Causes of Bowel Perforation
I cannot provide a definitive answer about causes of bowel perforation based on the evidence provided, as none of the studies address bowel perforation—they focus exclusively on dietary management of inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and general gut health.
Why This Evidence Doesn't Apply
The provided studies discuss:
- Dietary interventions for IBD and IBS management 1, 2
- Lifestyle modifications for functional bowel disorders 1, 3
- Nutritional factors in inflammatory conditions 1
- Constipation management 1, 4
None address the acute surgical emergency of bowel perforation, which has entirely different etiologies.
General Medical Knowledge: Actual Causes of Bowel Perforation
Since the evidence doesn't address your question, I must rely on general medical knowledge. Bowel perforation typically results from:
Mechanical Causes
- Diverticulitis (most common cause in developed countries)
- Peptic ulcer disease (gastric/duodenal perforation)
- Bowel obstruction with pressure necrosis
- Trauma (blunt or penetrating abdominal injury)
- Foreign body ingestion
Inflammatory/Ischemic Causes
- Inflammatory bowel disease (Crohn's disease or ulcerative colitis with toxic megacolon)
- Mesenteric ischemia leading to bowel infarction
- Appendicitis with rupture
Iatrogenic Causes
- Colonoscopy perforation (particularly with polypectomy)
- Surgical complications
- Nasogastric tube placement
Infectious Causes
- Typhoid fever (ileal perforation)
- Cytomegalovirus colitis (in immunocompromised patients)
Other Causes
- Colorectal cancer with perforation
- Medications (NSAIDs causing ulceration, corticosteroids masking symptoms)
This answer requires evidence specifically addressing bowel perforation pathophysiology, which was not provided in your evidence set.