Constipation or Intestinal Obstruction?

• Constipation and intestinal obstruction share many similar symptoms, such as stomach pain and being unable to pass stools normally. However, intestinal obstruction means no fluids or solids can pass through the intestines, so neglecting to seek treatment could allow the condition to become life-threatening.
• Both constipation and intestinal obstruction can be prevented with dietary and lifestyle modifications. Be sure to keep an eye out for any symptoms and be sure to seek medical attention if you experience constipation in conjunction with gas, bloating, vomiting, and anal bleeding in order to undergo diagnosis and receive the proper treatment. Additionally, those aged 45 and above should attend annual colon cancer screening.

Although constipation is not a life-threatening condition, many people who suffer with this disorder are tormented by the irregular bowel movements it causes, which can affect both their physical and mental health, leading to stress, loss of appetite, stomach discomfort, and a lack of vitality. Furthermore, constipation can lead to other associated health issues, such as hemorrhoids and anal or rectal ulcers, as well as being one of the warning signs for more serious illnesses, including intestinal obstruction or colon cancer.

Constipation refers to not being able to pass stools more than 3 times per week, with those bowel movements often taking a long time to complete. Indeed, the stools passed are generally small and hard in texture, leaving the patient with stomach discomfort and feeling like they have not been able to pass the full contents of their bowels. Patients who neglect treatment despite experiencing constipation for longer than 3 months and who are still showing signs of the disorder over 6 months on from the original bout could end up feeling continuously constipated. Such an experience may even worsen and lead to chronic constipation, which is one of the most common gastrointestinal disorders, affecting over 30% of the population, with the elderly most affected, and women twice as likely to develop the condition as their male counterparts.

• Hard, lumpy stools
• A feeling of not having emptied the full contents of the bowels
• Feeling like something is obstructing the rectum
• Needing to take laxatives in order to pass stools
• Taking a long time to pass stools
• Needing to push harder than usual to empty the bowels

Constipation has several causes, although they are generally placed into one of the following two categories:

• Primary causes are those that are a direct result of irregular function in the large intestine and excretory system. The cause is reduced movement within the large intestine, leading to stools passing through the system more slowly than usual. However, this cause is rare and accounts for just 5-6% of all cases of constipation.
• Secondary causes are those that are caused by other, indirect factors, such as a diet low in fiber, not drinking enough fluids, not exercising regularly, the use of certain drugs or food supplements, and the effects of certain liver and GI disorders.

• Making behavioral adjustments: Constipation is not a life-threatening condition and initial treatment can be as simple as eating more fiber, drinking more fluids, exercising more regularly, daily training in how to pass stools effectively, not playing on your phone while in the bathroom, and using laxative drugs as appropriate. 
• Biofeedback training: This is used to teach patients how to pass stools properly through the use of special equipment that provides feedback on the movements of the muscles used when passing stools. This training is used to treat patients with chronic constipation who are unsure of whether their condition is related to irregular function in the large intestine, or a result of improper technique employed when passing stools. Indeed, there are many patients who clench or do not relax the anus when using the bathroom, making it difficult for the stool to pass through, resulting in dyssynergia. Doctors can diagnose this condition using a screening technique called anorectal manometry, which monitors muscle function during bowel movements.

Nevertheless, if constipation occurs alongside other symptoms or indicators, such as a sudden loss of weight, passing blood with stools, alternating between bouts of constipation and bouts of diarrhea, a lump forming, having a direct relative who suffered with colon cancer, of experiencing a first bout of constipation after reaching the age of 50, medical attention should be sough in order to receive a diagnosis as there is a chance that these could be indicative of the onset of colon cancer. 

Intestinal obstruction refers to a condition whereby the regular movements of the intestines become disrupted or blocked. This means that neither fluids nor solids can pass through normally, which can cause stomach pain, gas, nausea, and vomiting. Symptoms are often an indicator of where the obstruction has occurred, with partial or complete blockages both possible. Untreated, intestinal obstructions can lead to severe complications or even life-threatening situations.

The symptoms of intestinal obstruction differ according to the location of the blockage, as follows:

1. Obstruction of the small intestine
   • Gas and bloating but an inability to release the pressure
   • Abdominal pain when pressed
   • Severe stomach pain around the naval and below the ribs, which comes and goes, with an elevated pulse also possible
   • Nausea and vomiting
2. Obstruction of the large intestine
   • Gas and bloating
   • Severe stomach pain
   • Constipation
   • Passing bloody stools

The causes are classified into 2 categories, as follows:

• Mechanical obstructions: These are caused by something blocking the intestines, with the most common mechanical obstruction being the membrane which can form in the intestine following an operation on the organ. However, there are several other potential issues that can cause a blockage, including colon cancer, a tumor, gallstones, a hernia, congenital intestinal abnormalities, and intestinal inflammation disorders, such as Crohn’s disease.
• Nonmechanical obstructions: These are caused by the intestine’s inability to contract properly and move normally, thus affecting the excretory system. This can be a result of abdominal or pelvic floor surgery, infection, the use of certain types of drugs, and disorders affecting the musculoskeletal and nervous system, such as Parkinson’s disease and diabetes. 
   

Treatment for an intestinal obstruction is reliant upon accurate identification of the cause and the patient’s symptoms. Treatments of the condition are categorized as follows:

• Partial intestinal obstruction treatment: In cases where fluids and solids are still able to pass through the intestine to some extent, treatment will begin with fluid meals. Then, if the symptoms improve, doctors will recommend a diet which is low in fiber for an extended period. However, should the symptoms not improve, surgery may be considered.
• Complete intestinal obstruction treatment: Patients whose intestines are fully blocked – meaning neither fluids nor solids can pass through – will need to have surgery in order to remove the blockage or to remove the affected section of the intestine.
• Pseudo-obstruction (paralytic ileus) treatment: These cases require feeding through a nasogastric tube or an IV to prevent malnourishment. If the symptoms do not improve with time, they may require medication to stimulate intestinal function or surgery to remove the affected section of intestine. If the colon is enlarged or severely dilated, doctors may also consider decompression using a colonoscopy.

Constipation and intestinal obstruction share many similar symptoms, especially stomach pain and the inability to pass stools normally. However, treatment for constipation is much simpler than what is required to treat an intestinal obstruction. Therefore, constipation is not considered a dangerous condition while an intestinal obstruction could potentially be life-threatening if not treated properly. 

Nevertheless, whether you are suffering from a temporary bout of constipation, chronic constipation, or an intestinal obstruction, it is vital that you seek medical treatment before it is allowed to deteriorate and cause other, more serious disorders, such as a perforated intestine, hemorrhoids, or kidney failure. Indeed, it is entirely possible that an intestinal obstruction could lead to loss of life if it restricts circulation to other areas of the intestine, resulting in tissue death and sepsis that could easily cause organ failure.

Fortunately, the symptoms of both constipation and intestinal obstruction are preventable by reducing exposure to certain risk factors, including making dietary and lifestyle adjustments. This means eating a diet that is low in fat, with plenty of fruit and vegetables that are high in fiber, avoiding smoking, and keeping an eye out for tell-tale signs of illness. You should also be sure to seek medical attention if you experience constipation alongside gas, bloating, vomiting, and anal bleeding as the doctor will carry out a thorough diagnosis and prescribe treatment as necessary. Furthermore, given the similarities of symptoms displayed in various digestive system disorders, those aged 45 and above who experience any of the aforementioned symptoms are advised to make a doctor’s appointment in order to undergo colon cancer screening. This can identify or rule out the disease, with subsequent screening appointments advisable on an annual basis thereafter.