Intestinal stenosis is a decrease in the normal lumen in any part of the digestive tract. The lumen can narrow due to various adverse conditions, as well as due to organic lesions. Pathology occurs in adults and children. Childhood stenosis most often presents as a congenital disease.
Symptomatics
An experienced doctor will not be difficult to diagnose "intestinal stenosis". Symptoms in adults are quite specific, but the disease can only be confirmed after an ultrasound scan.
So, the signs that signal the presence of this pathology include:
- frequent bloating;
- sharp pain in upper abdomen;
- vomiting, in which the presence of bile is noted;
- paleness of the skin, sometimes the presence of a gray tint;
- weight loss;
- increased gas formation;
- inability to gain weight;
- poor bowel function;
- impaired urine output;
- dry and flaky skin.
As you can see, the symptoms of this pathology are really specific and it is extremely difficult to confuse it, but sometimes atresia also manifests itself, which is often mistaken for intestinal stenosis. The 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 diagnostics.
Reasons for appearance
The development of the disease can occur at absolutely any age. In adults, the pathology, as a rule, is acquired, and in a child, intestinal stenosis is more often acquired.
Most often the disease develops for the following reasons:
- disturbance of normal metabolism;
- frequent smooth muscle spasms;
- intestinal volvulus;
- inflammation in the digestive organs;
- invagination;
- adhesions that occur after surgery;
- tumor-like processes in the intestines;
- injuries, etc.
If the patient was diagnosed with such a diagnosis, then it is worth preparing for a long and difficult treatment, since stenosis is not an easy pathology.
Also, do not self-medicate. Many patients begin with self-therapy, attributing 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 stenosisintestines. Symptoms and treatment of pathology are individual.
The most common method for diagnosing stenosis is ultrasound. During the procedure, it is desirable to use a contrast agent. However, ultrasound is not the only method. For the final diagnosis, it is also recommended to undergo an x-ray and donate blood for biochemical analysis.
It is worth remembering that stenosis can affect absolutely any part of the intestine. It can be the large intestine, small intestine, or duodenum. During an ultrasound examination, the doctor can determine exactly which area was affected, and sometimes understand the cause of this 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, the narrowing is present in the region of the stomach and small intestine.
- Duodenal. This variety means the presence of a narrowing in the region 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 food simply cannot move normally over the affected area.
Also in medical practice, this pathology is also divided according to the localization of the lesion. This may be a stenosis of the large intestine, small intestine, or an area around the duodenum.
At the time of diagnosis, it must beindicate which part of the digestive tract was narrowed. Without this, the diagnosis cannot be considered final.
Specific signs of disease
Even at the initial stage of the disease, a person immediately feels bad. This condition is characterized by dehydration, weakness, and abdominal pain. Septic shock in 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 low body temperature, but subsequently stenosis will manifest itself exactly the opposite.
In addition to the general symptoms, there is also a specific one that is most characteristic of this disease:
- bloating of one half of the abdomen, while a characteristic depression forms in the other half;
- the abdomen is very soft on palpation, and its left side is very painful during any manipulations;
- when the patient shakes the abdominal wall, a characteristic gurgle can be heard;
- due to the fact that the digestive tract is partially paralyzed, during examination, you can hear various extraneous sounds, such as exhalations, inhalations and heartbeat, 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 bloody discharge from the anus.
In the most difficult cases, tissue necrosis may develop due to occlusion of blood vessels. Necrosis almost never occurs in the sigmoidgut. Tissue death is more common in the small intestine.
Knot formation
Sometimes nodular formations can be seen on ultrasound, which is also a sign of intestinal stenosis. The symptoms are especially pronounced, and the pain becomes excruciating.
Stagnation of gases, human waste products, compression 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 for themselves. Frequent vomiting and severe weakness are quite possible. If a person does not tolerate pain, then even a short-term loss of consciousness is possible.
It is worth noting that with nodulation, external symptoms are not as pronounced as with normal intestinal stenosis. For example, a doctor cannot detect severe bloating, and the asymmetry is also mild.
Invagination
Invagination is another severe symptom of intestinal stenosis. In this case, treatment must 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 on another. As a rule, the department where the narrowing occurred is introduced into the department with a normal lumen. Usually there is an invagination of two layers, however, in severe conditions, the number of layers can reach up to seven.
It is worth noting that intussusception can develop at absolutely any age, but most often this condition is characteristicfor children under the age of 5.
Stenosis due to tumor development
If a patient has a neoplasm in the intestinal tract, then intestinal stenosis is formed in the very department where the tumor develops. At the same time, very often the disease proceeds sluggishly for a long time and does not manifest itself in any way. Symptoms are either absent or very mild.
Most often, a malignant process begins to be suspected with non-specific symptoms, including:
- prolonged rise in temperature to small levels;
- anemia;
- weight loss.
The most dangerous is the tumor, which is located in the right part of the intestine. It is poorly diagnosed, but quickly grows into other tissues. A tumor in the left side gives severe symptoms and severe pain.
Stenosis against the background of tumor development is characterized by:
- frequent abdominal pain;
- severe pain after eating;
- bloating due to gas accumulation;
- constipation;
- frequent diarrhea due to irritable bowel, which is affected by inflammation.
Coprostasis
Coprostasis is one of the symptoms of intestinal stenosis, which is typical for the elderly. As a rule, it develops against the background of chronic constipation, senile atony, weak muscles of the abdominal region, etc. Also, coprostasis is often found in patients who abuse laxatives.
When coprostasis and stenosisintestines unite, the patient develops the following symptoms:
- long delay in bowel movements;
- expressed abdominal pain;
- abdominal distention;
- 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, however, modern medicine and the high qualifications of the clinic staff can help the patient cure coprostasis without surgical intervention.
Gallbladder stones and stenosis
Intestinal stenosis 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 happens, then, as a rule, stenosis is noted in the small intestine. It is relatively difficult to detect this pathology. It is given out by increased gas formation in the gallbladder and its ducts.
If, nevertheless, doctors diagnosed stenosis against the background of the movement of stones from the gallbladder, then it is necessary to start treatment as soon as possible. The fact is that a foreign body very strongly injures the surface of the intestine. As a result, gangrenous changes can develop, which are extremely difficult to treat.
Treatment of disease
When a person is faced with a similar disease, most often he is interested in the question, is surgery necessary for intestinal stenosis? Unfortunately, conservative treatment for this pathology, as a rule, does not bringpositive results.
The operation depends on several factors:
- where the constriction is located;
- reasons for which stenosis formed;
- are there any complications that arose against the background of stenosis.
It is worth remembering that the appointment of an operation is possible only after a complete examination of the patient. If stenosis occurs against the background of the development of a malignant tumor, then a resection of the intestinal tract is prescribed. In addition, the removal of part of the intestine is also indicated if irreversible processes in soft tissues have already begun, for example, their necrosis.
Unfortunately, any surgical intervention has its drawbacks. For example, during an operation that is aimed at treating stenosis, adhesions in the intestine may form during the recovery period. In order to minimize the risks, doctors actively use the endoscopic method of treatment, but it is not always possible to use it. Endoscopic treatment of stenosis cannot be performed on malignant lesions or large lesions.
As a result, it should be noted that it is possible to cure stenosis, but the outcome largely depends on high-quality diagnostics, the qualifications of a specialist and a surgeon. It is also important to follow all the recommendations during the recovery period, since it is at this time that various complications may develop.
