The aims are threefold
To remove any damaged or diseased bowel.
To join the ends of healthy bowel together.
To prevent the problem from coming back again.
You would have a general anaesthetic and be completely asleep for the operation.
You should stop having pain and vomiting. A hernia swelling should be gone. The cause of the small bowel problem should be gone.
Are there any alternatives?
Simply waiting and seeing if an obstruction settles down can be reasonable. This would be if the symptoms are not severe and if the blockage may be just a plug of food, which could pass through the bowel without an operation. The waiting could be a matter of hours, or rarely a day or two, if obstruction seems only partial. However, most of the small bowel conditions mentioned earlier usually need surgery as soon as possible.
Drug treatment for inflammatory bowel disease works well for many patients, but some will also need an operation.
Bypassing a diseased part of bowel may be safer than removing it, if the bowel is very stuck in the tummy. Rarely, making a stoma, which is a new opening for bowel waste on the skin of the tummy, above the diseased part, is the best that can be done.
A very large hernia may have several loops of bowel caught up in it, but with only one loop damaged. It may be safest to remove the damaged bowel but leave the hernia repair to a later date.
Taking laxatives can be dangerous, making the bowel condition worse.
Sometimes, there is only a little damage to the bowel e.g. caused by a needle. A trial of antibiotics and possibly washing out the tummy cavity with a tube passed through the tummy wall, is worth trying.
Author: Mr Michael Edwards FRCSEng FRCSEd. Consultant general surgeon.
© Dumas Ltd 2006