Materiały źródłowe

• #1 Intestinal obstruction – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/symptoms-causes/syc-20351460

  Without treatment, the blocked parts of the intestine can die, leading to serious problems. However, with prompt medical care, intestinal obstruction often can be successfully treated. […] Because of the serious complications that can develop from intestinal obstruction, seek immediate medical care if you have severe abdominal pain or other symptoms of intestinal obstruction. […] Untreated, intestinal obstruction can cause serious, life-threatening complications, including: […] Intestinal obstruction can cut off the blood supply to part of your intestine. Lack of blood causes the intestinal wall to die. Tissue death can result in a tear (perforation) in the intestinal wall, which can lead to infection. […] Peritonitis is the medical term for infection in the abdominal cavity. It’s a life-threatening condition that requires immediate medical and often surgical attention.

• #2 Intestinal obstruction – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/diagnosis-treatment/drc-20351465

  Treatment for intestinal obstruction depends on the cause of your condition, but generally requires hospitalization. […] When you arrive at the hospital, the doctors stabilize you so that you can undergo treatment. This process may include: […] A barium or air enema is used both as a diagnostic procedure and a treatment for children with intussusception. If an enema works, further treatment is usually not necessary. […] If you have an obstruction in which some food and fluid can still get through (partial obstruction), you may not need further treatment after you’ve been stabilized. Your doctor may recommend a special low-fiber diet that is easier for your partially blocked intestine to process. If the obstruction does not clear on its own, you may need surgery to relieve the obstruction.

• #3 Evaluation and Management of Intestinal Obstruction | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0115/p159.html

  Management of intestinal obstruction is directed at correcting physiologic derangements caused by the obstruction, bowel rest, and removing the source of obstruction. The former is addressed by intravenous fluid resuscitation with isotonic fluid. […] Antibiotics are used to treat intestinal overgrowth of bacteria and translocation across the bowel wall. […] The decision to perform surgery for intestinal obstruction can be difficult. […] Conservative management of a high-grade obstruction should be attempted initially, using intestinal intubation and decompression, aggressive intravenous rehydration, and antibiotics. […] Conservative management is successful in 40 to 70 percent of clinically stable patients, with a higher success rate in those with partial obstruction. […] If intestinal obstruction is not resolved with conservative management, surgical evaluation is required.

• #4 Evaluation and Management of Intestinal Obstruction | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0115/p159.html

  Management of intestinal obstruction is directed at correcting physiologic derangements caused by the obstruction, bowel rest, and removing the source of obstruction. The former is addressed by intravenous fluid resuscitation with isotonic fluid. […] Antibiotics are used to treat intestinal overgrowth of bacteria and translocation across the bowel wall. […] The decision to perform surgery for intestinal obstruction can be difficult. […] Conservative management of a high-grade obstruction should be attempted initially, using intestinal intubation and decompression, aggressive intravenous rehydration, and antibiotics. […] Conservative management is successful in 40 to 70 percent of clinically stable patients, with a higher success rate in those with partial obstruction. […] If intestinal obstruction is not resolved with conservative management, surgical evaluation is required.

• #5 Intestinal Obstruction – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/intestinal-obstruction

  Treatment is fluid resuscitation, nasogastric suction, and, in most cases of complete obstruction, surgery. […] Patients with possible intestinal obstruction should be hospitalized. Treatment of acute intestinal obstruction must proceed simultaneously with diagnosis. A surgeon should always be involved. […] Supportive care is similar for small- and large-bowel obstruction: nasogastric suction, IV fluids (0.9% saline or lactated Ringers solution for intravascular volume repletion), and a urinary catheter to monitor fluid output. […] If bowel ischemia or infarction is suspected, antibiotics should be given (eg, a third-generation cephalosporin, such as cefotetan or cefoxitin) before operative exploration. […] Complete obstruction of the small bowel is preferentially treated with early laparotomy, although surgery can be delayed 2 or 3 hours to improve fluid status and urine output in a very ill, dehydrated patient.

• #6 Bowel Obstruction: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/digestive/bowel-obstruction/treatment

  Bowel obstruction treatment depends on what type of obstruction you have (physical blockage or pseudo-obstruction, for example) as well as the severity of it. Some simple or partial blockages can be treated by bowel rest and decompression, while more serious obstructions require immediate surgery. […] No matter what type of bowel obstruction, you will likely be sent to the hospital to receive medication and fluids through an IV to start. […] Your doctor may insert a nasogastric tube through your nose and into your stomach to remove built up fluids and gas. This can help relieve some of the abdominal pain and pressure, and open up the blockage for patients with partial obstruction and prevent aspiration. […] Partial bowel obstructions generally resolve on their own, with the help of a nasogastric tube and bowel rest. If the blockage remains or worsens, however, it may require surgery to treat.

• #7 Bowel obstruction – Wikipedia

  https://en.wikipedia.org/wiki/Bowel_obstruction

  This tube is uncomfortable but relieves the abdominal cramps, distention, and vomiting. […] Intravenous therapy is utilized and the urine output may be monitored with a catheter in the bladder. […] Most people with SBO are initially managed conservatively because in many cases, the bowel will open up. […] Conservative treatment involves insertion of a nasogastric tube, correction of dehydration and electrolyte abnormalities. […] Opioid pain relievers may be used for patients with severe pain but alternate pain relievers are preferred as opioids can decrease bowel motility. […] Antiemetics may be administered if the patient is vomiting. […] Adhesive obstructions often settle without surgery. […] If the obstruction is complete surgery is usually required. […] Most patients improve with conservative care in 25 days.

• #8 Evaluation and Management of Intestinal Obstruction | AAFP

  https://www.aafp.org/pubs/afp/issues/2011/0115/p159.html

  Management of intestinal obstruction is directed at correcting physiologic derangements caused by the obstruction, bowel rest, and removing the source of obstruction. The former is addressed by intravenous fluid resuscitation with isotonic fluid. […] Antibiotics are used to treat intestinal overgrowth of bacteria and translocation across the bowel wall. […] The decision to perform surgery for intestinal obstruction can be difficult. […] Conservative management of a high-grade obstruction should be attempted initially, using intestinal intubation and decompression, aggressive intravenous rehydration, and antibiotics. […] Conservative management is successful in 40 to 70 percent of clinically stable patients, with a higher success rate in those with partial obstruction. […] If intestinal obstruction is not resolved with conservative management, surgical evaluation is required.

• #9 Intestinal Obstruction: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0915/p362.html

  Antibiotics are used to treat intestinal overgrowth of bacteria and translocation across the bowel wall. The presence of fever and leukocytosis should prompt inclusion of antibiotics in the initial treatment regimen, with coverage against gram-negative organisms and anaerobes. Although the choice of agent should be determined by local susceptibility patterns, ciprofloxacin plus metronidazole (Flagyl), or piperacillin/tazobactam (Zosyn) is commonly administered. […] Nonoperative management is successful in 40% to 70% of clinically stable patients with acute intestinal obstruction and is associated with shorter initial hospitalization (4.9 vs. 12 days in those who undergo surgery). However, there is a higher rate of recurrence in patients who are treated nonoperatively because the cause of obstruction (adhesive disease) is not addressed.

• #10 Intestinal obstruction – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/diagnosis-treatment/drc-20351465

  Treatment for intestinal obstruction depends on the cause of your condition, but generally requires hospitalization. […] When you arrive at the hospital, the doctors stabilize you so that you can undergo treatment. This process may include: […] A barium or air enema is used both as a diagnostic procedure and a treatment for children with intussusception. If an enema works, further treatment is usually not necessary. […] If you have an obstruction in which some food and fluid can still get through (partial obstruction), you may not need further treatment after you’ve been stabilized. Your doctor may recommend a special low-fiber diet that is easier for your partially blocked intestine to process. If the obstruction does not clear on its own, you may need surgery to relieve the obstruction.

• #11 Bowel Obstruction: Signs & Symptoms, Causes, Treatment

  https://my.clevelandclinic.org/health/diseases/bowel-obstruction

  Most people with bowel obstruction need prompt treatment in the hospital. Complete obstructions usually require immediate surgery. Partial bowel obstructions may require treatments to stabilize your condition, followed by nonsurgical solutions, like bowel rest. It all depends on how severe the obstruction is. […] Treatment may include: […] Surgery: You’ll likely need surgery if your intestine is completely blocked. Your healthcare provider may remove adhesions or tumors that are causing a blockage. Rarely, they may need to remove diseased segments of tissue. Sometimes, your provider can place a stent (a mesh tube) to keep your intestine open and resolve the obstruction without additional surgery. Or you may need a stent as a temporary solution until you’re healthy enough for surgery to repair the obstruction.

• #12 Intestinal Obstruction Treatments | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/gastroenterology/intestinal-obstruction/treatments

  Treatment for intestinal obstruction will vary depending on the location and severity of the blockage. In almost all cases, you will need to let your bowel rest. This may involve eating a soft, low-fiber diet. If you are hospitalized, you will receive IV fluids and nutritional support. […] Other treatments may include: […] Medications: Your physician may change any medications that are causing low motility. He or she may also prescribe pain medication, antibiotics to treat any infection, or medication that helps increase the contractions in your intestines. […] Surgery: In serious cases, you may need surgery to remove the blockage and fix any damage to the intestinal tissue. Minimally invasive surgery may be performed during a colonoscopy. […] Treatment is needed right away to manage a blockage in the colon to avoid tissue death or rupture.

• #13 Bowel Obstruction and Cancer – Side Effects – NCI

  https://www.cancer.gov/about-cancer/treatment/side-effects/bowel-obstruction

  Bowel obstructions require immediate medical attention. After your doctor finds the cause of the obstruction, they can help you choose a treatment option. […] Treating a bowel obstruction depends on what caused the blockage and whether the intestines are partly or completely blocked. If you have a complete blockage, you will probably need surgery. Partial obstructions may clear up with nonsurgical treatments. […] Treatment for a bowel obstruction may include: Bowel rest. This is when you avoid eating and drinking to keep the obstruction from getting worse. Bowel rest or a liquid diet that is easy on your intestines can help your body clear the blockage. You may also receive fluid replacement therapy (IV fluids) to help the fluids and electrolytes in your body return to normal. […] Nasogastric tube. This tube is inserted through the nose and esophagus into the stomach to relieve pressure caused by a bowel obstruction by removing fluid and gas from the digestive system. A nasogastric tube helps control nausea, vomiting, and pain related to the obstruction and may help your body clear the blockage.

• #14 Bowel Obstruction and Blockage: Symptoms, Causes, and Treatment

  https://www.webmd.com/digestive-disorders/what-is-bowel-obstruction

  Youll probably need to go to the hospital for treatment. If you have a complete bowel obstruction, you’ll likely have surgery right away. Most partial obstructions don’t need surgery. Your doctor will help stabilize your condition and may put you on a liquid diet to help your intestines rest. […] Depending on how serious your obstruction is and what caused it, bowel obstruction treatment might include: […] IV fluids. If you have dehydration, you’ll get fluids and electrolytes through an IV. […] Medications. You might also get nausea and pain relief drugs by IV to ease symptoms. If you have an infection, you’ll also get antibiotics. […] Nasogastric tube. A doctor may place a thin tube through your nose and into your stomach to suction out fluids and gases that have built up in your digestive tract. This can relieve symptoms and may also help clear the blockage.

• #15 Intestinal obstruction – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/diagnosis-treatment/drc-20351465

  Treatment for intestinal obstruction depends on the cause of your condition, but generally requires hospitalization. […] When you arrive at the hospital, the doctors stabilize you so that you can undergo treatment. This process may include: […] A barium or air enema is used both as a diagnostic procedure and a treatment for children with intussusception. If an enema works, further treatment is usually not necessary. […] If you have an obstruction in which some food and fluid can still get through (partial obstruction), you may not need further treatment after you’ve been stabilized. Your doctor may recommend a special low-fiber diet that is easier for your partially blocked intestine to process. If the obstruction does not clear on its own, you may need surgery to relieve the obstruction.

• #16 Bowel obstruction: Symptoms, causes, treatment, and diet

  https://www.medicalnewstoday.com/articles/324037

  Surgery: Surgeons can remove blocked or damaged sections of the bowel. In cases of IBDs, a strictureplasty may be necessary. Here, a surgeon will widen the narrowed section of the bowel by cutting and sewing. […] Therapeutic enema: A nurse or doctor will push a medication or tap water into the bowel to try to relieve stool impaction, which can happen in severe constipation. […] Medication may help ease discomfort due to a bowel obstruction. This can include: antinausea medicines to prevent vomiting, pain relief medication, antibiotics to fight bacterial infection. […] Those with Crohns disease may benefit from steroids.

• #17 Small-Bowel Obstruction Treatment & Management: Approach Considerations, Surgical Care

  https://emedicine.medscape.com/article/774140-treatment

  In 2013, the World Society of Emergency Surgery published updated guidelines for the diagnosis and management of adhesive SBO (ASBO). The recommendations include the following: […] In the absence of signs of strangulation and a history of persistent vomiting or combined computed tomography (CT) scan signs, patients with partial ASBO can be safely managed with nonoperative management; tube decompression should be attempted. […] Water-soluble oral contrast medium (WSCM) is recommended for both diagnostic and therapeutic purposes in patients undergoing nonoperative management. […] Nonoperative management can be prolonged for up to 72 hours in the absence of signs of strangulation or peritonitis; surgery is recommended after 72 hours of nonoperative management without resolution. […] Open surgery is frequently used for patients with strangulating ASBO and after failed conservative management; in appropriate patients, a laparoscopic approach using an open access technique is recommended.

• #18 Intestinal Obstruction Treatments | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/gastroenterology/intestinal-obstruction/treatments

  Treatment for intestinal obstruction will vary depending on the location and severity of the blockage. In almost all cases, you will need to let your bowel rest. This may involve eating a soft, low-fiber diet. If you are hospitalized, you will receive IV fluids and nutritional support. […] Other treatments may include: […] Medications: Your physician may change any medications that are causing low motility. He or she may also prescribe pain medication, antibiotics to treat any infection, or medication that helps increase the contractions in your intestines. […] Surgery: In serious cases, you may need surgery to remove the blockage and fix any damage to the intestinal tissue. Minimally invasive surgery may be performed during a colonoscopy. […] Treatment is needed right away to manage a blockage in the colon to avoid tissue death or rupture.

• #19 Bowel obstruction – Wikipedia

  https://en.wikipedia.org/wiki/Bowel_obstruction

  This tube is uncomfortable but relieves the abdominal cramps, distention, and vomiting. […] Intravenous therapy is utilized and the urine output may be monitored with a catheter in the bladder. […] Most people with SBO are initially managed conservatively because in many cases, the bowel will open up. […] Conservative treatment involves insertion of a nasogastric tube, correction of dehydration and electrolyte abnormalities. […] Opioid pain relievers may be used for patients with severe pain but alternate pain relievers are preferred as opioids can decrease bowel motility. […] Antiemetics may be administered if the patient is vomiting. […] Adhesive obstructions often settle without surgery. […] If the obstruction is complete surgery is usually required. […] Most patients improve with conservative care in 25 days.

• #20 Bowel Obstruction and Cancer – Side Effects – NCI

  https://www.cancer.gov/about-cancer/treatment/side-effects/bowel-obstruction

  Antibiotics. Sometimes a bowel obstruction causes a tear in the intestines that lets fluids leak into the abdomen. These fluids can cause your body to have an extreme immune response to an infection (sepsis). Antibiotics can help prevent tissue damage, organ failure, or death from sepsis. […] Antinausea and pain medicines. These can treat or control nausea, vomiting, and pain caused by a bowel obstruction. […] If you have a bowel obstruction caused by cancer (also called malignant bowel obstruction), talk to your health care team about available treatments and your goals of care. In most cases, treatments for malignant bowel obstructions relieve symptoms and improve quality of life but may not help you live longer from cancer. You and your family may need to make difficult decisions about your care at this time. If you choose care meant to relieve symptoms over more aggressive treatments, you can learn more about Choices for Care When Treatment May Not Be an Option. […] If you think you have a bowel obstruction, contact your doctor right away. They can help you decide on a treatment that is right for you.

• #21 Intestinal Obstruction and Ileus | Doctor

  https://patient.info/doctor/intestinal-obstruction-and-ileus

  In view of the risk of perforation and absorption of toxins from ischaemic bowel, prophylactic antibiotics for gut surgery are advised. […] Endoscopic stenting is a further advance in the management of small and large bowel obstruction and may be particularly useful in the palliative care of cancer patients and in the elderly. Self-expanding stents are of particular value in the management of obstruction of the large bowel. […] Sigmoid volvulus can be treated conservatively in many cases. Sigmoidoscopy and passage of a flatus tube may be successful. Failure of decompression or evidence of perforation requires operation. […] In intestinal pseudo-obstruction the cautious use of neostigmine may aid recovery but most important is the correction of fluid and electrolyte imbalance. Colonoscopy may need to be used for decompression. Early recognition and management are vital if perforation is to be avoided.

• #22 Medical Management of Bowel Obstructions | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/medical-management-of-bowel-obstructions/

  Medical Management of Bowel Obstructions […] Treatment options include surgical correction, placement of a venting gastrostomy tube, stent placement across the obstructed site, or medical management […] There has been significant advances in the medical management of this problem, so that many patients can avoid dying with the traditional approach of intravenous fluids and nasogastric tubes („drip and suck”). […] The goal of medical management is to decrease pain, nausea and secretions into the bowel in order eliminate the need for a nasogastric tube and IV hydration. […] When NG output is less than 100 cc/day, the NG tube can be clamped for 12 hours and then removed. […] Once out, patients are instructed that they may drink and even eat, although vomiting may occur. […] If a venting gastrostomy tube is already in place, oral intake can be normal without fear of vomiting. […] Supplemental parenteral hydration is only indicated if a) patients remain dehydrated despite oral intake, and b) use of hydration to extend life is consistent with the patients’ goals.

• #23 Bowel obstruction – surgical and non-surgical management | Right Decisions

  https://rightdecisions.scot.nhs.uk/nhs-borders-clinical-guidelines/acute-services/gastroenterology/bowel-obstruction-surgical-and-non-surgical-management/

  Dexamethasone 6-16mg may be of benefit in high or low intestinal obstruction, whether complete or incomplete. Octreotide should be used under specialist advice only, but may reduce the amount of fluid secreted by a blocked intestine, as well as reducing secretions associated with inflamed tumours. […] Palliative fluid/diet may be appropriate in some patients. Intravenous or subcutaneous fluids may be indicated in some patients but sensitive discussion is required. […] Review current medications in line with cause of obstruction for example avoiding constipating medications (such as Amitriptyline, Ondansetron though the latter may be used for nausea in cases of complete obstruction), use of prokinetic/laxatives if partial obstruction/avoid if complete. […] Consider route of medications in vomiting patients, or patients who are unlikely to absorb well from the stomach. Transdermal routes can be used for stable pain, syringe drivers for unstable pain. Consider carefully whether IV access is indicated in palliative patients.

• #24 Blocked bowel | Coping physically | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/coping/physically/bowel-problems/types/blocked-bowel-obstruction

  You might also have a drug called octreotide. Octreotide reduces the amount of fluid that builds up in your stomach and digestive system. It can help to control sickness. […] Or you might have steroids. Steroids can help to reduce the inflammation of your bowel. They can also help to control sickness.

• #25 Blocked bowel | Coping physically | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/coping/physically/bowel-problems/types/blocked-bowel-obstruction

  You might also have a drug called octreotide. Octreotide reduces the amount of fluid that builds up in your stomach and digestive system. It can help to control sickness. […] Or you might have steroids. Steroids can help to reduce the inflammation of your bowel. They can also help to control sickness.

• #26 Intestinal obstruction – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/diagnosis-treatment/drc-20351465

  If nothing is able to pass through your intestine, you’ll usually need surgery to relieve the blockage. The procedure you have will depend on what’s causing the obstruction and which part of your intestine is affected. Surgery typically involves removing the obstruction, as well as any section of your intestine that has died or is damaged. […] Alternatively, your doctor may recommend treating the obstruction with a self-expanding metal stent. The wire mesh tube is inserted into your intestine via an endoscope passed through your mouth or colon. It forces open the intestine so that the obstruction can clear. […] If your doctor determines that your signs and symptoms are caused by pseudo-obstruction (paralytic ileus), he or she may monitor your condition for a day or two in the hospital, and treat the cause if it’s known. […] In cases where the colon is enlarged, a treatment called decompression may provide relief. Decompression can be done with colonoscopy, a procedure in which a thin tube is inserted into your anus and guided into the colon. Decompression can also be done through surgery.

• #27 Bowel Obstruction: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/digestive/bowel-obstruction/treatment

  A complete bowel obstruction, when no stool or gas can pass through the intestines, is a much more serious and life-threatening condition. Typically, surgery is needed if your intestines are entirely blocked. The blocked part of the intestine may be removed in surgery if there is a tumor and/or inflammation. Otherwise, the blockage will be removed. […] Pseudo-obstructions dont involve an actual physical blockage, so treating them is slightly different from treating other obstructions. Your doctor may use nutrition support, decompression, medication, and sometimes surgery to treat pseudo-obstruction of the bowels. […] In more serious cases, you may need a colonoscopy to help decompress your intestines, or surgery to address the pseudo-obstruction. That may include a gastrostomy, where doctors place a tube through your abdomen into the stomach or small intestine, or a colectomy and/or stoma, which diverts the colon to an opening in the abdomen to remove waste.

• #28 Intestinal obstruction – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/diagnosis-treatment/drc-20351465

  If nothing is able to pass through your intestine, you’ll usually need surgery to relieve the blockage. The procedure you have will depend on what’s causing the obstruction and which part of your intestine is affected. Surgery typically involves removing the obstruction, as well as any section of your intestine that has died or is damaged. […] Alternatively, your doctor may recommend treating the obstruction with a self-expanding metal stent. The wire mesh tube is inserted into your intestine via an endoscope passed through your mouth or colon. It forces open the intestine so that the obstruction can clear. […] If your doctor determines that your signs and symptoms are caused by pseudo-obstruction (paralytic ileus), he or she may monitor your condition for a day or two in the hospital, and treat the cause if it’s known. […] In cases where the colon is enlarged, a treatment called decompression may provide relief. Decompression can be done with colonoscopy, a procedure in which a thin tube is inserted into your anus and guided into the colon. Decompression can also be done through surgery.

• #29 Management of Colonic Obstruction: A Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3577614/

  Traditionally, surgical management of large bowel obstruction included mandatory colostomy. This could be either an end colostomy, with resection of the distal obstruction if possible, or more proximal loop colostomy. This approach has the benefits of usually shorter operative times and no risk of anastomotic leak. It remains the procedure of choice for most surgeons in patients with hemodynamic instability, gross contamination of the operative field from perforation, or other significant barriers to healing such as severe malnutrition or an immunocompromised state. […] Fortunately, there are several options for avoiding colostomy formation. Operative choices include segmental colectomy and subtotal colectomy, with or without on-table decompression of the proximal bowel. […] One increasingly accepted strategy to manage colorectal obstruction, particularly in the case of colorectal cancers, is endoscopic stenting. Colonic stents for malignancy were first used in the early 1990s. Since that time, multiple authors have described their experience with stents and their use both in providing palliation for patients with incurable disease and acting as a bridge to surgery. The latter is a phrase used to describe the practice of using a stent to relieve the obstruction, allowing for decompression of the proximal colon over a period of days to weeks, bowel preparation, and in some cases more proximal endoscopic evaluation for synchronous lesions, followed by semielective resection and usually primary anastomosis.

• #30 Intestinal obstruction – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/diagnosis-treatment/drc-20351465

  If nothing is able to pass through your intestine, you’ll usually need surgery to relieve the blockage. The procedure you have will depend on what’s causing the obstruction and which part of your intestine is affected. Surgery typically involves removing the obstruction, as well as any section of your intestine that has died or is damaged. […] Alternatively, your doctor may recommend treating the obstruction with a self-expanding metal stent. The wire mesh tube is inserted into your intestine via an endoscope passed through your mouth or colon. It forces open the intestine so that the obstruction can clear. […] If your doctor determines that your signs and symptoms are caused by pseudo-obstruction (paralytic ileus), he or she may monitor your condition for a day or two in the hospital, and treat the cause if it’s known. […] In cases where the colon is enlarged, a treatment called decompression may provide relief. Decompression can be done with colonoscopy, a procedure in which a thin tube is inserted into your anus and guided into the colon. Decompression can also be done through surgery.

• #31 Large-Bowel Obstruction Treatment & Management: Approach Considerations, Ileus, Acute Colonic Pseudo-Obstruction

  https://emedicine.medscape.com/article/774045-treatment

  Endoscopic reduction and decompression of a sigmoid volvulus can be performed in the absence of peritoneal signs. […] Recurrence after decompression is as high as 50%; thus, surgical resection is indicated. […] Surgery is indicated if there are signs of peritonitis or bowel perforation, or if attempts at reduction by contrast enema are unsuccessful. […] Endoscopic dilation and stenting of colonic obstruction is helpful in selected cases and may be an alternative to multistage surgery. […] Patients with persistent obstruction secondary to diverticular disease despite appropriate medical management are treated surgically. […] For obstructed defecation syndrome (ODS) with rectocele, surgery is a last resort. […] The morbidity and mortality of large-bowel obstruction (LBO) are often related to the surgical procedure used to relieve the colonic obstruction and, in the long term, to the underlying disease that caused the obstruction.

• #32 Intestinal obstruction – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/diagnosis-treatment/drc-20351465

  Treatment for intestinal obstruction depends on the cause of your condition, but generally requires hospitalization. […] When you arrive at the hospital, the doctors stabilize you so that you can undergo treatment. This process may include: […] A barium or air enema is used both as a diagnostic procedure and a treatment for children with intussusception. If an enema works, further treatment is usually not necessary. […] If you have an obstruction in which some food and fluid can still get through (partial obstruction), you may not need further treatment after you’ve been stabilized. Your doctor may recommend a special low-fiber diet that is easier for your partially blocked intestine to process. If the obstruction does not clear on its own, you may need surgery to relieve the obstruction.

• #33 Bowel Obstruction: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/digestive/bowel-obstruction/treatment

  Treatment for intussusception, one of the most common forms of bowel obstruction in children, can involve a water-soluble contrast, air enema, or surgery. […] Typically, doctors will choose an enema as first-line treatment for intussusception before surgery. In the majority of cases, enemas solve the problem. In adults, surgery is recommended as the cause of the interspersion needs to be investigated. […] In more severe cases, such as when the intestine is torn or the enema doesn’t work, your doctor may suggest surgery. The surgeon can remove the part of the intestine that is blocked.

• #34 Intestinal Obstruction: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0915/p362.html

  Surgical exploration is recommended in patients who clinically deteriorate at any point during hospitalization and in those for whom three to five days of nonoperative management is ineffective, because the risk of complications in these patients is increased. A longer observation period is safe in select patients who undergo frequent clinical reassessment by the surgical team. Signs of peritonitis, clinical instability, leukocytosis, leukopenia, and acidosis are concerning for abdominal sepsis, ischemia, or perforation, and mandate immediate surgical exploration. Immediate surgery is required in patients with an irreducible or strangulated hernia. […] In the past, surgical exploration of acute intestinal obstruction mandated laparotomy. However, advancements in minimally invasive surgical techniques have made laparoscopy an accepted approach for initial exploration in most patients with uncomplicated or adhesive intestinal obstruction. Stable patients with a history of or high suspicion for intra-abdominal malignancy should be evaluated for optimal surgical planning. Although disseminated or advanced intra-abdominal malignancy causing multilevel obstruction is rarely treated operatively, isolated obstructive gastrointestinal or intra-abdominal malignancy can be treated with primary resection and reconstruction, or with palliative decompression.

• #35 Intestinal Obstruction – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/intestinal-obstruction

  Treatment is fluid resuscitation, nasogastric suction, and, in most cases of complete obstruction, surgery. […] Patients with possible intestinal obstruction should be hospitalized. Treatment of acute intestinal obstruction must proceed simultaneously with diagnosis. A surgeon should always be involved. […] Supportive care is similar for small- and large-bowel obstruction: nasogastric suction, IV fluids (0.9% saline or lactated Ringers solution for intravascular volume repletion), and a urinary catheter to monitor fluid output. […] If bowel ischemia or infarction is suspected, antibiotics should be given (eg, a third-generation cephalosporin, such as cefotetan or cefoxitin) before operative exploration. […] Complete obstruction of the small bowel is preferentially treated with early laparotomy, although surgery can be delayed 2 or 3 hours to improve fluid status and urine output in a very ill, dehydrated patient.

• #36 Management of Colonic Obstruction: A Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3577614/

  Traditionally, surgical management of large bowel obstruction included mandatory colostomy. This could be either an end colostomy, with resection of the distal obstruction if possible, or more proximal loop colostomy. This approach has the benefits of usually shorter operative times and no risk of anastomotic leak. It remains the procedure of choice for most surgeons in patients with hemodynamic instability, gross contamination of the operative field from perforation, or other significant barriers to healing such as severe malnutrition or an immunocompromised state. […] Fortunately, there are several options for avoiding colostomy formation. Operative choices include segmental colectomy and subtotal colectomy, with or without on-table decompression of the proximal bowel. […] One increasingly accepted strategy to manage colorectal obstruction, particularly in the case of colorectal cancers, is endoscopic stenting. Colonic stents for malignancy were first used in the early 1990s. Since that time, multiple authors have described their experience with stents and their use both in providing palliation for patients with incurable disease and acting as a bridge to surgery. The latter is a phrase used to describe the practice of using a stent to relieve the obstruction, allowing for decompression of the proximal colon over a period of days to weeks, bowel preparation, and in some cases more proximal endoscopic evaluation for synchronous lesions, followed by semielective resection and usually primary anastomosis.

• #37 Bowel Obstruction and Blockage: Symptoms, Causes, and Treatment

  https://www.webmd.com/digestive-disorders/what-is-bowel-obstruction

  Bowel rest: To allow your intestine to clear the obstruction and let swelling go down, you may need to stop eating or drinking temporarily. You’ll get a liquid that provides the nutrition you need. […] Stent. A doctor may place a mesh tube called a stent into your bowel to open the blocked area. This may be enough to treat the bowel obstruction. Or you might need surgery once your condition is stable enough. […] Bowel decompression. In this procedure, a doctor guides a thin tube into the blocked area to open it up and relieve pressure. It can be done with a colonoscopy, in which the tube is inserted through your anus, or with surgery. […] Bowel obstruction surgery. Your doctor may do surgery to remove whatever is causing the obstruction. They may also need to remove damaged parts of your bowel. If a hernia caused the blockage, you’ll get surgery to repair it.

• #38 Bowel obstruction in adults – causes and symptoms | healthdirect

  https://www.healthdirect.gov.au/bowel-obstruction

  Go to your nearest hospital emergency department straight away if you have symptoms of a bowel obstruction. Some types of bowel obstruction can lead to very serious complications and even death. […] A bowel obstruction is an emergency and needs treatment in hospital to prevent serious complications. […] You may need surgery or another procedure to remove the blockage. […] Treatment for bowel obstruction depends on the cause. You will usually need treatment and monitoring in hospital. If you think that you may have bowel obstruction don’t eat or drink and go immediately to your nearest hospital. […] While in hospital, you might have the following treatment: Your urine output may be monitored. You may get fluids through an intravenous (IV) drip. You may receive pain relief and anti-nausea medicines. A nasogastric tube may be inserted through your nose and down into your stomach (but usually only if you have severe bloating or vomiting). You may have procedures such as a colonoscopy or sigmoidoscopy. You may need to have surgery.

• #39 Small-Bowel Obstruction Treatment & Management: Approach Considerations, Surgical Care

  https://emedicine.medscape.com/article/774140-treatment

  The decision for surgical intervention for SBO is made on the basis of the severity of the patient’s clinical presentation and the underlying cause. […] A strangulated obstruction is a surgical emergency. In patients with a complete SBO, the risk of strangulation is high and early surgical intervention is warranted. […] Laparoscopy has been shown to be safe and effective in selected cases of SBO.

• #40 Intestinal Obstruction: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0915/p362.html

  Surgical exploration is recommended in patients who clinically deteriorate at any point during hospitalization and in those for whom three to five days of nonoperative management is ineffective, because the risk of complications in these patients is increased. A longer observation period is safe in select patients who undergo frequent clinical reassessment by the surgical team. Signs of peritonitis, clinical instability, leukocytosis, leukopenia, and acidosis are concerning for abdominal sepsis, ischemia, or perforation, and mandate immediate surgical exploration. Immediate surgery is required in patients with an irreducible or strangulated hernia. […] In the past, surgical exploration of acute intestinal obstruction mandated laparotomy. However, advancements in minimally invasive surgical techniques have made laparoscopy an accepted approach for initial exploration in most patients with uncomplicated or adhesive intestinal obstruction. Stable patients with a history of or high suspicion for intra-abdominal malignancy should be evaluated for optimal surgical planning. Although disseminated or advanced intra-abdominal malignancy causing multilevel obstruction is rarely treated operatively, isolated obstructive gastrointestinal or intra-abdominal malignancy can be treated with primary resection and reconstruction, or with palliative decompression.

• #41 Management of small bowel obstruction in adults – UpToDate

  https://www.uptodate.com/contents/management-of-small-bowel-obstruction-in-adults

  Management of small bowel obstruction in adults […] Small bowel obstruction (SBO) occurs when the normal flow of intestinal intraluminal contents is interrupted. The management of bowel obstruction depends upon the etiology, severity, and location of the obstruction. The goals of initial management are to relieve discomfort and restore normal fluid volume, acid-base balance, and electrolytes. Bowel compromise (ischemia, necrosis, or perforation) and a surgically correctable cause of SBO (eg, incarcerated hernia) require upfront surgical exploration; other patients may be candidates for a trial of nonoperative management. Although 60 to 85 percent of adhesion-related SBOs resolve without surgery, it is difficult to predict a priori which patients will fail nonoperative management. Non-adhesion-related SBO is usually secondary to another intra-abdominal process (eg, inflammation, infection), the targeted treatment of which will lead to the resolution of SBO symptoms.

• #42 Small-Bowel Obstruction Treatment & Management: Approach Considerations, Surgical Care

  https://emedicine.medscape.com/article/774140-treatment

  In 2013, the World Society of Emergency Surgery published updated guidelines for the diagnosis and management of adhesive SBO (ASBO). The recommendations include the following: […] In the absence of signs of strangulation and a history of persistent vomiting or combined computed tomography (CT) scan signs, patients with partial ASBO can be safely managed with nonoperative management; tube decompression should be attempted. […] Water-soluble oral contrast medium (WSCM) is recommended for both diagnostic and therapeutic purposes in patients undergoing nonoperative management. […] Nonoperative management can be prolonged for up to 72 hours in the absence of signs of strangulation or peritonitis; surgery is recommended after 72 hours of nonoperative management without resolution. […] Open surgery is frequently used for patients with strangulating ASBO and after failed conservative management; in appropriate patients, a laparoscopic approach using an open access technique is recommended.

• #43 Adhesive small bowel obstruction: How long can patients tolerate conservative treatment?

  https://www.wjgnet.com/1007-9327/full/v9/i3/603.htm

  AIM: To evaluate how long patients with small bowel obstruction caused by postoperative adhesions can tolerate conservative treatment. […] CONCLUSION: With closely monitoring, most patients with small bowel obstruction due to postoperative adhesions could tolerate supportive treatment and recover well averagely within 1 week, although some patients require more than 10 days of observation. […] In conclusion, the actual incidence of serious complications in patients with small bowel obstruction due to postoperative adhesions is low. Most patients can be managed medically. With closely monitoring and in the absence of signs suggestive of complications, an observation period even longer than 10 days before proceeding to surgical intervention appears to be safe.

• #44 Bowel obstruction – Wikipedia

  https://en.wikipedia.org/wiki/Bowel_obstruction

  When the obstruction is cancer, surgery is the only treatment. […] Those with bowel resection or lysis of adhesions usually stay in the hospital a few more days until they can eat and walk. […] Small bowel obstruction caused by Crohn’s disease, peritoneal carcinomatosis, sclerosing peritonitis, radiation enteritis, and postpartum bowel obstruction are typically treated conservatively, i.e. without surgery.

• #45 Bowel obstruction: a narrative review for all physicians | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-019-0240-7

  For palliation of obstructing left colon cancer, self-expanding metallic stents are preferred to colostomy because they are associated with similar mortality/morbidity rates but a shorter hospital stay. […] In case of perforation/bowel resection with contaminated surgical fields, suture repair is preferred due to the risk of mesh infection. […] Historically, abdominal adhesiolysis through laparotomy has been the standard therapy for adhesive small bowel obstruction. […] Laparoscopic adhesiolysis has been introduced in recent decades and can decrease morbidity in subgroups of patients undergoing surgery for adhesive small bowel obstruction. […] Small bowel obstruction caused by small bowel tumors (adenocarcinoma, neuroendocrine tumors, gastrointestinal stromal tumors, and lymphomas) is treated with resection and anastomosis.

• #46 Intestinal obstruction – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/diagnosis-treatment/drc-20351465

  If nothing is able to pass through your intestine, you’ll usually need surgery to relieve the blockage. The procedure you have will depend on what’s causing the obstruction and which part of your intestine is affected. Surgery typically involves removing the obstruction, as well as any section of your intestine that has died or is damaged. […] Alternatively, your doctor may recommend treating the obstruction with a self-expanding metal stent. The wire mesh tube is inserted into your intestine via an endoscope passed through your mouth or colon. It forces open the intestine so that the obstruction can clear. […] If your doctor determines that your signs and symptoms are caused by pseudo-obstruction (paralytic ileus), he or she may monitor your condition for a day or two in the hospital, and treat the cause if it’s known. […] In cases where the colon is enlarged, a treatment called decompression may provide relief. Decompression can be done with colonoscopy, a procedure in which a thin tube is inserted into your anus and guided into the colon. Decompression can also be done through surgery.

• #47 Large-Bowel Obstruction Treatment & Management: Approach Considerations, Ileus, Acute Colonic Pseudo-Obstruction

  https://emedicine.medscape.com/article/774045-treatment

  Initial therapy in patients with suspected large-bowel obstruction (LBO) includes volume resuscitation, appropriate preoperative broad-spectrum antibiotics, and timely surgical consultation. […] Surgical intervention is frequently indicated, depending on the cause of the obstruction. Closed loop obstructions, bowel ischemia, and volvulus are surgical emergencies. […] Transfer to another facility is indicated if adequate surgical management or backup is not available. […] Adynamic ileus is treated with conservative measures. This involves correction of fluid and electrolyte imbalances, and treatment of the underlying disorder. […] If no perforation is present, acute colonic pseudo-obstruction (ACPO; Ogilvie syndrome) is treated with conservative management for the first 24 hours. […] Surgical intervention for ACPO is associated with a high mortality and morbidity. This treatment is reserved for refractory cases or cases complicated by perforation.

• #48 Intestinal Obstruction – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/intestinal-obstruction

  The obstructing lesion is removed whenever possible. […] In most patients with early postoperative obstruction or repeated obstruction caused by adhesions, nasogastric decompression through a sump tube may be attempted in the absence of peritoneal signs. […] Disseminated intraperitoneal cancer obstructing the small bowel is a major cause of death in adult patients with gastrointestinal tract cancer. […] Obstructing colon cancers can sometimes be treated by a single-stage resection and anastomosis, with or without a temporary colostomy or ileostomy. […] When diverticulitis causes obstruction, perforation is often present. […] Fecal impaction usually occurs in the rectum and can be removed digitally and with enemas. […] Treatment of cecal volvulus consists of resection and anastomosis of the involved segment or fixation of the cecum in its normal position by cecostomy in a patient who is frail. […] In sigmoid volvulus, an endoscope or a long rectal tube can often decompress the loop, and resection and anastomosis may be deferred for a few days.

• #49 Intestinal Obstruction and Ileus | Doctor

  https://patient.info/doctor/intestinal-obstruction-and-ileus

  In view of the risk of perforation and absorption of toxins from ischaemic bowel, prophylactic antibiotics for gut surgery are advised. […] Endoscopic stenting is a further advance in the management of small and large bowel obstruction and may be particularly useful in the palliative care of cancer patients and in the elderly. Self-expanding stents are of particular value in the management of obstruction of the large bowel. […] Sigmoid volvulus can be treated conservatively in many cases. Sigmoidoscopy and passage of a flatus tube may be successful. Failure of decompression or evidence of perforation requires operation. […] In intestinal pseudo-obstruction the cautious use of neostigmine may aid recovery but most important is the correction of fluid and electrolyte imbalance. Colonoscopy may need to be used for decompression. Early recognition and management are vital if perforation is to be avoided.

• #50 Bowel Obstruction: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/digestive/bowel-obstruction/treatment

  Treatment for intussusception, one of the most common forms of bowel obstruction in children, can involve a water-soluble contrast, air enema, or surgery. […] Typically, doctors will choose an enema as first-line treatment for intussusception before surgery. In the majority of cases, enemas solve the problem. In adults, surgery is recommended as the cause of the interspersion needs to be investigated. […] In more severe cases, such as when the intestine is torn or the enema doesn’t work, your doctor may suggest surgery. The surgeon can remove the part of the intestine that is blocked.

• #51 Bowel obstruction in adults – causes and symptoms | healthdirect

  https://www.healthdirect.gov.au/bowel-obstruction

  Some people need to have surgery immediately. Some people are treated with IV fluids and medicines for 2 or 3 days and then have surgery if they are not getting better. Other people don’t need surgery at all. Your doctor will discuss the likely cause of your bowel obstruction and the options for treatment. […] If your obstruction is caused by bowel cancer, you might need surgery to remove the affected part of your bowel.

• #52 Bowel obstruction – Wikipedia

  https://en.wikipedia.org/wiki/Bowel_obstruction

  This tube is uncomfortable but relieves the abdominal cramps, distention, and vomiting. […] Intravenous therapy is utilized and the urine output may be monitored with a catheter in the bladder. […] Most people with SBO are initially managed conservatively because in many cases, the bowel will open up. […] Conservative treatment involves insertion of a nasogastric tube, correction of dehydration and electrolyte abnormalities. […] Opioid pain relievers may be used for patients with severe pain but alternate pain relievers are preferred as opioids can decrease bowel motility. […] Antiemetics may be administered if the patient is vomiting. […] Adhesive obstructions often settle without surgery. […] If the obstruction is complete surgery is usually required. […] Most patients improve with conservative care in 25 days.

• #53 Management of Intestinal Obstruction in the Patient With Ovarian Cancer

  https://www.cancernetwork.com/view/management-intestinal-obstruction-patient-ovarian-cancer

  Intestinal obstruction in the patient with ovarian cancer is a difficult situation for both patient and physician. In women presenting with ovarian cancer, obstruction is almost never complete. […] These women should undergo aggressive bowel surgery only if it is part of an optimal surgical cytoreduction. […] Women who are not candidates for surgery can be effectively palliated pharmacologically so that they are comfortable with the obstruction, often without intestinal drainage. […] Algorithms are available to assist in the management of ovarian cancer patients with obstruction, but ultimately the treatment decision rests with the patient. […] Most patients presenting with obstruction require intravenous hydration and intestinal decompression with a nasogastric tube. […] It is not unusual for patients to have no frank obstruction on radiology studies, and the symptoms of a proportion of these women will resolve simply with bowel rest with decompression and rehydration.

• #54 Palliative care – bowel obstruction | Healthify

  https://healthify.nz/health-a-z/p/palliative-care-bowel-obstruction

  Bowel obstruction is a condition where your bowel is blocked either partially or totally, keeping food or liquid from passing down your bowel to your rectum. […] Treatment aims to reduce your symptoms and not to cure your condition. […] Treatment of bowel obstruction often depends on the cause and could be medical or surgical. These treatments are not meant to cure your condition. They aim to make you feel more comfortable by reducing your symptoms. Medical treatment includes prescribing medications to relieve nausea, vomiting and pain. […] The management of intestinal obstruction should be tailored to the individual at the time with different strategies being employed when needed. […] Give dietary advice, eg, foods with minimal residue. […] Minimise colic by stopping osmotic/stimulant laxatives (continue softeners) and give subcutaneous hyoscine butylbromide (20 mg bolus followed by 60 to 80 mg subcut infusion over 24 hours).

• #55 Intestinal obstruction repair: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/002927.htm

  Intestinal obstruction repair is surgery to relieve a bowel obstruction. A bowel obstruction occurs when the contents of the intestines cannot pass through and exit the body. A complete obstruction is a surgical emergency. […] Intestinal obstruction repair is done while you are under general anesthesia. This means you are asleep and do not feel pain. […] Your surgeon locates the area of your intestine (bowel) that is blocked and unblocks it. […] Any damaged parts of your bowel will be repaired or removed. This procedure is called bowel resection. If a section is removed, the healthy ends will be reconnected with stitches or staples. […] This procedure is done to relieve a blockage in your intestine. A blockage that lasts for a long time can reduce or block blood flow to the area. This can cause the bowel to die. […] The outcome is usually good if the obstruction is treated before bowel blood flow is affected. […] People who have had many abdominal surgeries may form scar tissue. They are more likely to have bowel obstructions in the future.

• #56 Small bowel obstruction – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000119

  Small bowel obstruction (SBO) is a medical emergency that requires early diagnosis and intervention. […] Treatment involves a combination of nasogastric decompression and intravenous fluids. Surgery may be required, so the diagnosis requires urgent surgical assessment. […] Patients who are treated in a timely manner have a very good prognosis. If untreated, it is often fatal. […] complete or complicated small bowel obstruction: surgery indicated […] complete or complicated small bowel obstruction: surgery not indicated […] incomplete small bowel obstruction or complete without complications.

• #57

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=uh3175

  Most of the time, complete blockages require a stay in the hospital and possibly surgery. […] If your bowel is only partly blocked, your doctor may tell you to wait until it clears on its own and you are able to pass gas and stool. […] Follow-up care is a key part of your treatment and safety. […] These may include eating a liquid diet to avoid complete blockage. […] Your doctor will tell you about any foods you should not eat. […] Bowel blockage (obstruction) may be prevented by doing several things. […] Your doctor may ask that you drink high-calorie liquid formulas if your symptoms require them. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

• #58 Preventing and Treating Bowel Obstructions | Banner Health

  https://www.bannerhealth.com/healthcareblog/better-me/preventing-and-treating-bowel-obstructions

  If you have a history of physical bowel obstructions, you often cant prevent them, but a low-residue diet (a diet that limits high fiber foods) and medication such as MiraLAX can help make things flow more easily through your bowel, Dr. Gordon said. […] If you have pain, nausea and vomiting that dont ease up quickly, seek medical attention since bowel obstructions can be serious.

• #59 Large-Bowel Obstruction Treatment & Management: Approach Considerations, Ileus, Acute Colonic Pseudo-Obstruction

  https://emedicine.medscape.com/article/774045-treatment

  Aggressive screening for colorectal cancer in individuals who are older than 50 years or who have a strong family history of colorectal cancer, as indicated by current guidelines, should reduce the future incidence of malignant colonic obstruction. […] Care after discharge following surgical management of large-bowel obstruction (LBO) focuses on surgical convalescence and, if relevant, the need to care for the disease that caused the obstruction.

• #60 Intestinal Obstruction: Evaluation and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0915/p362.html

  Management of acute intestinal obstruction is directed at correcting physiologic derangements, providing bowel rest and decompression, and removing the source of obstruction. Evaluation for admission to a surgical service is recommended for patients presenting to the emergency department with intestinal obstruction. Surgical consultation should be sought after diagnosis of obstruction in inpatients admitted to nonsurgical services. Surgical involvement during admission for SBO is associated with improved patient satisfaction, and patients admitted to a surgical service have shorter hospital stays and shorter time to operation when required. […] In clinically stable patients with a diagnosed intestinal obstruction and a history of abdominal surgery, nonoperative management should be attempted. As soon as acute intestinal obstruction is suspected, intravenous isotonic fluid should be started, and oral intake should be restricted. Nasogastric intubation should be performed for decompression in most patients. Aggressive replacement of electrolytes is recommended after confirming adequate renal function.

• #61 Bowel obstruction: a narrative review for all physicians | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-019-0240-7

  For large bowel obstruction caused by sigmoid volvulus without ischemia or perforation, the best strategy is an endoscopic detorsion procedure followed by same admission surgery that includes a sigmoid colectomy with primary anastomosis. […] Resection and primary anastomosis are the desired procedure for diverticular large bowel obstruction, and it should be attempted regardless of bowel preparation after a successful conservative treatment in the same admission. […] Resection and primary anastomosis are the best options for malignant large bowel obstruction in the absence of significant risk factors or perforations. […] Conservative treatment should be started in the absence of ischemia or perforation, but surgery is needed as a rescue therapy for failed conservative treatments or as elective therapy to prevent recurrence.

• #62 Management of Intestinal Obstruction in the Patient With Ovarian Cancer

  https://www.cancernetwork.com/view/management-intestinal-obstruction-patient-ovarian-cancer

  Surgical correction may be appropriate in the patient who is likely to live long enough to benefit from the improvement in bowel function, and who is fit to withstand the surgery without undue morbidity. […] A significant proportion of women will not be suitable for surgery or will not desire surgery. These women should continue to be proactively managed in a humane and conscientious fashion that relieves their discomfort and illustrates our perpetual commitment to the care of women with ovarian cancer.

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