Hole In The Gut!

What happens when a hole forms right through the wall of a stomach, small intestine or large intestine? While not a very common occurrence, gastrointestinal perforation can occur to anyone at any age. This month let’s take a closer look at this condition and how it can be treated.

- Lim Teck Choon

Gastrointestinal perforation is also known as ruptured bowel, and like its name would suggest, it describes a hole in the wall of any part of the gastrointestinal tract (stomach, small intestine, and large intestine).

Most people have only one perforation at a time. However, it is possible, although rare, for one to have a few perforations at a time. These people usually have pre-existing diseases such as abdominal tuberculosis and cancer.

WHAT CAN CAUSE A HOLE TO FORM IN THE GUT WALL?

Most commonly, it begins with an untreated ulcer.

“The most common cause is an ulcer,” says Dr. Chieng. The wound from an untreated ulcer in the gut wall lining may spread into deeper layers of tissue until it completely “burns” through the entire lining.

Therefore, people with existing health conditions that leave them more at risk of developing gastrointestinal ulcers are more at risk of gastrointestinal perforation. These conditions include:

• Peptic ulcer disease, which causes ulcers to form on the stomach and the upper portion of the small intestine.

• Inflammatory bowel disease, which includes ulcerative colitis and Crohn’s disease.

Certain people who take nonsteroidal anti-inflammatory drugs (NSAIDs) on a long-term basis and/or in high dosage may also develop ulcers as a side-effect of these medications. They too face a risk of developing gastrointestinal perforation.

It can also be caused by direct damage to the gut wall. As bizarre as it may seem at first, there are cases of people who either deliberately or unknowingly swallow sharp objects such as glass shards and nails. These sharp objects can cause perforation in the gut wall. Direct injuries to the gut — such as a knife wound in the stomach — are also common causes.