Diabetic neuropathy produces episodic constipation or diarrhea. Other signs and symptoms include dysphagia, orthostatic hypotension, syncope, and painless bladder distention with overflow incontinence. A male patient may also experience impotence and retrograde ejaculation.
Diverticulitis.In diverticulitis, constipation or diarrhea occurs with left lower quadrant pain and tenderness and possibly a palpable, tender, firm, fixed abdominal mass. The patient may develop mild nausea, flatulence, or a low-grade fever.
Hemorrhoids.Thrombosed hemorrhoids cause constipation as the patient tries to avoid the severe pain of defecation. The hemorrhoids may bleed during defecation.
Hepatic porphyria.Abdominal pain, which may be severe, colicky, localized, or generalized, precedes constipation in hepatic porphyria. The patient may also have a fever, sinus tachycardia, labile hypertension, excessive diaphoresis, severe vomiting, photophobia, urine retention, nervousness or restlessness, disorientation and, possibly, visual hallucinations. Deep tendon reflexes may be diminished or absent. He may also have skin lesions causing itching, burning, erythema, altered pigmentation, and edema in areas exposed to light. Severe hepatic porphyria can produce delirium, coma, seizures, paraplegia, or complete flaccid quadriplegia.
Hypercalcemia.With hypercalcemia, constipation usually occurs along with anorexia, nausea, vomiting, polyuria, and polydipsia. The patient may also display arrhythmias, bone pain, muscle weakness and atrophy, hypoactive deep tendon reflexes, and personality changes.
Hypothyroidism.Constipation occurs early and insidiously in patients with hypothyroidism, in addition to fatigue, sensitivity to cold, anorexia with weight gain, menorrhagia in women, decreased memory, hearing impairment, muscle cramps, and paresthesia.
Intestinal obstruction.Constipation associated with an intestinal obstruction varies in severity and onset, depending on the location and extent of the obstruction. With partial obstruction, constipation may alternate with leakage of liquid stools. With complete obstruction, obstipation may occur. Constipation can be the earliest sign of partial colon obstruction, but it usually occurs later if the level of the obstruction is more proximal. Associated findings include episodes of colicky abdominal pain, abdominal distention, nausea, or vomiting. The patient may also develop hyperactive bowel sounds, visible peristaltic waves, a palpable abdominal mass, and abdominal tenderness.
Irritable bowel syndrome (IBS).IBS commonly produces chronic constipation, although some patients have intermittent, watery diarrhea and others complain of alternating constipation and diarrhea. Stress may trigger nausea and abdominal distention and tenderness, but defecation usually relieves these signs and symptoms. Patients typically have an intense urge to defecate and feelings of incomplete evacuation. Typically, the stools are scybalous and contain visible mucus.
Mesenteric artery ischemia.Mesenteric artery ischemia is a life-threatening disorder that produces sudden constipation with failure to expel stool or flatus. Initially, the abdomen is soft and nontender, but soon severe abdominal pain, tenderness, vomiting, and anorexia occur. Later, the patient may develop abdominal guarding, rigidity, and distention; tachycardia; syncope; tachypnea; a fever; and signs of shock, such as cool, clammy skin and hypotension. A bruit may be heard.
Spinal cord lesion.Constipation may occur with a spinal cord lesion, in addition to urine retention, sexual dysfunction, pain and, possibly, motor weakness, paralysis, or sensory impairment below the level of the lesion.
Other causes
Diagnostic tests.Constipation can result from the retention of barium given during certain GI studies.
Drugs.Patients commonly experience constipation when taking an opioid analgesic or other drugs, including vinca alkaloids, calcium channel blockers, antacids containing aluminum or calcium, anticholinergics, and drugs with anticholinergic effects (such as tricyclic antidepressants). Patients may also experience constipation from excessive use of laxatives or enemas.
Surgery and radiation therapy.Constipation can result from rectoanal surgery, which may traumatize nerves, and abdominal irradiation, which may cause intestinal stricture.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Intestinal Obstruction:
Intestinal Obstruction - pathophysiology
(The 5-Minute Pediatric Consult)
- Mechanical obstruction:
- Intestinal contents accumulate proximal to the site of obstruction.
- The bowel distends with swallowed air, ingested food, secretions, and gases from intestinal reactions and bacterial fermentation.
- Retrograde flow of intestinal contents and reflex gut distention cause vomiting.
- Internal and external losses result in hypovolemia, oliguria, and azotemia.
- Bacteria proliferate in the small bowel and its contents become feculent.
- Strangulation obstruction (impaired blood flow to the intestine in addition to intestinal content obstruction):
- Loss of plasma into the bowel, leading more rapidly to shock
- When strangulation progresses, gangrene, peritonitis, and perforation may ensue.
- Damage to the normal gut barrier may enable bacteria, bacterial toxins, and inflammatory mediators to enter the circulation causing sepsis
Intestinal Obstruction - etiology
- Neonates:
- Atresia of the intestine (33% of all neonatal obstructions, 1:2700 newborns)
- Meconium ileus (30% of all neonatal obstructions, almost all caused by cystic fibrosis) and meconium plug
- Anorectal malformation: Anal atresia and stenosis (1 in 4,000–8,000 newborns)
- Necrotizing enterocolitis
- Hirschsprung disease
- Infants:
- The most common cause of intestinal obstruction is pyloric stenosis.
- The 2nd most common is intussusception (the most common cause between 3 months and 6 years of age, with 60% of cases occurring before 1 year of age).
- Other, less common causes:
- Postoperative intestinal obstruction and adhesion
- Incarcerated or strangulated inguinal hernia. Inguinal hernias have 10–28% risk for incarceration
- Hirschsprung disease
- Duplications
- Meckel diverticulum
- Older children:
- Malrotation
- Annular pancreas
- Meckel diverticulum
- Cancer-related intestinal obstruction, and radiotherapy induced adhesions
- Superior mesenteric artery syndrome
- Corrosive injury-induced gastric outlet obstruction
- Esophageal injury or foreign body ingestion (e.g., coin in esophagus)
- Postoperative intestinal obstruction and adhesions
- Juvenile polyposis and related syndromes (e.g., Peutz-Jeghers)
- Inflammatory bowel disease
- Meconium ileus equivalent (occurs only in patients with cystic fibrosis)
- Roundworm (A. lumbricoides)
- Gastric and intestinal bezoars
» READ BOOK EXCERPT ONLINE »
Source: The 5-Minute Pediatric Consult, 2008
A tiny camera called laparoscope can be used to peek inside the body and diagnose disease. Learn how this minimally invasive technique is now being...
Whenever you go to a hospital or clinic for a major procedure or diagnostic test, one of the many forms you are given to sign is an "informed...
Health insurance is important to everyone, especially people with chronic conditions like Crohn's disease and ulcerative colitis. Tune in to...
Sleep is necessary to feel refreshed, but now we know sleep actually impacts the way the body functions. Sleeping poorly can affect how often you get...
See full list of 4 related videos
» Next page: Symptoms of Intestinal obstruction
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
