The bowels, both the small and large intestines, have a constant flow of food, fluids and wastes moving through it. Overall the transit through the bowels is a long journey – the small intesine is about 20 feet (6 meters) long while the large intestine is another 5 feet (1.5 meters) in length. For various reasons, the bowel contents can become backed up and cause the bowels to be congested with partially digested food, stool and sometimes even fluids cannot pass through.
Reason for Bowel Congestion
The bowels are a hollow cavity that is continuous with the rest of the gastrointestinal tract. At one of the this tract is the mouth whereby food and fluids enter. The passage from the mouth continues to the throat, down the esophagus and into the stomach. The duodenum (first part of the small intestine) starts at the outlet of the stomach and continues into the large intestine (cecum and colon). Eventually the large intestine passes to the rectum and the gut ends at the anus.
Read more on blocked colon.
A host of problems can occur anywhere along this course of the bowels. Congestion of food, fluid or stool within the bowels are usually due to some obstruction or pseudo-obstruction in the bowels, rectum or anus. As a result, the bowel contents cannot move beyond a certain point. These obstructions may be partial, where some contents can still pass through, or complete where no solids can pass. Fluids may still be able to seep through in complete bowel obstructions.
Causes of Congested Bowels
There are many different causes of bowel congestion. Firstly the bowels may be backed up due to an obstruction caused by stool itself, as may occur with constipation and impacted feces. At other times, the lack of movement through the bowels also causes the bowel contents to obstruct the passage through its length. Lastly, there may be physical obstructions that prevents the bowel contents from moving through the gut.
Constipation is a symptom of too few bowel movements in a week, often with the passage of hard and dry stool. There are many different causes of constipation. While there may be no blockage in the bowels, congestion of the large bowels with feces can still occur when there is constipation.
Stool accumulates in the bowels and this can cause stretching of the colon (megacolon) or lead to impacted feces. However, the problem has more to do with dietary factors including water and fiber intake, weakened muscles and in many cases contipation occurs for no known reason (idiopathic).
Fecal impaction is most common in people with prolonged constipation. The stool becomes large, hard and dry and eventually becomes stuck in the rectum. This prevents any stool from moving further down the colon and rectum. The obstruction in this case is the stool itself. Therefore the stool becomes backed up in the bowels. It can occur even without any physical obstruction in the bowels. Fluid in the bowels, including watery stool may pass around the obstruction.
Read more on fecal impaction.
A pseudo-obstruction is where there is no physical obstruction but stool cannot move along the course of the small or large intestines. This is mainly due to weakness or paralysis of the small muscles in the bowel walls that contract to push the contents along its course.
A pseudo-obstruction may occur with trauma, surgery, certain drugs, dehydration, diabetes, hypothyroidism, neuromuscular disorders, congenital conitions and sometimes even for unknown reasons. Pseudo-obstructions may be acute or chronic.
There are several physical obstructions apart from stool. This includes:
- Adhesions – scar tissue that forms arounds the bowels.
- Diverticulitis – bowel wall outpouchings in the colon and less commonly in the small intestine.
- Foreign body – object within the bowels that entered the gut through ingestion.
- Gallstone ileus – obstruction of the bowel caused by a large gallstone.
- Incarcerated hernia – portion of the bowel becomes trapped in an outpouching (hernia).
- Intussusception – collapsing of the bowels in telescope arranagement.
- Polyps – growths that protrude from the bowel walls into the cavity.
- Tumors – benign (non-cancerous) and malignant (cancerous).
- Volvulus – twisting of the bowels.
Signs and Symptoms
The signs and symptoms of bowel congestion may largely overlap among the different causes. It is therefore important that congested bowels are investigated by a medical professional to confirm the underlying cause. The following signs and symptoms may be present:
- Constipation – passing stool less than 3 times a week, often with difficulty.
- Excessive flatulence – passing gas more frequently than normal.
- Abdominal pain – from cramps to ache and overt abdominal pain.
- Enlarged abdomen – increase in abdominal girth.
- Nausea with or without vomiting.
- Blood in the stool – dark stool (melena) or fresh blood (hematochezia).
- Diarrhea – frequent passing of watery stool can occur.
The intensity and onset of these symptoms can vary based on the underlying cause. Sometimes the symptoms may be vague and a congested bowel or bowel obstruction is not immediately suspected.These signs and symptoms may be seen with a host of gastrointestinal conditions even when there is no obstructions of the bowels. Therefore diagnostic investigations like an abdominal ultrasound, x-ray, CT scan or endoscopic investigations such as a colonoscopy may be necessary.
Treatment for Congested Bowels
There is no specific treatment for all causes of bowel congestion. The underlying cause needs to be first identified before treatment can be commenced. The choice of treatment will depend on the underlying cause. It may involve a combination of diet, lifestyle medication and sometimes even surgery. Some of these treatment options include:
- Laxatives to promote bowel movements in constipation.
- Stool softeners for impacted feces.
- Fiber supplements and a high fiber diet for constipation.
- Surgical intervention for most physical obstructions.
Untreated congestion of the bowels can lead to a host of complications.The bowels may stretch excessively and there is even the risk of bowel rupture. In this instance the bowel contents can spill into the abdominal cavity. Apart from irritating the abdominal lining and wall, it can lead to an infection. This irritation and possible infection are known as peritonitis. It can be life-threatening if emergency medical attention is not forthcoming.