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Management of Patients With Intestinal and Rectal Disorders Part 5. Miss: Iman Shaweesh. Intestinal Obstruction. Intestinal obstruction exists when blockage prevents the normal flow of intestinal contents through the intestinal tract. Two types of processes can impede this flow.
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Miss: Iman Shaweesh
An intraluminal obstruction or a mural obstruction from pressure on the intestinal walls occurs. Examples are intussusception, polypoid tumors and neoplasms, stenosis, strictures, adhesions, hernias, and abscesses.
The intestinal musculature cannot propel the contents along the bowel. Examples are amyloidosis, muscular dystrophy, endocrine disorders such as diabetes mellitus, or neurologic disorders
most of these are found in the sigmoid colon
hypovolemic shock may occur.
propelled toward the mouth instead of toward the rectum.
status, and assessing improvement (eg, return of normal bowel sounds, decreased abdominal distention, subjective improvement in abdominal pain and tenderness, passage of flatus or stool).
obstruction. Obstruction in the large bowel can lead to severe distention and perforation unless some gas and fluid can flow back through the ileal valve. Large bowel obstruction, even if complete, may be undramatic if the blood supply to the colon is not disturbed.
disease in 2002
save almost three of every four people with colorectal cancer. If the disease is detected and treated at an early stage, the 5-year survival
rate is 90%, but only 34% of colorectal cancers are found at an early stage.
Survival rates after late diagnosis are very low. Most people are asymptomatic for long periods and seek health care only when they notice a change in bowel habits or rectal bleeding. Prevention and early screening are key to detection
the location of the tumor and the extent of invasion into surrounding tissues
the large intestine than in the small intestine. Although most polyps do not develop into invasive neoplasms, they must be identified and followed closely. Adenomatous polyps are more common in men.
also occur. If the polyp is large enough, symptoms of obstruction occur.
or immunosuppressive conditions such as AIDS are particularly susceptible to these infections. Many of these abscesses result in fistulas.
on the fistula tract.
Untreated fistulas may cause systemic infection
Extremely painful defecation, burning, and bleeding characterize fissures. Most of these fissures heal if treated by conservative measures, which include stool softeners and bulk agents
increase in water intake, sitz baths, and emollient suppositories. A suppository combining an anesthetic with a corticosteroid helps relieve the discomfort. Anal dilation under anesthesia may be required.