Obstipation

Obstipation Definition

Obstipation is the patient’s inability to pass fecal matters or gas. It is essentially an extended and chronic  constipation.  When wastes cannot be completely eliminated from the intestines it becomes a chronic state and the intestines can become obstructed.

There is no precise diagnostic exam for obstipation.  The condition of obstipation is identified by the patient’s health history and the signs and symptoms which are present at the time of the medical examination.

A person who is chronically constipated is likely to feel bloated almost continually.  Often that will lead to anorexia, tenderness and abdominal discomfort.  If constipation is ignored, the patient will have more complications. It is wise to seek treatment at the earliest possible time if severe constipation persists.

Since the role of the intestines is to eliminate solid and semi-solid wastes from the body, it is clear that if the bowel is not cleared regularly, wastes will accumulate.  Similarly, toxins can be accumulated at the same time.  This process leads to inflammation, infection, bad breath and body odor.  Prolonged inflammation may also  interrupt the blood supply to the intestines.  If this happens, the patient may experience cramps, collapse of the intestines, peritonitis, malaise, fever and tachycardia.

When intestinal distention arises, peristaltic movement of the intestines is interrupted or stopped.    The normal secretions within the intestines become reduces or absent.  By that time, the intestines will begin to lose their ability to absorb water and nutrients.   In addition, there are 0ther physical symptoms such as  nausea, dehydration and vomiting.[1]

Difference between obstipation and constipation

If a person does not have a routine bowel movement or has fewer than three bowel movements in a single week, that person is considered to be constipated.  Constipation means the patient had inadequate bowel movements to maintain good intestinal health.  Their stool is usually hard and dry. That results in straining during a regular bowel movement and sometimes pain during the elimination process.

Beyond that is obstipation.   This is a case of constipation that is persistent and severe.  It could be a result of obstruction within the intestines.

Obstipation Causes

The same symptoms that cause chronic constipation can lead to and result in obstipation if not corrected.  It is important to remember that constipation and obstipation are not diseases. They are significant symptoms which are not to be ignored.  Some contributing factors may be:

  • Poor muscle tone,
  • Particular medications,
  • Insufficient exercise,
  • Some metabolic conditions, like celiac disease, diabetes,etc.
  • Insufficient water consumption,
  • Low fiber diet–A recommended fiber intake is 20-35 grams per day.
  • Anal fissure
  • Impaction of fecal material
  • Obstruction of the intestines
  • Adhesions in the peritoneum
  • Gallstone ileus
  • Fecalith
  • Colonic stricture
  • Hypokalemia
  • Hypothyroidism
  • Intestinal atresia-narrowing or closure of the intestines
  • Functional constipation
  • Intussusception – the intestines fold into itself which causes obstruction

Obstipation Diagnosis

Obstipation diagnosis is helped by a physical examination and palpation of the abdomen. A manual rectal exam can reveal polyps or hemorrhoids or the presence or absence of stool in the rectum. [5]  Urine tests may show a decreased level of urobilinogen. [2]

In addition,  several diagnostic tests can be performed.  By examining the patient with  x-rays or CT scans of the abdomen, the physician can confirm the condition of obstipation.  Other useful diagnostic tests may include an upper GI series, a barium enema, a colonoscopy or sigmoidoscopy.

Obstipation Treatment

Essentially the common sense treatment for chronic constipation is increased fluid consumption, increase fiber content in food choices and, if possible increase exercise. This remains the initial treatment for obstipation.  When it is possible, exercise helps to improve peristalsis by increasing circulation in the intestines.

Traditionally enemas have been used but they are not as productive because they only evacuate the lower part of the colon.  Some laxatives may be recommended or prescribed as a way to clear the obstruction, two new products have demonstrated positive results: prucalopride and lubiprostone.[5]  There is a preference for using osmotic laxatives rather than stimulant laxatives for short periods of time.  The use of stool softeners may be sufficient in some cases. [8]

If the patient is severely dehydrated there may be a need for intravenous fluids to correct the electrolyte balance and restore bodily fluids. If severe pain is present, antispasmodic or analgesic medications may be needed for short periods of time.

If the impaction or obstruction cannot be relieved, a colonoscopy or laparoscopic surgery may be necessary.

Obstipation Prevention

The best way to prevent obstipation is to maintain a regular bowel movement and avoid constipation.  Drink clear liquids, like water, herbal teas, broths, throughout the day, not just at meals. A daily amount of 3 liters (8 glasses) is recommended.  Fruit juice requires metabolic activity and is not as helpful. Alcohol, coffee and milk are not ideal liquids to help with this process.

Increase the amount of fiber in your diet. Bran, psyllium or other natural fibers will provide bulk. Be sure to drink plenty of liquid when adding these fibers to your diet.

Daily walnut or prune consumption is a standard in many cultures. They serve as natural laxatives.

Bitters such as chicory, radicchio or artichoke, help to activate the liver and gallbladder which stimulates peristalsis and improve the ability to defecate.

References:

  1. http://www.livestrong.com/article/63928-colon-obstruction-symptoms/
  2. http://en.diagnosispro.com/disease_information-for/obstipation/17265.html
  3. http://www.ailments.com/3294/Obstipation.html
  4. http://medical-dictionary.thefreedictionary.com/obstipation
  5. http://www.rightdiagnosis.com/o/obstipation/intro.htm
  6. http://en.wikipedia.org/wiki/Obstipation
  7. http://emedicine.medscape.com/article/774045-overview
  8. http://www.merckmanuals.com/home/digestive_disorders/symptoms_and_diagnosis_of_digestive_disorders/symptoms.html



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