Obstruction

Obstruction is another common complication of SB CD. It is important, but may be difficult to differentiate, whether the stricture is due to bowel wall thickening from active inflammation or fibrosis from repeated healing process. In addition, obstruction may be secondary to adhesions, especially in CD patients who often have had prior abdominal surgery. The first line therapy should be conservative measure, with bowel rest, nasogastric decompression, and IV hydration. Medical therapy should be initiated if there is evidence of active CD. An empiric course of medical therapy is appropriate when the contribution of active inflammation to the obstruction is unclear. Patients who fail to respond to medical therapy likely have a significant fibrotic component to their stricture and require surgical therapy. Patients with mild stricturing and intermittent partial obstruction should be instructed to avoid high residue diet, and may be managed as outpatients by a brief course of clear diet or bowel rest. Recurrent obstruction despite optimal medical therapy is an indication for surgery. Surgical options for stricture include resection of the involved segment or stricturoplasty as mentioned before. There is a separate chapter on dilatation of strictures (see Chapter 85, "Intestinal and Colonic Strictures").

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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