What is Bowel Strangulation & How is it Treated?
What is Bowel Strangulation?
Bowel Strangulation is a pathological condition in which the intestines tend to get trapped in a hernia and the blood supply to these trapped segments gets completely cut off resulting in the tissues in these trapped segments becoming necrotic which may lead to potentially serious life threatening complications if it is not addressed appropriately and on time.
Bowel Strangulation is quite a painful condition and needs to be treated on an emergent basis. If left untreated, it can result in life threatening complications within a short span of time. Bowel Strangulation is pretty rare in occurrence but tends to affect both adults and children alike. In children who have hernia only about 2% of children tend to have Bowel Strangulation. Surgery is the only way of treating Bowel Strangulation as there is no other way of un-strangulating the hernia.
What Causes Bowel Strangulation?
Bowel Strangulation is basically caused as a result of hernias. Hernias are of different types namely inguinal hernia, femoral hernia, incisional hernia and umbilical hernia. The main reason behind development of any type of hernia is abdominal wall weakness. This weakness of the abdominal wall may arise due to abnormal closing of the abdominal wall which usually happens after birth and is seen mostly in preterm babies.
Abdominal wall weakening can also occur as a result of intense pressure on the abdomen. This can be due to persistent intense coughing episodes as seen with conditions like tuberculosis or any other infection of the lungs, straining during bowel movements, obesity and multiple pregnancies. People who are employed where they have to lift heavy weights or professional weight lifters are also at risk for development of abdominal weakening which may lead to hernias.
Any surgery done to the abdomen may also make the abdominal wall weak increasing the risk for hernias. The abdominal wall holds all the organs of the abdomen and once there is a pouch or an opening then it is easy for any of the abdominal organs to slip inside the pouch or pocket.
The intestines being long and coiled easily slip inside the hernias and get trapped within it. Due to this entrapment, the bowel contents are not able to move forward resulting in bowel obstruction. In some cases, the bowels become so tightly entrapped that the blood supply to the bowels get cut off which results in tissue death within no time which may result in the bowel wall to rupture and its contents being emptied inside the abdominal cavity. This is what happens in Bowel Strangulation and it may very quickly lead to a situation of shock and even prove to be fatal.
What are the Symptoms of Bowel Strangulation?
Bowel Strangulation is a condition which arises due to complication of hernia and hence it is extremely vital to have a know-how on the symptoms of hernia. The symptoms of hernia may persist for many months before Bowel Strangulation actually occurs. Hernias normally are painless and only a bump may be seen in the abdominal area during straining like when coughing or during a bowel movement.
Thus, it is quite normal that a diagnosis of hernia may be missed in its early stages. This bulging in most of the cases can be pushed back and the lump goes away. This is what is known as reducible hernia. As the condition advances with time and the lump is not longer able to be pushed back then it is termed as irreducible hernia.
When the hernia advances to an extent that there is Bowel Strangulation then the symptoms may include intense abdominal pain which worsens with activity like bowel movements or coughing. The hernia in cases of Bowel Strangulation is irreducible and is tender to touch. Nausea and vomiting additionally may occur following which serious symptoms like shock may follow pretty quickly due to Bowel Strangulation.
How is Bowel Strangulation Treated?
Bowel Strangulation is an emergent medical condition and needs to be treated before it poses a threat to the life of an individual. Medication is not something that will treat Bowel Strangulation. Antibiotics for hernia may be given but again this is only symptomatic and not curative. Hence, surgery is the only alternative left for treating Bowel Strangulation.
In fact, Bowel Strangulation is a surgical emergency and the patient needs to be operated right away before any serious complications arise due to Bowel Strangulation. A strangulated hernia is considered to be a surgical emergency.
It should be noted here that the hernia should not be forcefully reduced as it may lead to cutting off even a little bit of blood supply that may be there which may be keeping the tissue alive. Hence the best way to treat this condition is exploratory surgery to first undo the strangulation and bring the bowels back to their original position and next to reduce the hernia. Once this is done, then an individual can be prevented from having any serious complications arising out of Bowel Strangulation.