What is the Difference Between Small and Large Bowel Obstruction?

Small and large bowel obstructions are partial or complete blockages of the small or large intestines, respectively. They can be caused by various factors, such as scar tissue from abdominal surgery, hernias, and colon cancer. The main differences between small and large bowel obstructions are their causes, symptoms, and treatment options.

Causes:

• Small bowel obstructions (SBOs) are most commonly caused by post-surgical adhesions, with incarcerated hernias being the second most common cause. Other causes include malignancy, inflammatory bowel disease (Crohn's disease), stool impaction, and foreign bodies.
• Large bowel obstructions (LBOs) are often caused by colon cancer, diverticulitis, or strictures from an inflamed intestine caused by conditions like Crohn's disease or diverticulitis.

Symptoms:

• Both SBOs and LBOs can cause abdominal pain, nausea, vomiting, constipation-to-obstipation, and distention. However, symptoms of SBOs typically occur shortly after onset, with abdominal cramps centered around the umbilicus or in the epigastrium, vomiting, and obstipation in patients with complete obstruction.

Treatment:

• SBOs may be treated conservatively with nasogastric decompression, fluid resuscitation, pain control, and antibiotics. However, a large percentage of SBO patients require surgical management.
• LBOs caused by colon cancer may be treated with resection and anastomosis, with or without a temporary colostomy or ileostomy. In some cases, a diverting colostomy with delayed resection is recommended.

In both cases, a timely diagnosis and appropriate treatment are crucial to prevent complications, such as bowel necrosis and perforation. If you suspect a bowel obstruction, it is essential to seek medical care immediately.

Comparative Table: Small vs Large Bowel Obstruction

Here is a table comparing the differences between small and large bowel obstruction:

Small bowel obstruction is commonly caused by adhesions or hernias, while large bowel obstruction is commonly caused by malignancy or diverticular disease. The cardinal features for bowel obstruction are abdominal pain, vomiting, abdominal distension, and absolute constipation.