Bowel Perforation Symptoms, Causes, Treatment

Bowel perforation is a painful medical condition that occurs due to holes in any part of the gastrointestinal system. These holes in the gastrointestinal walls develop for different reasons, causing intestinal fluids or feces to leak into the abdomen.

This condition causes inflammation, and a severe infection called peritonitis poisons the blood and leads to a septic shock. Bowel perforation is an emergency condition that can lead to other medical complications if not diagnosed and treated early.

Various medical conditions or disorders such as diverticulitis, inflammatory bowel disease, or appendicitis can increase the risk of developing this condition. However, the most common cause of bowel injuries is abdominal injuries during surgical procedures and trauma during a car accident.

Generally, symptoms of bowel perforation begin gradually and can be misleading; you can easily mistake these symptoms for other chronic health conditions.

This article will help you explore what you need to know about bowel perforation and when to consult your doctor.

Causes of Bowel Perforation

Several conditions can result in the development of bowel perforation; such of which includes:

  • blunt trauma or surgery to the abdomen
  • ingestion of foreign substances
  • Bowel obstruction due to weakened colon caused by cancer or diverticular disease
  • reactions to Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen

Bowel perforation mostly happens in the small intestine; surgical procedures such as colonoscopy and endoscopy can also cause bowel perforation.

Symptoms of Bowel Perforation

Typically, the symptoms of perforated bowel progress slowly and gradually get worse depending on the underlying medical condition causing it; however, common noticeable symptoms include:

Bowel perforation makes your abdomen feel tender and sensitive to touch. The onset of the pain is usually sudden if the Perforation is in the small intestine, while pain can gradually progress if Perforation occurs in the large intestine. The pain gets better when you lie still.

Risk Factor for Bowel Perforation

You cannot prevent Perforation of the Bowel; however, some factors can increase the risk of developing this condition. Factors that can increase your susceptibility to bowel perforation include:

  • aged adult above 75 years
  • Trauma to the abdominal cavity
  • History of diverticular disease, inflammatory bowel disease, or Colon cancer
  • Diagnostic procedures of the gastrointestinal cavity
  • Multiple underlying medical conditions
  • Bowel blockage or strangulated hernia

How to Diagnose Bowel Perforation

While trying to diagnose the cause of your bowel perforation, your doctor may ask questions about your symptoms, health record, and medication before ordering a test to confirm his suspicion. In addition, your doctor will examine the tenderness and swelling of your tummy.

Small Perforation may take some time to diagnose correctly; your doctor may listen for bowel sounds which is a sign of digestion. If you have bowel perforation, there will be no noticeable sound in the Bowel.

If the physical examination does not provide enough information, your doctor can order an imaging test such as an x-ray, CT scan, or a blood test for proper diagnosis.

Treatment for Bowel Perforation

Early diagnosis and treatment can help reduce medical complications. For example, if you develop a bowel perforation, your doctor will recommend emergency surgery.

You will undergo an exploratory laparotomy to repair the holes in the Bowel to prevent sepsis infection. A colostomy or ileostomy may remove escaped intestinal contents into a bag attached to the abdomen. If sepsis is diagnosed, your doctor will treat it with intravenous antibiotics.

Complications of Bowel Perforation

Frequently noticeable complications resulting from a perforated bowel are peritonitis and sepsis. These conditions have an approximately 30% mortality rate in victims and result in a decreased life quality of survivors. This condition is commonly diagnosed in aged adults and people with underlying chronic conditions.

Repairing a perforated bowel is quite a simple procedure with a high success rate; however, it depends on the size and time of diagnosis. Recovery chances are increased when the condition is diagnosed early. Seek medical advice if you have concerns about any of the symptoms discussed earlier.

Certain lifestyle factors such as obesity, smoking, and alcohol consumption can increase the risk of complications and prevent healing, leading to an infection.


Bowel perforation is a severe medical condition that you can prevent with a change of lifestyle decisions; however, consult your doctor for medical advice if you have an underlying medical condition that may increase your risk of developing this condition.

Early diagnosis is essential to a proper management and treatment option, which aids quick recovery.

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