Understanding Bowel Perforation

The colon is the last part of the digestive tract, before it reaches the anus and feces are expelled from the body. It consists of multiple layers of smooth muscle and mucosa that line the tortuous tubular colon.

Intestinal perforation occurs when the bowel is perforated mucosa, the innermost layer of this liner. Whether it’s surgery or serious bowel disease, it’s a real medical emergency. It requires immediate medical attention.

This article explains how this type of hole in colon tissue can cause its contents to leak into your abdominal space. It details the causes, risks, symptoms, and treatment of bowel perforation.

bowel perforation symptoms

Symptoms of bowel perforation can vary. Depending on the cause, they may start slowly or very quickly. Symptoms may include:

  • pain, usually severe, that spreads into your abdomen
  • severe stomach cramps
  • bloating, or a feeling of tightness or swelling
  • nausea and vomiting
  • Changes in bowel movements or habits
  • rectal bleeding
  • fever, usually delayed
  • body chills
  • fatigue, or feeling tired


A bowel perforation is a hole in the lining of the colon. When this happens, the contents of the digestive tract may leak from the affected area. This can lead to life-threatening or even fatal infections. If you have symptoms, seek emergency care right away.


Intestinal contents can leak through holes in the colon wall. Stomach acid, bacteria, and food particles leak into the abdominal cavity, which contains many internal organs. It is usually sterile, which means it is free of this contamination.

Leaked intestinal contents can lead to infection and inflammation. It can also cause an abscess or pus-filled space to form in the abdomen. Often, this causes a lot of pain.

When this happens, it is called peritonitis. This painful infection can lead to a systemic infection called sepsis. If left untreated, these diseases can be life-threatening and often fatal.

Complications of untreated perforation may include:

  • bleeding
  • Infection leading to sepsis
  • die

Factors that affect the severity of bowel perforation include your overall age and health. Results may also depend on how long it takes to diagnose and treat the problem. That’s why it’s so important to act quickly if you have any symptoms.


A normally sterile intra-abdominal infection can lead to a painful condition called peritonitis. If left untreated, this can lead to sepsis. Bleeding may also occur due to intestinal perforation.

Abdominal pain – when to see a healthcare provider


You may have a hole in your colon and it will happen on its own. Such spontaneous perforations are often due to diseases such as inflammatory bowel disease (IBD).

Bowel perforation can also be caused by medical procedures performed in or near the digestive tract. Some procedures rely on instruments that can accidentally create holes in the colon.

Intestinal perforation can also be caused by trauma from some kind of accident or external force. This is especially true for blunt trauma to the abdomen, such as a direct kick or prolonged fall.

Program-Related Reasons

Some medical procedures can cause bowel perforation. These reasons may include:

  • Enema: Most enemas use a tube inserted into the rectum. It can tear or puncture the lining of the colon if you use too much force or the wrong way.
  • Bowel preparation for colonoscopy: This is rare, but bowel cleansing done before a colonoscopy can create a hole. This is more common in people with a history of constipation.
  • Sigmoidoscopy: The endoscope is a tool for flexible examination Sigmoidoscopy. It can also be safely used in other programs. But a piercing is still a risk, even if it’s rare.
  • Colonoscopy: The tip of the endoscope may pass through the lining of the colon. This is a rare complication not seen during virtual colonoscopy. Holes created by colonoscopy are more common when polyps are removed during surgery.
  • Abdominal or pelvic surgery: Surgery, especially for colon cancer, may create a risk of perforation.

Canadian researchers looked at more than 96,000 colonoscopies to assess their complications. The incidence of intestinal perforation was 6 per 10,000 people. The incidence of bleeding after colonoscopy was 26 per 10,000.

Spontaneous cause

Other causes of bowel perforation are not related to medical procedures. They may include:

  • IBD conditions such as Crohn’s disease and ulcerative colitis. The lifetime risk of bowel perforation in Crohn’s disease is between 1% and 3%, making it a very common cause.
  • Severe bowel obstruction, especially when the colon is “weak.” This can be due to diverticulosis, cancer, or other underlying health conditions.
  • Intestinal trauma or injury
  • ischemic bowel disease, which interferes with the blood supply to the colon in some way
  • colon cancer
  • Foreign objects, such as fish bones, bone fragments, or other non-food items
  • Intestinal impaction, where you cannot pass stool due to severe constipation

Fecal Impaction Symptoms, Causes, Treatment, and Prevention

risk factor

Several factors may increase the risk of bowel perforation, including:

  • recent or previous abdominal surgery
  • recent or previous pelvic surgery
  • Age over 75
  • History of more than one medical problem
  • trauma to the abdomen or pelvis, such as an accident
  • history of diverticulosis
  • History of IBD
  • colon cancer
  • Take Yevoy (ipilimma) as part of cancer treatment
  • scar tissue in the pelvis, usually from previous surgery
  • Designated female at birth because the colon is more likely to be injured during surgery


Some bowel perforations are caused by chronic or underlying medical conditions such as Crohn’s disease. Others occur when a hole is accidentally created during surgery, such as a colonoscopy. You are at greater risk if you are older, have a digestive disorder, or were designated female at birth.


If your healthcare provider thinks you have a bowel perforation, they may order some tests. A simple X-ray may show gas outside your colon, but it’s usually not enough to make a diagnosis.

Usually, you will need a computed tomography (CT) scan of your abdomen. A barium enema may be required, but this process of introducing contrast fluid for better imaging may inherently carry a risk of bowel perforation.

A complete blood count may show that you have high levels of white blood cells. This is common in infections and indicates that a hole in the wall of your colon may have been there for some time. Your blood tests may also show signs of anemia from bleeding.

Smaller perforations can be more difficult to diagnose, which can mean more time and imaging tests.

What happens when you have a CT scan


In most cases, you will need surgery to repair a perforated bowel. It depends on the size and location of the tear.A sort of gastroenterologist Or a colorectal surgeon may be able to repair it endoscopically. However, this is not an option for everyone.

Open bowel surgery is more complicated. In some cases, it can lead to a stoma and colostomy. Complete a procedure to create a stoma, an intentional opening outside your stomach. Your stool will then pass into a small bag until the colon heals.

Do you need a colorectal surgeon or gastroenterologist?


You will not be able to drink or eat anything by mouth at the beginning of recovery. This is called letting the gut rest. It gives the lining of the colon time to heal properly.

You will also have a nasogastric tube to drain your stomach contents over a period of time. If you are in the hospital, you may receive intravenous antibiotics and nutrition for a few days.

One thing is for sure, you’ll want to get back to your normal routine. But it’s important to give your colon time to heal properly and to follow your healthcare provider’s orders.

Recovery after bowel surgery can be physical or emotional


A bowel perforation is a hole in the lining of the colon. This happens for many reasons, some of which are related to diseases people already have, such as IBD or colon cancer. The holes can also be caused by injuries, including rare perforations that occur during medical procedures such as colonoscopies.

The contents of the colon may leak through the hole created by the intestinal perforation. This can lead to bleeding, as well as painful and serious infections. Bowel perforation can usually be treated with surgery. However, if left untreated, the infection it causes can lead to death and disability.

If you think you have symptoms of bowel perforation, don’t wait. Get medical attention immediately.

VigorTip words

People with chronic digestive problems may not consider symptoms like constipation as serious. Yes, it can even lead to bowel perforation. Be sure to keep your healthcare provider up to date on your situation.

Frequently Asked Questions

  • How long can a person with a perforated bowel live?

    Life expectancy shouldn’t be affected at all when you seek immediate treatment. However, if there is no treatment and you develop sepsis, the chances of life changing or death are high. About one-third of people with sepsis die. Those who are alive may experience organ failure, chronic pain or other problems.

  • What does a bowel perforation feel like?

    The most common thing in a person’s body feel Severe abdominal pain due to intestinal perforation. Chills, fever, and nausea are also symptoms.