Intestinal stenosis is a decrease in the normal lumen in any part of the digestive tract. Clearance may narrow due to various adverse conditions, as well as due to organic lesions. Pathology occurs in adults and children. Pediatric stenosis most often manifests itself as a congenital disease.
Symptomatology
An experienced doctor will not be difficult to establish a diagnosis of "intestinal stenosis." Symptoms in adults are quite specific, however, the disease can only be confirmed after an ultrasound scan.
So, the signs that signal the presence of this pathology can be attributed to:
- frequent bloating;
- sharp pains in the upper abdomen;
- vomiting, in which the presence of bile is noted;
- pallor of the skin, sometimes the presence of a gray tint;
- weight loss;
- increased gas formation;
- inability to gain weight;
- poor bowel function;
- violation of the excretion of urine;
- dryness and peeling of the skin.
As you can see, the symptomatology of this pathology is really specific and it is extremely difficult to mix it up, but sometimes atresia also often manifests itself, which is often mistaken for intestinal stenosis. Symptoms of the two diseases are very similar, but with atresia there is a complete overlap of the human intestine. To accurately establish the diagnosis, doctors resort to modern types of diagnosis.
Reasons for the appearance
The development of the disease can occur at absolutely any age. In adults, pathology, as a rule, is acquired in nature, and in a child, intestinal stenosis is more often acquired.
Most often, the disease develops for the following reasons:
- violation of normal metabolism;
- frequent smooth muscle spasms;
- intestinal inversion;
- inflammation in the digestive system;
- intussusception;
- adhesions that occur after surgery;
- tumor processes in the intestine;
- injuries and others
If the patient was given such a diagnosis, then it is worth preparing for a long and difficult treatment, since stenosis is a difficult pathology.
Also, do not self-medicate. Many patients begin with self-treatment, attributing the symptoms to poisoning. Over time, the patient's condition worsens, and it becomes more difficult to cure stenosis.
Existing Diagnostics
Diagnosis begins with a visual inspection. Already at the initial stage, the doctor may suspect intestinal stenosis. Symptoms and treatment of pathology are individual.
The most common method for diagnosing stenosis is ultrasound. During the procedure, the use of a contrast medium is desirable. However, ultrasound is not the only method. For a final diagnosis, an X-ray and blood donation for biochemical analysis are also recommended.
It is worth remembering that stenosis can affect absolutely any part of the intestine. It can be the colon, small intestine, or duodenum. During an ultrasound examination, the doctor can determine exactly which area was affected, and sometimes also understand the cause of the disease.
Types of Stenosis
In medicine, there are several types of this pathology. They are divided depending on the site of the lesion, as well as taking into account the development of the disease.
There are three types of stenosis in total:
- Pyloric. With this variety, narrowing is present in the region of the stomach and small intestine.
- Duodenal. This variety means the presence of narrowing in the area of the duodenum.
- Atresia This variety means almost complete overlap of the lumen in any part of the intestine. The clearance is reduced so much that the food simply cannot move normally in the affected area.
Also in medical practice, this pathology is shared by the location of the lesion. This may be stenosis of the large intestine, small intestine, or area in the area of the duodenum.
At the time of diagnosis, it must be indicated which part of the digestive tract has been narrowed. Without this, the diagnosis cannot be considered final.
Specific signs of the disease
Even at the initial stage of the disease, a person immediately feels bad. In this condition, dehydration, weakness, and abdominal pain are characteristic. Septic shock with intestinal stenosis is also very common due to the rapid development of pathology.
It is worth noting that in the first hours of the development of pathology, a person may have normal stools, as well as a lowered body temperature, but in the future, stenosis will manifest itself exactly the opposite.
In addition to general symptoms, there is also a specific one that is most characteristic of this disease:
- bloating of one half of the abdomen, while in the other half a characteristic cavity forms;
- the abdomen on palpation is very soft, and its left part is very painful during any manipulation;
- when the patient shakes the abdominal wall, you can hear a characteristic gurgle;
- due to the fact that the digestive tract is partially paralyzed, during examination you can hear various extraneous sounds, for example, exhalations, inspirations and palpitations, this is due to a large accumulation of gases;
- if the disease has already developed to the stage of necrosis, the patient may complain of spotting from the anus.
In the most difficult cases, tissue necrosis may develop due to constriction of blood vessels. Necrosis is almost never found in the sigmoid colon. The death of tissues is more characteristic of the small intestine.
Node formation
Sometimes ultrasound can be seen nodular formations, which is also a sign of intestinal stenosis. Symptoms are especially pronounced, and the pain becomes excruciating.
Stagnation of gases, products of human vital activity, clamping of soft tissues lead to panic and anxiety of patients. Patients complain of extremely unpleasant sensations in the peritoneum, constantly moan and cannot take a comfortable position. Frequent vomiting and severe weakness are possible. If a person does not tolerate pain, then even a short-term loss of consciousness is possible.
It should be noted that with nodulation, external symptoms are not as pronounced as with ordinary bowel stenosis. For example, the doctor cannot detect severe bloating, and asymmetry is also weak.
Intussusception
Invagination is another severe symptom of bowel stenosis. In this case, treatment should be started immediately, since there is a high probability of developing tissue necrosis and large blood loss.
Invagination is the layering of one section of the intestine to another. As a rule, the department where the narrowing occurred is introduced into the department with a normal clearance. Usually there is invagination from two layers, but in severe conditions, the number of layers can reach up to seven.
It is worth noting that invagination can develop at absolutely any age, but most often this condition is typical for children under the age of 5 years.
Stenosis on the background of tumor development
If the patient has a neoplasm in the intestinal tract, then intestinal stenosis is formed in the department where the tumor develops. Moreover, very often the disease for a long time proceeds sluggishly and does not manifest in any way. Symptoms are either absent altogether or very mild.
Most often, the malignant process is suspected with nonspecific symptoms, including:
- prolonged temperature increase to small indicators;
- anemia;
- losing weight.
The most dangerous is a tumor, which is located in the right intestine. It is poorly diagnosed, but quickly grows into other tissues. The tumor on the left side gives severe symptoms and severe pain.
Stenosis against the background of the development of a tumor is characterized by:
- frequent abdominal pain;
- severe pain after eating;
- bloating due to gas accumulation;
- constipation
- frequent diarrhea due to irritated bowel, which is affected by inflammation.
Coprostasis
Coprostasis is one of the symptoms of intestinal stenosis, which is characteristic of the elderly. As a rule, it develops against the background of chronic constipation, senile atony, weak muscles of the abdominal region, etc. Coprostasis is also common in patients who abuse laxatives.
When coprostasis and intestinal stenosis are combined, then the patient develops the following symptoms:
- prolonged delay in bowel movement;
- severe pain in the abdominal region;
- bursting in the abdomen;
- frequent bloating and flatulence;
- feces in the form of a thin ribbon;
- defecation is possible only with strong straining.
Doctors are especially cautious about such a diagnosis, but modern medicine and highly qualified clinic staff can help the patient cure coprostasis without surgical intervention.
Gallbladder stones and stenosis
Intestinal stenosis, which is caused by gallbladder stones, is a very rare pathology. The fact is that only very large stones with a diameter of at least 5 cm can block the intestinal lumen.
If this happened, then, as a rule, stenosis is noted in the small intestine. To detect this pathology is relatively difficult. It produces increased gas in the gallbladder and its ducts.
If, nevertheless, doctors diagnosed stenosis against the background of movement of stones from the gallbladder, then treatment should be started as soon as possible. The fact is that a foreign body injures the surface of the intestine very much. As a result, gangrenous changes can develop, which are extremely difficult to treat.
Disease treatment
When a person is faced with a similar disease, most often he is interested in the question: is surgery necessary for bowel stenosis? Unfortunately, conservative treatment for such a pathology, as a rule, does not bring positive results.
The operation depends on several factors:
- where is the narrowing;
- the reasons why stenosis formed;
- Are there any complications that arose against the background of stenosis?
It is worth remembering that the appointment of surgery is possible only after a complete examination of the patient. If stenosis has arisen against the development of a malignant tumor, then a resection of the intestinal tract is prescribed. In addition, removal of a part of the intestine is also indicated if irreversible processes in the soft tissues, for example, their necrosis, have already begun.
Unfortunately, any surgical intervention has its drawbacks. For example, during surgery aimed at treating stenosis, intestinal adhesions may form during the recovery period. In order to minimize risks, doctors actively use the endoscopic method of treatment, however, it is not always possible to use it. Endoscopic treatment of stenosis can not be carried out with malignant lesions or with large lesions.
In the end, it should be noted that it is possible to cure stenosis, but the outcome largely depends on high-quality diagnostics, qualifications of a specialist and surgeon. It is also important to follow all the recommendations in the recovery period, since it is at this time that the development of various complications is possible.