Intestinal blockages

A blockage, also known as an intestinal obstruction, causes the flow of stool from the stoma to slow down or even stop completely. This can happen suddenly. Blockages can occur in either the small or large intestine. A blockage can be described as partial or complete.

In a partial bowel obstruction, a small amount of fluid manages to bypass the obstruction in the bowel, resulting in a gelatinous type of fluid from the stomach. In a partial bowel obstruction, you may experience gas from the stomach. In a complete bowel obstruction, the bowel is unable to release any fluid from the stoma.

Causes of stoma obstruction/blocked bowel

It is not uncommon for people with a stoma to experience a bowel obstruction at some point. There are many different reasons why the small intestine can become obstructed. If you have a bowel obstruction and have been previously diagnosed with any of the following, you should seek medical attention by contacting your family doctor, specialist doctor or our stoma therapist ( https://stomaterapie.ro/formular-inscriere-pacient/ ):

  • diverticulitis;
  • inflammatory bowel disease, which can cause strictures, or narrowing of the intestine that can cause obstruction;
  • intestinal volvulus, otherwise called twisted intestine;
  • abdominal or parastomal hernia, which can cause strangulation of the intestine;
  • adhesions or strictures in the intestine after colorectal surgery;
  • recent abdominal or pelvic surgery;
  • intestinal cancer.

But hard-to-digest foods are the main reason for people with stomas developing a partial or complete bowel obstruction.

How do I know if I have a stoma obstruction?

As mentioned above, the most obvious sign of a bowel obstruction is that the flow of stool slows down or stops altogether. For people with a colostomy, a blockage can happen over several days and may begin with signs of constipation. For people with an ileostomy, a blockage can occur quickly, in less than 24 hours. An ileostomy is generally quite active, with people typically changing their ostomy five to seven times in a 24-hour period. With a bowel obstruction, you may notice that there is a reduced amount of stool passing through and you may need to drain your device less often.

Other symptoms you may experience are:
  • abdominal cramping pain (may be near the stoma or the entire abdomen);
  • swelling of the abdomen and/or stoma;
  • decreased urine flow; urine may be dark in color (this may happen due to dehydration due to not wanting to drink fluids because you are not feeling well); or
  • nausea and/or vomiting.

Another symptom in addition to the slowing of ostomy fluid production is stomach pain. You may begin to experience waves of cramping and abdominal pain, which can worsen if the symptoms you are experiencing are left unresolved.

What should you do when you suspect a stoma obstruction?

If you have an ILEOSTOM and suspect you have developed a bowel obstruction, it is important to contact your emergency nurse or GP urgently for advice. Some less severe blockages can be treated at home with the following tips:

  • if the stoma begins to swell, replace the bag by cutting the flange slightly larger than normal to accommodate the swelling;
  • if you have no or only a small amount of stool from your stoma and you do not feel nauseated or vomiting, stop eating solid foods and start a liquid diet, such as soup or plain yogurt;
  • If possible, take a short walk; as long as it's not too painful. Staying active increases blood flow to the intestines and therefore helps with peristalsis (the movement of the muscles in the intestines), which should help clear the obstruction.
  • gently massage around the stoma or the entire abdominal area. Since most blockages occur just below the stoma, this may help dislodge the blockage; or
  • A hot bath can help the abdominal muscles relax and clear the obstruction.

If you have a COLOSTOMY and suspect you have developed a bowel obstruction, you should contact your nurse or GP for advice, who may prescribe laxatives to help with the bowel obstruction. In addition, bowel obstructions can usually be treated at home with the following advice:

  • drink plenty of fluids, such as plain water, fresh fruit juices, tea, or carbonated drinks;
  • if you do not feel nauseated or vomiting, introduce high-fiber foods such as fresh fruits and vegetables (always remove the peel to reduce the risk of further blockages of the stoma);
  • if you have nausea or vomiting, stop eating solid foods and only eat a liquid diet, such as soup, plain yogurt;
  • If possible, take a short walk; as long as it's not too painful. Staying active increases blood flow to the intestines and therefore helps with peristalsis (the movement of the muscles in the intestines), which should help clear the obstruction.
  • Gently massage around the stoma or the entire abdominal area. As most blockages occur just below the stoma and this can help dislodge the blockage; or
  • A hot bath can help the abdominal muscles relax and clear the obstruction.

In both situations (ileostomy and colostomy) you should seek urgent medical attention by contacting your family doctor, nurse or StomaCare specialist if you do not experience any improvement by following the advice given or if:

  • abdominal cramps will become more severe;
  • there is no discharge from the stoma in the last 12 hours;
  • show signs of dehydration; or
  • vomiting.

How can you avoid an intestinal obstruction?

If your bowel obstruction was caused by poorly digested food, the following tips can help reduce your risk of developing a new obstruction in the future:

  • Chew your food thoroughly until you can break it down into small pieces. Doing this reduces the chance of food pieces getting stuck in your intestines and eventually causing an obstruction.
  • Don't rush. Eat slowly so that you give your body time to properly chew, digest, and assimilate your meals.
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