What Is a Perforated Bowel?

What Is a Perforated Bowel?

A perforated bowel is a medical condition in which a hole or gap forms in the wall of any part of the gastro-intestinal system. That system is made up of the small intestine, large intestine, and stomach. These holes form for various reasons, and lead to food or stools passing into the abdomen, resulting in inflammation and infection. Perforated bowel complications can cause infection in the blood, internal bleeding, and other problems that ultimately lead to death if left untreated. Timely treatment is required to avoid the potentially life-threatening consequences of a perforated bowel.

What Causes a Perforated Bowel?

There are two major chronic conditions that can cause a perforated bowel, and these two conditions make up a big chunk of incidences of perforated bowel in America.

What Is a Perforated Bowel? Crohn’s disease causes serious inflammation throughout the body’s intestines and can also cause intestinal blockages. People with Crohn’s disease are at the highest risk for perforated bowel.

The other chronic disease that can lead to perforated bowel is Diverticulitis. This is a condition in which the colon is covered in tiny pouches of organ tissue. These pouches are highly susceptible to infection, and if these infections aren’t removed and the body treated, you can have blockages in the colon which leads to a perforated bowel. Both Diverticulitis and Crohn’s disease are serious conditions which require treatment by a doctor.

Of course, any intestinal blockage will lead to a perforated bowel if left untreated. In an intestinal blockage, the gastro-intestinal system is unable to eliminate the body’s waste products, causing the bowel to rupture. Intestinal blockages occur for different reasons, such as physical “blockage” from a tumor or hernia, or even from muscle spasms in the lower abdomen that prevent the intestines from working properly.

One final cause of perforated bowel — injury. An injury or trauma to the abdomen can cause perforation of the bowel. Injuries like compression or stabbing can damage the bowel or intestines and cause a blockage.

Symptoms of Perforated Bowel

Though every patient will experience different sets of symptoms with perforated bowel, these are the most common. Some of these symptoms are serious enough to require medical care even if a perforated bowel isn’t the cause. Always contact a doctor if you’re concerned about your symptoms.

Pain in the abdomen — Severe pain in the abdomen could be a sign of a perforated bowel. Unfortunately, so can dull pain. That’s why simple pain in the abdomen is not enough to diagnose a perforated bowel. Still, pain is the most common symptom in patients with perforated bowels, so this pain could be the first sign of trouble, especially if there was a recent trauma to the abdomen.

Abdominal swelling — Painful swelling in the abdomen along with a constant feeling of fullness is another common symptom of perforated bowel. Swelling in the abdomen is uncommon, so this symptom usually alerts doctors to the presence of a bowel perforation.

Fever — High fevers (102 degrees F or above) when accompanied by chills are another sign of perforated bowel, especially in patients that have abdominal pain or swelling. The body’s temperature rises in response to infection.

Nausea — Abdominal pain accompanied by vomiting and nausea (also in conjunction with a feeling of fullness and/or a fever) is a tell-tale symptom set for perforated bowel.

Change in bowel movements — Patients with perforated bowel are likely to be constipated or experiencing severe diarrhea. There will likely be blood in stools or a change in the color of the stools. This is due to the intestinal blockage that caused the perforated bowel to begin with.

Treatment for Perforated Bowel Recovery

A perforated bowel is a serious condition. The only cure for perforated bowel is surgery, and this surgery should happen as quickly as possible. It isn’t possible to treat perforated bowel with medication, and since a perforated bowel is life-threatening, you must see a surgeon as soon as possible.

Perforated Bowel Surgery

A perforated bowel surgery is made up of two parts. First, the surgeon must clean the abdomen. A bowel perforation empties infectious material into the abdomen that must be removed. The second part of a perforated bowel surgery is repairing the perforation itself. Some bowel perforations are tiny, others rather large. The length of the surgery and the prognosis of the patient depends greatly on the size and complexity of the perforation.

Complications of a Perforated Bowel

The biggest possible complication from a perforated bowel is the spread of infection and possibility for re-occurrence of the perforated bowel or intestinal blockage. This can occur even after surgery and treatment are finished, and usually occurs with a larger or more complicated perforated bowel. To counteract this potential for spreading infection, patients who undergo perforated bowel surgery will take a heavy course of antibiotics after the surgery to prevent the infection coming back.

During the surgery, it is common for surgeons to remove much of the intestines, especially in more complex cases. In cases where doctors remove large sections of the intestine, recovery from a perforated bowel can take months.

If surgeons removed enough of the intestine to cause potential trouble in the future, they may have to use colostomy on the patient, especially if the infection is very wide spread. Colostomy involves the surgeon re-routing the intestinal system so that a patient’s waste is excreted into a bag they wear outside the body. If colostomy is avoidable, surgeons will avoid it, as colostomy is a huge burden on the patient and usually can not be undone.

Preventing Perforated Bowel

Perforated bowel is preventable, even in cases where perforated bowel is caused by another chronic health condition.

If a patient is diagnosed with Crohn’s disease or Diverticulitis, treatment is required within a short time window. Medication and other treatments exist to prevent bowel perforations in patients with these conditions. Besides drugs, patients can maintain good bowel health by eating food that is high in fiber, drinking lots of water, and getting regular exercise.

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10 thoughts on “What Is a Perforated Bowel?

  1. lucy love

    my best friend had surgery 2 weeks ago to remove a cystic ovary. They perforated her bowel. She is 38 years old and cant seem to shake this infection that came after surgery for repair. She is suffering so bad and antibiotic are not working for her. What is recovery like for something like this. Will she be okay. Is this normal for the healing process even though it seems she is not healing? Please help…

  2. B R Tiwari

    My mother have only 70 cm small intestine due to damage by some reason. her remaining 70 cm intestine again tried to connect but leackes on 17 feb. since 01 month she is suffering from leackage with colostomy bag and more weakness day by day. she is on liquid diet.problems is as liquid takes it out within a minuts. pls suggest what shoud i do to save my mother life.can be done transplat by any means or any suggestin pls.

  3. Jennifer

    A Tubal Ligation led to a perforated bowel and nearly killed me 5 years ago. As a result, I have to stick to a strict diet, have adhesions which can be painful especially with pressure from seatbelt or jeans and I still experience leakage. There is a chance I will one day end up with an illiostomy bag but I am lucky to be alive! When a bowel is perforated, there is always a chance it can happen again. If pain, swelling, cramping, fever or anything out of the ordinary such as sudden weight loss or weight gain occur it should be reported to your Primary Dr. immediately. It may not be anything serious but other complications can occur and I suggest keeping a daily log to keep track of emotional and physical health because it will give an overall snapshot and alert you to potential side effects. It took me nearly a year to get my body back in sync but emotionally I never really recovered especially since I have been left with a huge scar to remind me of my ordeal.

  4. daughter

    My mom complained a lot of having constipation as nothing helped it. was in hospipal as they dianosed her with pancriatitis and realeased her. still having lots of pain, barley being able to move went in to get checked at the Red deer hospital emergency. they found she had a massive bowel infection caused by perforated bowel. there were no causes found. they performed surgery and the infection spread into her body. she died within hours of that surgery. The nurses siad she should not have died from it, but from what i seen there is only a 50-50 chance, and a very good surgon. i pray that people can get a proper diagnoses, and treat that the earlest they can, as its very touchy and complicated surgery.

  5. Rebecca

    When can I expect a bowel movement after gastrointestinal perforation surgery? I have been on a clear liquid diet for a week now.

  6. Lani

    I am a 33yr old female. I had my bowel punctured when I was 24 after my endometrial ablation(to stop my periods because I have a bleeding disorder) well I told them something was wrong as soon as I got back to my room,nobody listened, on top of that I knew pain because I have hereditary pancreatitis. But they sent me home so I went back hours later barely able to walk barely able to pee and again they sent me home this time saying I was drug seeking,even though I had a major surgery the year before and I told them I have lots of meds at home,there is something wrong with me! Well the next day after vomiting ALL night filling garbage cans with black bowel contents(I didn’t know that at the time) I called an ambulance they had to get me from my bed cause I couldn’t move and was bawling in severe pain,I had no blood pressure and they rushed me in for emergency surgery the last thing I remember is the Dr.in his golf outfit saying you will probably have a bag (colostomy) and I ended up not getting one but I was in surgery for hours,both the bottoms of my lungs were collapsed I had bowel contents filling my entire body! I knew a lady who was in the O R and she said they had people on each side of me lifting me off the bed by my incision and just trying to shake the saline around to clean me out,my stomach was left wide open to heal as there was still infection.there were a lot more complications than that but it was about ten years ago and yes the Dr.’s say oh a few mons and you will be as good as new um,no. It has affected my life in EVERY ASPECT and at that time I had 1 2yr.old and a 6 yr.old! I have had a ton more health problems and surgeries since then but I know my body and I have NEVER been the same since then! Oh ya they had burned thru my bowel in 3 different places! So for anyone who is feeling overwhelmed,depressed,pain,helpless,hopeless I know how you feel. I also think they should maybe have a support group for people who have gone septic(I don’t really know how to say it) but I have NEVER met anyone else who has gone thru this so if anyone wants to respond it would be greatly appreciated!!!!

  7. Lani

    Sorry I have more to add. I was on life support for almost a week and in the hospital about 3weeks. I to have a huge scar and I don’t care about how it looks but it hurts to put it mildly,I just read the ladies story about getting her tubes tied and it reminded me of that and the fact that I can’t wear anything fitted,bras,jeans,seatbelts,belts,anything!also my body hurts EVERYWHERE like I can’t cut food because it feels like the utensils are gonna cut thru my fingers and that is just again one small example! Does anyone else have constant wide spread body pain? Because it has NEVER gone away and I’m not talking like oh my body hurts a bit I mean I feel like I have the flu(body ache) pulled muscles and like someone beat the hell out of me and I feel the same EVERY day,I also walk and swim but nothing helps.

  8. Dixie

    I had a tubal ligation in december 2011. I did not notice until January 2012 that I had gained a lot of weight and that my bowel movements were extremely infrequent. I didnt get in to see my dr until march when I told her about it. By this time I was suffering from abdominal pain as well as constipation. She suggested miralax and a high fiber diet, which I pretty much already ate. I tried the miralax and got no relief. I turned to magnesium citrate and finally got some relief. I have to drink one daily just to have a bm. She finally got me in for a colonoscopy and ultrasound in sept. The ultrasound was normal, but they cut 4 small polyps out n I am still waiting on pathology results. When I had the procedure done, they still found fecal matter even after the exhaustive evacuation measures. I am still having to take mag citrate every day n bloat up when I miss a dose. My abdominal pain is not severe, but its there…like a constant dull menstruation pain. Now my primary is out of the office until feb 2013. I am on medicaid n it is next to impossible to change doctors. Also, bfore the surgery the dr mentioned repeatedly mention ed repeatedly the risk of a nicked bowel so he probly had me sign a waiver(i signed so much I couldve missed it). He also did not inform me of the symptoms. I do not have fevers that im aware of, but my stool color is usually clay~colored. When they gave me the evacuation meds for the colonoscopy it turned black at the very end. Could these b the signs of a nicked bowel? Should I contact the dr who did the procedure? Cuz my primary is not helping much, n the mag citrate cant b good to take so much.

  9. Karen

    I would have taken a sample for diagnosis of the black to see if that was blood. for Dixie. I too am experiencing severe abdominal pain and bloating, so I’m trying to ignore this, as it’s been several years since my female operation; but the pain is getting worse! At times most unbearable. I’ve had an ultra sound of the stomach area, but that would not show much would it? I’m in a bit of a fix myself. I’ll go to a stomach DR. eventually to discuss this, very soon.

  10. e j

    I want to know if after all surgeriers and the following treatment and then the release, is it possible for the infection to return, this has been 2 months since it all started?. the antibiotics and the wound vac has been completed now I am on a wet dry dressing only. My wound is runny with a dark liquid. what is on the dressing is brown in color. I am just so afraid thing might gey ugly again. O had 2 major surgeries after they found out what was wrong with me, which was 5 days after a mayor surgery I spent 11 dys in icu 4 in icu step down and a total of 20 days in hosp. came home with wound vac and 4 weeks of antibiotics. I am so afraid the infection will come back

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