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Bowel Obstruction Surgery
Bowel Obstruction Surgery
Contraindications
Bowel obstruction surgery is a major procedure. But given that it is often a
critically needed one, the pros often outweigh the cons in many patients.
Chronic bowel obstructions that cannot be removed with surgery may occur
in some patients, particularly those with advanced cancer. This may be due
to narrowed structures and/or large tumor size.2
Potential Risks
In addition to the standard risks of surgery and anesthesia, possible
complications following bowel obstruction surgery include: 3
When certain causes are to blame, conservative measures may be tried prior
to considering bowel obstruction surgery. In others, surgery is the main
treatment option and, sometimes, is urgently needed.
You might need bowel obstruction surgery if it's determined that you have
any of the following issues:5
These options are used when a person is medically stable and the bowel isn't
in immediate danger or necrosis, or when the risk of surgery is very high
(such as due to underlying disease, like heart disease).
Conservative therapies include:6
If these treatments do not relieve the blockage, surgery might be the next
step.
How to Prepare
An acute bowel obstruction can be extremely painful and often results in a
visit to the emergency room. For acute and chronic bowel obstruction,
surgery may occur within a few hours to up to three days after the
diagnosis.9
Location
Bowel obstruction surgery is performed in the hospital in an operating room.
What to Wear
For the surgery and remaining hospital stay, you will wear a hospital gown.
It is recommended that you arrive for your surgery wearing loose-fitting
clothes that are easy to change out of.
Don't wear any jewelry during the surgery and leave anything of value at
home.
Medications
It is important to notify your surgical team of any prescription and over-the-
counter medications and supplements you are currently taking. Certain
medications may be problematic during surgery. In particular, blood thinners
can cause excessive bleeding.10
What to Bring
In addition to personal care and comfort items like toiletries and a change of
clothes, make sure you have health insurance documents and personal
identification with you.
A foley catheter is placed in the urethra to collect urine. You may also have a
nasogastric tube placed into your nose and down to your mouth to collect
blood and fluid from your stomach during surgery.
The surgical staff will swab your abdomen with a solution that kills germs
and put a drape around the surgical area to prevent infections.
After it is confirmed that you are fully under anesthesia, your surgery will
begin.
Minimally invasive surgery may utilize thin scopes, which are tubes inserted
through one or more tiny incisions in the abdomen.
Alternatively, endoscopy, in which a tube is placed into the mouth,
or sigmoidoscopy, in which a tube is placed into rectum, may be used to
treat the blockage.
With minimally invasive laparoscopic procedures, the surgeon uses a
computer monitor to view the intestines and the obstruction. Sometimes
trapped stool is broken apart and suctioned out through the tube. Or a polyp
or tumor might be removed, followed by repair of the adherent intestinal
tissue. A stent might be placed if the obstructed area is prone to recurrent
obstruction, such as due to nerve or muscle impairment.
Any abdominal incisions will be closed with stitches or steri-tape. And your
wound will be covered with sterile gauze and tape to protect it.
You will be groggy at first and slowly become more alert. Once you are
awake and your blood pressure, pulse, and breathing are stable, you will be
moved to a hospital room to begin recovering.
Your IV will stay in place so you can receive medications and fluids for the
remainder of your hospital stay. Likewise, your urinary catheter will remain
in place until you are physically able to get out of bed and walk to the
bathroom.
Recovery
After surgery for a bowel obstruction, your stomach and intestines need time
to regain normal function and heal. The amount of time that will take
depends on the extent of your procedure and any co-occurring health
conditions you may have, such as colon cancer.
Most patients stay in the hospital for between five and seven days following
bowel obstruction surgery. It can take several weeks or months to fully
return to normal activities.
Your medical team with work with you to manage post-surgical pain.
Opioids, which are typically used to relieve pain, can lead to post-operative
constipation and are used sparingly after bowel obstruction surgery. 13
Nonsteroidal anti-inflammatory medications (NSAIDs) can also be risky as
they may cause bleeding of the stomach or intestines.
Before Discharge
Your doctors will confirm that you can pass gas before you will be allowed to
drink small amounts of fluid. Your diet will start with clear fluids and (when
your body shows signs that it is ready) slowly advance to soft foods.
If a colostomy or ileostomy was needed, you will have a tube with a bag
attached to collect stool. Your nurse will instruct you on how to care for it
before you go home.14
Healing
Some patients may require a visiting nurse to check on the wound as it
heals, oversee colostomy/ileostomy care, or administer tube feedings.
Once you are home and on the road to recovery, some things to keep in
mind:
Vomiting or nausea
Diarrhea that continues for 24 hours
Rectal bleeding or tar-colored stool
Pain that persists or worsens and is not controlled with medication
Bloated, swollen, or tender belly
Inability to pass gas or stools
Signs of infection, such as fever or chills
Redness, swelling, or bleeding or draining from the incision site
Stitches or staples that come out on their own
Treatment protocols are not one-size-fits-all and it may take several tries to
find the right medication or combination of medications for you. If a
particular medication fails to bring relief or if you experience uncomfortable
side effects, notify your doctor, who can prescribe a different course of
action.
Lifestyle Adjustments
Once you recover from a bowel obstruction, it is important to maintain bowel
health and regularity. You may want to work with a dietitian to develop an
eating plan that contains the right amount of fiber for your individual needs.
If you have an ostomy, know that you can lead an active and healthy
lifestyle but will also have to make some adjustments. This means timing
your meals so you won't have to empty it at an inconvenient time, keeping it
clean, and wearing clothes that are comfortable and convenient.