Obstipation

Obstipation Definition

It is a term used to describe an obstructive constipation. It is a health condition wherein the body lacks the ability to pass gas and stool due to obstruction in the intestines.

It is a form of constipation, but chronic and severe type. Obstipation should be treated right away for it could lead to a life-threatening condition if left untreated. ^{(1, 2)}

Obstipation Symptoms

• The patient is constipated.
• The patient’s abdomen is distended.
• A feeling of fullness or bloating. ⁽²⁾
• The patient complains of persistent abdominal pain and cramping.
• There is an abnormal increase in bowel sounds.
• The patient notices a foul breath.
• The pulse is rapid/fast (tachycardia). ⁽³⁾
• The patient is dehydrated.
• The patient is dehydrated and has fever.
• The patient does not have the appetite to eat which leads to generalized body malaise (weakness).

Photo 2: Barium enema, one of the procedures used to detect obstipation.
Picture Source: www.drugs.com

Obstipation vs Constipation

What is the difference between constipation and obstipation? They differ in terms of the severity of symptoms and the retention time of the stool. Constipation pertains to the difficulty in passing out stool.

The patient could suffer at least three to four times bowel movements in a week. On the other hand, obstipation is the chronic form of constipation. The patient lacks the ability to pass stool, which makes obstipation more difficult to treat than constipation. ^{(4, 5)}

What are the causes of obstipation?

• Intestinal obstruction – The intestines are the longest part of the digestive system. Blockage both in the small and large intestines can lead to obstipation.
• Prolonged/untreated constipation – A constipation that has been going on for a long period of time could lead to obstipation. It is associated with decreased water intake and lack of dietary fiber in the body. ⁽³⁾
• Adhesions – It pertains to the formation of scar tissues in the abdomen. People who have precious abdominal surgery are prone to obstipation because the scar can form a lump that traps the surrounding organs.
• Hernia – It is a protrusion of the organs in the abdomen secondary to weakening of the abdominal wall cavity. The intestines can get strangled leading to obstruction.
• Tumor – An abnormal mass grows in the abdomen leading to obstruction.
• Intussusception – The small or large intestines telescope itself leading to blockage.
• Volvulus – It is a result of twisting of the intestines, which could result to ischemic damage and obstruction. ⁽⁶⁾
• Hirschsprung’s disease – It is a congenital defect in which a part of the colon is lacking. As a result, the colon fails to relax or does not have the reflex of contraction ability leading to obstruction. ⁽⁷⁾
• Diverticulitis – It is the inflammation of pouches that protrude outside of the colon. It could lead to formation of tissue scars leading to obstruction.
• IBD (Inflammatory Bowel Disease) – It is an inflammatory condition leading to hypertrophy and fibrosis of the walls of the intestines. Not treating it right away could lead to obstruction. ⁽⁷⁾

What causes obstipation in children?

Children are prone to obstipation too. It is primarily because of their diet and trying to withhold the stool to avoid pain. Those children who lack fiber in their diet and do not have sufficient intake of water are prone to obstipation. Congenital and neurological diseases can also increase the possibility of having obstipation. ⁽⁵⁾

How to diagnose obstipation?

If you are not having a normal bowel movement, then you should begin suspecting discrepancy in your gastrointestinal system. A physical examination of the rectum is done to watch for any signs of obstruction.

The rectum will also be assessed for any signs of inflammation and bleeding. Aside for physical examination, the doctor will also order the following:

• Blood work – The doctor will check the blood chemistry to check for any signs of infection.
• CT scan/x-ray – It is an imaging test that helps get a clear picture of the gastrointestinal system.
• Ultrasound – It helps locate the site of obstipation including the causes of obstipation.
• Barium enema – It is used in conjunction with x-ray to assess the bowel pathway.
• Bowel function test – It helps detect the tone of the muscles and nerve sensitivity of the intestines and anus.
• Colonoscopy – The colon is viewed using a camera to detect any damage to the tissues. A biopsy is also done to detect colon cancer. ^{(8, 9, 10)}

Obstipation Treatment

What is the best way to treat obstipation? What are your treatment options? There is a variety of treatment and management modalities for obstipation. Most of the time, it requires strict diet modification.

The patient should increase the fluid intake and intake of foods rich in dietary fiber. The patient should avoid foods that can irritate the intestines and the gastrointestinal tract as a whole. These foods include alcoholic beverage, coffee, milk, and fruit juices. The patient is also advice to perform rigorous exercises to promote blood circulation and promote peristalsis. ^{(6, 7)}

In severe cases, the patient is given an enema. A liquid is introduced into the rectum and colon via the anus. It causes volume on the lower intestinal tract leading to peristalsis. Eventually, the feces will be removed from the body. Laxatives can be introduced to the body to promote bowel movement. The commonly used laxatives are milk of magnesia, walnuts, and polyethylene glycol. ^{(3, 4, 7)}

The treatment method primarily depends on the overall condition of the patient and the factor that is causing the obstruction. If the cause is hernia and other abnormalities in the physical and physiologic structure of the intestines, the best approach is to perform surgical procedures.

If the obstruction is cause by diet, then it could be remedied using natural approach. There are herbs tested and proven effective in treating and managing the symptoms of obstipation. These herbs can hasten the healing process. Some of the commonly used herbs include Aloe Vera, licorice, elderflower, papaya orange, and guava. ^{(9, 10)}

References:

1. www.ihealthblogger.com
2. www.belmarrahealth.com
3. ehealthwall.com
4. www.healthhype.com
5. www.clinicaladvisor.com
6. www.constipation-remedies-for-all.com
7. https://hubpages.com
8. https://en.wiktionary.org
9. https://link.springer.com
10. https://drugsdetails.com