Fecal vomiting

Fecal vomiting is a symptom of the development of intestinal obstruction of various etiologies. Usually, such vomiting occurs with obstruction of the large intestine, and it begins several days after the onset of this acute surgical pathology.

Vomiting feces indicates that there is a serious pathology of the gastrointestinal tract - either diffuse peritonitis, or intestinal obstruction, or gastrocolic fistula.

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Causes fecal vomiting

The cause of fecaloid vomiting is usually acute colon obstruction. In addition, in some cases it can also develop as a result of a gastrocolic fistula.

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Pathogenesis

When there is an intestinal obstruction, a block is formed in one of the sections of the gastrointestinal tract, causing the intestinal contents to accumulate in this afferent loop, expanding it. As the intestine expands, the release of kinins with histamine begins, and these substances increase the permeability of the vascular wall, and also facilitate the process of fluid leakage into the gastrointestinal tract. In this case, the loss of circulating blood volume can reach 30-40%. As a result of the intestine mechanically increasing in size, vomiting occurs, due to which the body loses electrolytes and water, which subsequently leads to dehydration and disruption of the electrolyte balance.

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Symptoms fecal vomiting

With fecal vomiting, the following symptoms are also observed - sometimes the patient has weak bowel movements. He also feels pain, discomfort and heaviness in the abdomen, and along with this there is a feeling of general weakness. With blockage in the upper part of the intestine, vomiting of feces is observed often, several times a day.

Complications and consequences

Intestinal obstruction with fecal vomiting can cause the following consequences:

• Problems with the digestive process, as well as with the absorption of nutrients into the blood;
• Autointoxication of the body by decay products;
• Vomiting and impaired water absorption can cause dehydration;
• Complications that threaten the patient’s life may also develop – sepsis or peritonitis.

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Diagnostics fecal vomiting

The doctor conducts an external examination, which reveals that the intestines in the abdominal area are clearly visible - they protrude noticeably. In addition, you can hear the rumbling of the stomach during acute attacks. Also, during the examination, the presence of local bloating is revealed, which is called Wahl's syndrome.

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Tests

After a diagnostic examination, the doctor should prescribe a general urine and blood test.

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Instrumental diagnostics

Instrumental diagnostic procedures are also prescribed.

An ultrasound and X-ray examination are required. An ultrasound examination allows you to find out the diameter of the intestinal loops, as well as to identify the presence of accumulated free fluid inside the abdominal cavity - these factors confirm the diagnosis.

A repeat X-ray procedure may be performed in the surgery department to examine the passage of barium through the intestine. Barium suspension can be seen with X-rays, making it possible to determine the level of obstruction and assess how the disease is progressing. An emergency barium enema (barium enema) can identify the cause of the pathology in the colon. In this case, the colon is completely filled, after which its condition is assessed using X-rays.

Colonoscopy – during this procedure, the colon is cleansed, and then an endoscope is inserted through the anus to examine the organ from the inside. This method allows you to identify tumors, take a biopsy sample and perform intubation at the site of narrowing – this action will relieve the patient from the manifestations of acute intestinal obstruction. Thanks to these procedures, surgical intervention due to oncological disease will be performed in more comfortable conditions.

If it is very difficult to diagnose the disease, a laparoscopy procedure is performed - an endoscope is inserted through a puncture on the anterior abdominal wall, which allows the internal organs to be examined.

Treatment fecal vomiting

Treatment of the disease begins with conservative therapy methods. Initially, to stop vomiting, the patient is prescribed complete rest, as well as abstinence from food for some time. A nasogastric tube is inserted into the stomach through the nose, which helps to empty its contents. This is how vomiting is stopped.

Medicines

During the treatment, intravenous administration of drugs (anesthetics, antispasmodics, antiemetics) and solutions is performed. Proserin is also used - it is injected under the skin to stimulate intestinal motility.

Proserin should be administered subcutaneously 1-2 times a day, 1 ml of a 0.05% solution. The maximum single dose is 0.002 g, but no more than 0.006 g can be administered per day. Side effects of the drug: severe sweating, hypersalivation, digestive disorders, dizziness and headaches, pollakiuria, visual impairment, twitching of the tongue muscles and skeletal muscles. The drug is contraindicated in hyperkinesis, epilepsy, angina pectoris and bradycardia, as well as in severe atherosclerosis and bronchial asthma.

Sodium chloride solution 0.9% is used in case of severe loss of extracellular fluid (observed with incessant vomiting), intestinal obstruction, as well as hyponatremia and hypochloremia, combined with dehydration, and as a detoxifying drug. Contraindicated in acidosis, hypernatremia and hyperkalemia, pulmonary and cerebral edema, extracellular hyperhydration, left ventricular failure in acute form. Side effects include: hyperhydration, acidosis, and hypokalemia.

Folk remedies

Beetroot can be used as a folk remedy for treating fecal vomiting due to intestinal obstruction. The tincture is prepared as follows: boil water in a saucepan (5 l), peel 0.5 kg of beetroot, and add them to the water. Leave to boil for 45 minutes, then leave to infuse for 3 hours. Next, strain the tincture, add 150 g of sugar to it, as well as yeast (1 tsp). Leave the resulting drink to settle for a day, and then drink without restrictions at any time and in any quantity.

Intestinal obstruction is also treated with enemas using butter and milk. You can prepare an enema mixture in the following way: heat 100 g of milk and melt 20 g of melted butter in it. Pour the resulting medicine into the enema, then use it to insert it into the patient's anus. Then you need to lie on your left side for some time (so that the medicine goes as deep into the intestines as possible). This procedure should be done before bedtime (2 hours before) for 3 days.

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Herbal treatment

Herbal treatment also helps to cope with the manifestations of the disease.

An effective recipe uses sand sedge and St. John's wort. To make the medicine, take 100 g of sedge and 70 g of St. John's wort, chop them finely and pour them into a thermos (the thermos should hold at least 3 glasses of water (600-650 g)). Then let the herbs steep overnight, and strain the tincture in the morning. The medicine should be taken before meals four times a day for 1 week. A single dose should be ¾ of a glass (approximately 175-180 g).

Fennel can also be used to treat intestinal obstruction. This recipe is usually used for children. The decoction is made as follows: pour 0.5 tsp of fennel into a cup, pour boiling water over it, cover and leave for 15-20 minutes. Drinking drinks with fennel helps improve intestinal peristalsis. An alternative option would be to use tea bags with fennel - this is a more convenient method.

Homeopathy

The homeopathic medicine Conium is prescribed for fecal vomiting or weak peristalsis. It is taken under the tongue until completely dissolved - 8 granules per dose, 5 doses per day. The treatment course usually lasts 8 weeks. If necessary, it can be prescribed again.

Contraindications to taking the drug include individual hypersensitivity to any of the components, pregnancy and lactation, kidney disease and severe epilepsy, and children under 18 years of age. Conium is prescribed with caution to people with hypotension. Side effects include rare manifestations of dermatitis or allergies. In case of overdose, a strong decrease in blood pressure is possible.

Surgical treatment

Surgical treatment of intestinal obstruction is performed under general anesthesia (endotracheal anesthesia with additional muscle relaxants is used through intubation). The presence of such a pathology involves performing a midline incision in the abdominal cavity (its anterior wall) - the so-called wide median laparotomy. This incision is needed for a full examination of the organs from the inside to identify the cause of the intestinal obstruction. After establishing the cause, appropriate surgical procedures are performed.

There are different methods to eliminate obstruction – it depends on the degree of changes that have occurred in the strangulated section of the intestine, the etiology of the disease, and the general condition of the patient. The following procedures are most often performed:

• When turning, detorsion is performed;
• In case of intussusception, the process of disintussusception is carried out;
• If adhesive obstruction is observed, adhesions are dissected;
• If a gallstone obstruction is observed due to an obstructing calculus, the intestine is opened to remove this obstruction;
• The non-viable part of the intestine or the part affected by the tumor is completely removed.

Before the operation, the legs are bandaged with an elastic bandage to prevent the risk of blood clots in the veins of the legs.

Prevention

To prevent the occurrence of the disease or its recurrence, it is necessary to promptly treat pathologies that disrupt the process of food movement through the gastrointestinal tract. Among such methods are planned regular dispensary examination of the colon to detect the presence of a cancerous tumor, timely elimination of hernias in the anterior abdominal wall, as well as removal of tumors detected in the colon.

After abdominal surgeries, the patient should change his diet. Food should be consumed in small portions, but often (every 2-3 hours). At the same time, it is necessary to limit the consumption of products that contain a lot of fiber, as well as various spices, as they irritate the intestinal mucosa.

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Forecast

Fecal vomiting is a sign of a serious disease, in which an unfavorable prognosis should be expected. That is why it is extremely important to diagnose intestinal obstruction before such vomiting begins. Often, after the appearance of this symptom, the patient is diagnosed with intestinal oncology at the last stage.

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