Alternative Names: Intestinal Blockage
Intestinal obstruction (bowel obstruction) involves disruption of the normal movement of fecal matter through the bowel.
Most of the 6-8 liters of fluid that enter the small bowel each day is absorbed through the microvilli in the small intestine. The walls of the small and large bowel contain layers of smooth muscle that propel their contents forward using a series of muscle contractions called peristalsis. The nerve supply to this smooth muscle is from both the parasympathetic (vagus nerve) and sympathetic divisions of the autonomic nervous system. Parasympathetic stimulation increases movement (motility) through the gut using waves of peristalsis. Sympathetic activity has the opposite effect: it brings about a reduction in intestinal motility and peristalsis.
When intestinal obstruction occurs, peristalsis is either severely reduced or absent. As a result, fluid, gas and intestinal contents accumulate and abdominal distention with nausea and vomiting occurs. This leads to fluid loss, dehydration and electrolyte imbalances involving sodium, potassium and chloride. These disturbances contribute further to the existing intestinal obstruction.
Laboratory Findings of Dehydration:
Distention of the bowel wall brings about an increase in capillary permeability, and intestinal fluid and electrolytes leak into the peritoneal cavity, causing peritonitis. Peritonitis is a major cause of paralytic ileus and together with fluid loss and electrolyte disturbances rapidly places the patient – unless treated correctly – into a state of hypovolemic shock.
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