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.
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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