Treatment of Intestinal Blockade/obstruction

What is the treatment of Intestinal Blockade/obstruction?

A cancer patient can have intestinal blockage due to several reasons like previous surgery, chemotherapy or the spread of cancer itself. Bowel obstruction is sometimes due to a stool (feces) that has become hard and difficult to pass. Enemas and other measures can resolve this issue. It is important to determine the cause which may be difficult at times. The surgeon thoroughly examines and evaluates the patient and performs one or more tests like x rays, ultrasound and CT scan to study the nature of obstruction. Intestinal blockade can be complete or partial. There are 3 main types of treatments for obstruction.

  • * Surgery
  • * Drug therapy
  • * Chemotherapy

Surgery

When the blockade is complete, surgical treatment is usually required to relieve the blockade. The type of surgery will depend on the extent of the tumor and the general health of the patient to withstand the operation.

Removal of the tumor: Though there may be deposits at multiple sites, only one tumor could be causing the blockade, this tumor could be removed by surgery.

Bypass surgery: Some times when this is not possible, a bypass surgery is performed connecting together the intestine before and beyond the obstructing tumor.

Stoma: Sometimes even this is not possible, and a loop of intestine proximal (before) to the blocked area is brought out as a stoma (opening in the intestine on the abdominal wall through which stool will collect into a bag fixed to the skin of the abdominal wall). At times when there is blockade at multiple levels, an aggressive approach is employed and the surgeon tries to remove all the tumor deposits with the goal of relieving the obstruction

intestinal_blockage

Multiple tumor deposits out of which one is causing complete blockage. The yellow loops lie above the level of the blockage and are dilated. The orange loops are the collapsed intestine after the blockage. The area of intestine containing the tumor could be removed during surgery and the ends rejoined. Alternatively, a stoma could be created.

 
intestinal_blockage

In this scenario, more than one tumor is causing blockage of the intestine. Sometimes it maybe be possible to relieve this blockage whereas in other cases, only drug therapy is feasible

When the tumor is very extensive and the surgeon feels that none of the above mentioned surgeries is possible, then drugs are used to control the symptoms of the patients.  
intestinal_blockage

Extensive tumor deposits on the small intestine. The small bowel is compressed and kinked in multiple areas. Surgery is usually not possible in such scenarios and only drug therapy is feasible.