How do you know if you have a bowel obstruction?

Small Bowel Obstruction

What is Small Bowel Obstruction?

From the moment you swallow food until you release the remains of your meal in a bowel movement, the entire digestive tract performs an amazing feat of moving the food through the organs by way of a special set of muscles that contract and expand. In fact, the sound you hear when your stomach growls is a result of the contractions that are going on as you digest food.

Small bowel obstruction is a potentially dangerous condition. There are a number of conditions in which the contractions of the bowel muscles make the process of moving the food very slow. These can be annoying and impact the quality of life.

There are two types of small bowel obstruction:

  • functional — there is no physical blockage, however, the bowels are not moving food through the digestive tract
  • mechanical — there is a blockage preventing the movement of food.

Funtional causes may include:

  • Muscle or nerve damage that may be the result of abdominal surgery, or disorders such as Parkinson’s disease
  • Infections
  • Certain medications that paralyze the contractions. Strong narcotics have this effect.

There are also serious conditions which may require immediate intervention:

  • Hernias — probably the most common condition in children and adults, in which a small part of the intestine protrudes through another part of the body. Adhesions may also be a cause. Scar tissue can form that blocks the intestinal canal.
  • Inflammatory Bowel Disease — a condition in which the walls of the intestine become inflamed
  • Tumors in the intestine that impede the flow
  • A volvulus, or a twisting of the intestine
  • Intussusception, a condition in which a segment of the intestine collapses into itself

Symptoms of Small Bowel Obstruction

  • intermittent pain due to perstalsis
  • distension of the stomach depending on where the obstruction is located
  • vomiting
  • constipation
  • fever and a racing heart

Why you need to see a physician if you suspect you have a small bowel obstruction?

If a part of the intestine becomes twisted, blood flow to that portion may be reduced, and the blocked part may die. This is a very serious condition. Another serious condition can occur in which the intestine ruptures, leaking contents into the bowel cavity. This causes an infection known as peritonitis.

Your doctor may ask you these questions about your condition:

  • How long have you been experiencing this problem
  • Have you had this condition before? Did it clear up?
  • Did the pain arise quickly?
  • Is the pain constant?
  • Have you ever had surgery in the abdominal area?

Diagnosis of Small Bowel Obstruction

Usually all that is required to diagnos an obstruction of the small bowel is an x-ray of the abdomen.

  • Luminal contrast studies
  • computed tomography (CT scan)
  • ultrasonography (US)

Once the diagnosis of bowel obstruction is entertained, location, severity and etiology are to be determined. Most importantly is the differentiation between simple and complicated obstruction.

Treatment of Small Bowel Obstruction

  • Antiemetics are medications that keep you from throwing up
  • Analgesics are mild pain relievers
  • Antibiotics will attack any infection you may have
  • Bowel decompression is a procedure in which a tube is guided into the impacted area in an attempt to reduce the pressure and address adhesions.
  • Surgery

Complications of Small Bowel Obstruction

  • Abdominal abscesses are pockets of infected pus in the abdominal cavity
  • Sepsis, a condition in which the blood becomes infected
  • Short Bowel Syndrome is a condition that results in malabsorption of nutrients

Quick intervention is the best medicine for small bowel obstructions. Complications arise quickly, and require complex surgery. Early intervention results in favorable outcomes with few complications. See your doctor if you think you may be having a problem.

Large Bowel (Intestinal) Obstruction

What is the large bowel?

The large bowel (see illustration), also called the large intestine, is the last part of your digestive tract, helping transport waste to be eliminated. It includes your colon and rectum. Digested food enters your large bowel as liquid. Your large bowel absorbs water and changes the liquid to stool.

What is large bowel obstruction?

Large bowel (intestinal) obstruction occurs when there is a blockage in the colon or rectum that prevents food or gas from passing through. This leads to swelling of the intestine. If the blockage and swelling are severe, the bowel can rupture, or the blood supply to the bowel can be cut off leading to bowel death. Both rupture and bowel death lead to bowel contents and bacteria leaking into the abdomen.

Who is at risk of a large bowel obstruction?

People who:

  • Are any age, but more often those over 70.
  • Have had surgery on abdomen.
  • Have had radiation therapy to the abdomen or pelvis.
  • Have/have had a form of cancer.

Note: Fewer than 1 in 3 colorectal cancer patients actually develop large bowel obstruction.

What are the causes/risk factors of large bowel obstruction?

  • Previous abdominal surgery and scar tissue.
  • Colon or rectal cancer, or cancer from other organs that has spread to the abdomen.
  • Inflammatory bowel disease.
  • Diverticulitis.
  • Previous abdominal or pelvic radiation.
  • Hernias.
  • Twists in the bowel.

What are the symptoms of large bowel obstruction?

The most common symptoms are:

  • Not being able to pass gas.
  • Not being able to have a bowel movement.
  • Nausea.
  • Vomiting.
  • Abdominal bloating and swelling.
  • Abdominal pain, usually crampy.

The pain usually comes in sharp waves and may get better for a while.

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What is bowel obstruction?

Bowel obstruction (also called intestinal obstruction) refers to when something prevents the normal movement of food and liquids through your bowel (intestines). It can happen to people of all ages, and for a variety of reasons.

The blockage to your digestive system can be:

  • either in the small intestine or the large intestine
  • partial, meaning the intestine is partly blocked, or complete, meaning it is fully blocked and not even gas can get through
  • simple, meaning it is just a blockage, or complicated, meaning the blockage has caused other problems

It’s important to get medical treatment straight away if you have signs of a bowel obstruction because it can lead to very serious complications.

Causes of bowel obstruction

There are many reasons for bowel obstruction. Depending on your age and medical history, you might be more susceptible to certain types of bowel obstruction.

In babies, bowel obstruction can be caused by:

  • a birth defect
  • a twisted or malformed section of intestine
  • intestinal contents that have hardened and formed a blockage

In adults, common causes of bowel obstruction are:

  • adhesions – scar-like bands of tissue that can form after abdominal or pelvic surgery
  • tumours – bowel cancer (colon cancer)
  • hernias

Less frequently, bowel obstruction can be caused by:

  • inflammatory bowel diseases such as Crohn’s disease
  • diverticulitis
  • twisting of the colon, known as a volvulus
  • severe constipation

There is also a type of bowel obstruction known as ‘pseudo-obstruction’. This is when the bowel is not working properly because of something other than a physical blockage. Possible causes include a muscle or nerve disorder, intestinal surgery or infection, or certain medications.

Symptoms of bowel obstruction

The symptoms of bowel obstruction depend on where the obstruction is, and the cause. Generally, symptoms come on within hours, although if a disease like diverticulitis or bowel cancer is the cause, symptoms might take weeks to develop.

The main symptoms of bowel obstruction are:

  • bloating, cramps and pain in the abdomen
  • loss of appetite
  • constipation (or diarrhoea if there is a partial blockage)
  • inability to pass gas
  • nausea and vomiting
  • generally feeling sick

If you have signs of bowel obstruction, seek medical attention straight away.

Diagnosis of bowel obstruction

To diagnose bowel obstruction, your doctor will likely:

  • ask you questions about your health
  • examine your abdomen
  • run some blood tests
  • use imaging, such as x-rays, a CT scan or an ultrasound

Treatment of bowel obstruction

Treatment for bowel obstruction depends on the cause, but you will need to go to hospital.

While in hospital, you might have the following procedures:

  • Your urine output may be monitored.
  • You may be given fluids through an intravenous drip.
  • You may receive pain relief and anti-nausea medicines.
  • A nasogastric tube may be inserted through your nose and down into your stomach (but usually only if there is severe bloating or vomiting).
  • Other procedures, such as colonoscopy or sigmoidoscopy, may be done.
  • You may need to discuss the need for surgery.

Sometimes surgery needs to be done immediately; sometimes, other treatments are used before it’s decided that surgery is necessary. However, surgery may also not be needed at all.

If the obstruction is caused by bowel cancer, surgery might be needed to remove the affected part of the bowel. Read more about bowel cancer here.

More information

  • Mayo Clinic
  • Bowel Cancer Australia

5 Signs You Have Irritable Bowel Syndrome

The symptoms of IBS can be embarrassing, but you don’t have to suffer in silence. IBS is more common than you think, especially in women under age 45. In fact, one in 10 people have IBS symptoms, but only half have been diagnosed with the disorder. Could you be one of them?

What is IBS?

Irritable bowel syndrome is a chronic condition caused by problems in the large intestine. The symptoms of IBS may be constant, or they can come and go. There may even be times when it seems your tummy woes have disappeared. Then IBS symptoms flare up again.

Symptoms of IBS

Some of the symptoms of irritable bowel syndrome include:

  1. Abdominal Pain – The most common complaint among people with IBS is abdominal pain or cramping. The discomfort frequently starts shortly after eating and may go away after a bowel movement. But that is not always the case.
  2. Diarrhea or Constipation – Bouts of diarrhea and constipation, or sometimes fluctuating between the two states, are other common symptoms. People with IBS often feel they need to stay home or near a bathroom for these reasons.
  3. Bloating – IBS can cause stomach swelling to the point you can’t fit into your normal clothes. So if you find yourself reaching for elastic-waist pants after eating, it could be a sign of IBS.
  4. Excessive Gas – Perhaps the most disturbing symptom of IBS is uncontrollable gassiness. Publicly passing gas can be humiliating. Fear of “letting one go,” or discomfort from suppressing a necessary biological function, can make socializing difficult.
  5. Mucus in Stool – It is normal to pass a small amount of mucus in your stool. However, people who have IBS may notice increased amounts of mucus in their stool.

Concerned you might have IBS? If you have been experiencing digestive distress three times per month for three months, or you’ve been suffering from symptoms for at least six months, talk to your doctor.

IBS Treatment

The exact cause of IBS is not known, however, it’s clear that multiple factors play a role, such as:

  • Certain foods
  • Increased stress levels
  • Fluctuating hormones during menstrual cycles
  • Depression and other mental health conditions

Doctors can’t diagnose IBS with a test, however, certain exams may help rule out other diseases like colon cancer. Tests may include:

  • Stool sampling
  • Blood tests
  • X-rays
  • Colonoscopy

You should see your primary doctor or a doctor specializing in gastrointestinal services if you are experiencing IBS symptoms. A gastroenterologist, a doctor that specializes in the digestive system, can help determine what factors have the most significant impact on your gut health and the treatments that will help you feel better. Improve your quality of life by finding a doctor today.

Many people manage symptoms using the top tactics for relieving IBS. Treatments like nutritional counseling, lifestyle adjustments and medication can make a big difference. With the appropriate medical care, you can live a healthy, normal life, without pain. Learn what foods may cause a flare-up in IBS symptoms.

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Learn More about IBS

  • How to Manage IBS on Vacation
  • The Best IBS Diet to Prevent Flare-Ups
  • National Institute of Health – Irritable Bowel Syndrome
  • National Institute of Diabetes and Digestive and Kidney Diseases – Irritable Bowel Syndrome
  • Mayo Clinic – Irritable Bowel Syndrome
  • Mayo Clinic – Mucus in Stool

By Robbie Schneider
Social Media Manager

Irritable bowel syndrome (IBS) is a common disorder in Americans. According to the National Institute of Diabetes and Digestive and Kidney Diseases, one in every five men and women has IBS (which is not the same as inflammatory bowel disease). Women are twice as likely as men to have the disorder. Half of all cases are diagnosed before age thirty-five.

Despite its high prevalence in the population, much remains unknown about IBS. This is due in part to the fact that the area affected, the gastrointestinal (GI) tract, is so dynamic. The GI tract comprises the stomach, small intestine and colon (a.k.a. large intestine). It is influenced by the immune and nervous systems, and contains hundreds of different types of bacteria that aid digestion.

Patients with IBS have a constellation of symptoms, including abdominal pain and changes in bowel habits – either constipation or diarrhea, said Dr. David Hudesman, a gastroenterologist and professor of medicine at NYU’s Langone Medical Center in New York City. “The cause is unclear, but it’s a functional disorder,” meaning it impairs intestinal function even though the body appears normal in tests, he said.

There are four subtypes of IBS, according to a 2016 article by Y.A. McKenzie, et al., published in the Journal of Human Nutrition and Dietetics:

  • IBS-D is diarrhea-predominant
  • IBS-C is constipation-predominant
  • IBS-M is both diarrhea and constipation
  • IBS-U is unspecified,.

Bacteria in the stomach and intestines can cause problems of digestion, bloating and constipation.

Symptoms & causes

Normally, food moves through the digestive system by muscle contractions in the intestines. In people with IBS, the contractions are no longer coordinated — they may last for too long or not long enough, according to the Mayo Clinic. Either extreme affects bowel movements and can result in uncomfortable and painful symptoms.

The predominant symptoms are cramping and abdominal pain, bloating, gas and trouble with bowel movements (either diarrhea or constipation), according to the Mayo Clinic. Symptoms often vary between people. Stress and changes in hormone levels, such as during menstruation, may exacerbate symptoms in prone individuals.

Scientists do not know the exact cause of IBS but several possibilities exist, Hudesman said. Triggers usually include environmental factors, diet, stress and anxiety, or intestinal bacteria, he said. This could include food allergies or intolerances such as an inability to process gluten. According to McKenzie, et al, up to nine out of 10 of those who suffer from IBS report that certain foods trigger increased symptoms. Those who do should first determine if they suffer from a food allergy or intolerance as there is no conclusive evidence that the immune system that is working on the allergy is related to IBS symptoms.

IBS most likely also has a genetic component. A study reported in April in the American Journal of Gastroenterology expanded on previous research showing that the disorder “clusters in families.” The scientists surveyed families of individuals with IBS and compared them to a control group. They found that about half of IBS-affected individuals had a relative with the disorder, compared to 27 percent of unaffected individuals.

Other research shows that abnormal levels of a chemical called serotonin in the GI tract may cause IBS. Although serotonin is usually thought of as a brain chemical, up to 95 percent of it can be found in the GI tract, according to the National Institutes of Health (NIH). Normally, the serotonin is moved out of the digestive system but in people with IBS, it builds up, causing the hallmark symptoms of the disease.

Complications

IBS doesn’t cause permanent damage to the GI tract, or lead to more severe illnesses such as cancer, according to the NIH. It can, however, drastically affect quality of life. For example, the symptoms associated with the disorder may make it difficult to attend social functions, or be away from home for long periods of time.

Moreover, many individuals with IBS suffer professionally because of workdays missed. According to the Mayo Clinic, individuals with IBS are three times as likely to take sick days. Libido may decrease because of IBS-related discomfort and pain.

These symptoms may eventually lead to depression.

Diagnosis & tests

Diagnosis of IBS is usually based on negative results for other tests since no specific test for the disorder exists. Examples of tests that may be performed include stool sample, blood test and colonoscopy (in which a tube with a small camera attached to the end is inserted into the anus).

Other tests such as CT scans, ultrasounds and endoscopies can also be used to rule out other disorders, according to Akram Alashari, an acute care surgeon. It is not uncommon for those who suffer from IBS to undergo unnecessary surgical procedures.

Including the symptoms described earlier, the following criteria, known as Rome criteria, are used to diagnose the disorder: abdominal pain in 12 weeks out of the year, disappearance of pain after a bowel movement, changes in the characteristics of bowel movements when pain appears, and urge to have a bowel movement.

Patients who experience non-intestinal symptoms such as bleeding, weight loss or recurrent fevers should see a doctor. Those with blood in their stool, persistent diarrhea or persistent pain should see a gastroenterologist, Hudesman said.

Treatment & medication

There is no cure for IBS, but supplements and prescription drugs may help. “A lot of it is treating the symptoms,” Hudesman said.

Prescription or over-the-counter medications can treat pain, diarrhea or constipation. Alosetron (sold under the brand name Lotronex) and lubiprostone (Amitiza) are two mediations specifically indicated for IBS. The first works on nerve receptors in the GI tract to slow down contractions and ease diarrheal symptoms; however, due to severe side effects, it is only approved for severe instances. Lubiprostone increases fluid in the intestine to ease constipation. Both drugs are only approved for women.

Diet adjustments, such as limiting high-gas foods and incorporating fiber, may improve systems. For example, Hudesman said, some people find relief from the FODMAP diet (short for Fermentable Oligo-, Di0, Mono-saccharides And Polyols), which restricts the consumption of short-chain carbohydrates such as wheat bread or cereal.

According to McKenzie, et al, about two-thirds of those who suffer from IBS experience improvements with dietary changes. These changes typically include reductions in alcohol and caffeine, as well as dairy, spicy and fatty foods, while gradually drinking more noncaffeinated and nonalcoholic fluids (increasing your intake too quickly can increase IBS symptoms) and eating more fiber (such as linseeds and fresh vegetables and fruit). Probiotics that do not contain other ingredients that could increase IBS symptoms may also be tried one at a time for a minimum of four weeks to see if the specific probiotic works or doesn’t.

The researchers also suggesting keeping to a regular meal pattern (breakfast, lunch and dinner, with snacks as needed), taking time to sit down to eat, chewing all food thoroughly, and not eating late at night could potentially decrease IBS symptoms.

Several alternative therapies are under investigation, but research showing the effectiveness of these treatments is limited. Examples of areas under investigation include herbs, peppermint oil, probiotics, acupuncture, and hypnosis. Hypnotherapy is commonly used for IBS and, according to the National Center for Complementary and Alternative Medicine, some research indicates it may improve depression and anxiety symptoms.

Additional reporting by staff writer Tanya Lewis and contributor Rachel Ross

Additional resources

  • To learn more about irritable bowel syndrome, check out the National Institutes of Health website.
  • For more information on the symptoms, causes and treatments for IBS, visit the Mayo Clinic website.
  • For a patient’s guide to living with IBS, see the website Gastro.org.

Bowel Obstruction

What Is It?

Published: May, 2017

In a bowel obstruction (intestinal obstruction), a blockage prevents the contents of the intestines from passing normally through the digestive tract. The problem causing the blockage can be inside or outside the intestine. Inside the intestine, a tumor or swelling can fill and block the inside passageway of the intestine. Outside the intestine, it is possible for an adjacent organ or area of tissue to pinch, compress or twist a segment of bowel.

A bowel obstruction can occur in the small bowel (small intestine) or large bowel (large intestine or colon). Also, a bowel obstruction can be total or partial, depending on whether any intestinal contents can pass through the obstructed area.

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Coping with cancer

Treatments for a blocked bowel can include:

Drips and drains

Your doctor might suggest treatment to give your bowel time to rest. You need to stop eating and drinking until your bowel is working normally again. You may need fluids through a drip so you don’t get dehydrated. This is called an intravenous infusion.

Sometimes you can have an infusion of fluids at home. You have this through a fine needle put just under the skin, instead of into a vein.

This may fix the blockage. But if it isn’t successful, you may need other treatments.

You might have a tube that goes up your nose and down into your stomach (called a nasogastric tube). This drains fluid from your stomach and stops you feeling sick.

Or your doctor might suggest that you have a venting gastrostomy to help relieve nausea and vomiting. This is when they put a special tube called a percutaneous endoscopic gastrostomy tube (PEG tube) into your stomach through an opening made on the outside of your abdomen. You usually have this under sedation.

Surgery

If your cancer is advanced and cannot be cured your doctor might suggest surgery to offer you longer term relief from your symptoms. The surgeon removes enough of the cancer to unblock the bowel. They might remove part of the bowel as well.

After the operation your surgeon is most likely to repair the bowel by stitching the ends back together. But sometimes it isn’t possible to do this and you may need to have a colostomy or ileostomy (stoma). A stoma is an opening from the bowel onto the abdomen. Your poo comes out of this opening into a plastic bag that sticks over it.

Deciding whether to have an operation like this can be difficult.

The surgery won’t cure your cancer. But it can relieve the symptoms that you have. Unfortunately, no one can tell beforehand how much you will benefit from an operation to unblock your bowel.

The operation could be successful and the cancer might not grow back to block the bowel again. But it is quite a big operation to have when you are likely to be feeling very weak and ill.

You might want to talk through having this operation with your close family and friends as well as your doctor and nurse.

A stent

A stent is a tube that the surgeon puts into the bowel. It expands to keep the bowel open. This can relieve the symptoms caused by the obstruction.

Your surgeon may be able to put in a stent if you are not able to have a big operation.

Medicines

Instead of an operation, medicines can sometimes help to control symptoms of a blocked bowel. Unfortunately these types of treatment will usually only control your symptoms for a while.

A drug called hyoscine butylbromide (Buscopan) stops muscle spasms and reduces pain. You can also have painkillers and anti sickness medicines.

You might also have a drug called octreotide. Octreotide reduces the amount of fluid that builds up in your stomach and digestive system. It can help to control sickness.

Or you might have steroids. Steroids can help to reduce the inflammation of your bowel. They can also help to control sickness.

Understanding an Intestinal Obstruction

An intestinal obstruction means that something is blocking your intestine. Food and stool may not be able to move freely.

When your intestine works normally, digested food moves from your stomach to your rectum. Along the way, your body breaks food down into usable parts and turns the rest to feces (stool). You eventually eliminate it through a bowel movement.

An intestinal obstruction may partially or completely block this natural process. A complete blockage is an emergency and needs medical attention right away.

Among the many possible reasons for an intestinal obstruction are:

  • Abdominal adhesions. These are growths of tissue in bands that may force your intestines out of place.

  • Hernia. A hernia is a split in the muscle wall of your abdomen. Hernias can cause bulges and pockets. These may block your intestine.

  • Volvulus. A volvulus happens when part of your intestine twists around itself. This creates a blockage.

  • Intussusception. This condition means that a segment of your intestine slides into another segment. This narrows but may not block your intestine.

  • Scarring. When your body heals small cuts (wounds), scar tissue forms. This can happen inside your intestine as well. These scars can build up and create partial or total intestinal blockages. Scarring can result from tears in your intestinal wall, belly (abdominal) or pelvic surgery, or infections.

  • Inflammatory bowel disease. Crohn’s disease and ulcerative colitis are 2 examples.

  • Diverticulitis. Tiny pouches (diverticulae) can grow off the large intestine lining. These may become inflamed.

  • Tumors. Growths may be cancer or harmless (benign). Either way, they can block your intestine completely or partially.

  • Foreign objects. Nonfood objects that you swallow on purpose or accidentally may cause partial or complete intestinal obstruction.

  • Meckel diverticulum. About 2 in 100 people are born with this additional small pouch inside the intestine.

Symptoms

Symptoms of intestinal obstruction are:

  • Severe pain in your belly

  • Severe cramping sensations in your belly

  • Throwing up

  • Feelings of fullness or swelling in your belly

  • Loud sounds from your belly

  • Feeling gassy, but being unable to pass gas

  • Constipation (being unable to pass stool)

Who’s at risk

You may be at risk of an intestinal obstruction if you have:

  • Abdominal surgery. This can increase the risk for scar tissue or other growths. They also increase the risk for hernias.

  • Diverticulosis. This condition means that something irritates the lining of the intestine. It may cause inflammation, infection, and scarring, which can lead to blockage.

  • Cancer

  • Inflammatory bowel disease

  • Swallowed foreign objects

  • Chronic constipation

Diagnosis

To diagnose your condition, your healthcare provider will consider your overall health and health history. He or she will ask you about your symptoms. Tell your provider where your pain is and how strong it is. Also tell your provider if you have had changes in your bowel movements or appetite. Tell your provider if you have any other unusual symptoms, such as digestive sounds or a feeling of being bloated.

Your provider will give you a physical exam. You may also need certain tests. These may include:

  • Abdominal X-ray

  • Barium contrast study

  • CT scan

  • MRI

  • Contrast fluoroscopy

Treatment

The treatment your healthcare provider recommends will depend on what is causing the blockage. For a simple blockage you may need to have only fluids and no solids to eat. Your provider will work to fix any metabolic problems. You may have an intestinal decompression. This is usually done with a nasogastric tube. You may also have bowel rest.

You will need surgery right away if your intestinal obstruction is more complicated. This could be from a tear (perforation) in the intestine or a problem with blood flow. You may also need surgery if other treatment does not remove the blockage. The goal is to remove the blockage and repair your organs.

Your provider also might recommend using a small, flexible tube to keep your intestine open, instead of having more invasive surgery.

Complications

Complications are problems caused by your condition. Complications of intestinal obstruction include:

  • Pain

  • Constipation

  • Loss of appetite

  • Inability to keep food or fluids down

  • Fever

  • Infection

  • Tear (perforation) of the intestine

  • Death (rare)

Prevention

Abdominal adhesions that occur after surgery may be prevented if your medical team takes certain measures. These include keeping the incision site moist instead of dry. Discuss in advance what steps your medical team can take to reduce your risk for adhesions after surgery.

When to call the doctor

Get medical help right away if you have symptoms of intestinal obstruction. These include severe abdominal pain, vomiting, and inability to pass stool.

How to manage or live with this condition

Follow your doctor’s instructions. If he or she has told you to change your diet as part of your treatment, stick to the new plan. The goal of the diet is to reduce the work that your digestive tract has to do, while still giving you the nutrition you need.

Topic Overview

What is a bowel obstruction?

A bowel obstruction happens when either your small or large intestine is partly or completely blocked. The blockage prevents food, fluids, and gas from moving through the intestines in the normal way. The blockage may cause severe pain that comes and goes.

This topic covers a blockage caused by tumors, scar tissue, or twisting or narrowing of the intestines. It does not cover ileus, which most commonly happens after surgery on the belly (abdominal surgery).

What causes a bowel obstruction?

Tumors, scar tissue (adhesions), or twisting or narrowing of the intestines can cause a bowel obstruction. These are called mechanical obstructions.

In the small intestine, scar tissue is most often the cause. Other causes include hernias and Crohn’s disease, which can twist or narrow the intestine, and tumors, which can block the intestine. A blockage also can happen if one part of the intestine folds like a telescope into another part, which is called intussusception.

In the large intestine, cancer is most often the cause. Other causes are severe constipation from a hard mass of stool, and narrowing of the intestine caused by diverticulitis or inflammatory bowel disease.

What are the symptoms?

Symptoms include:

  • Cramping and belly pain that comes and goes. The pain can occur around or below the belly button.
  • Vomiting.
  • Bloating and a large, hard belly.
  • Constipation and a lack of gas, if the intestine is completely blocked.
  • Diarrhea, if the intestine is partly blocked.

Call your doctor right away if your belly pain is severe and constant. This may mean that your intestine’s blood supply has been cut off or that you have a hole in your intestine. This is an emergency.

How is a bowel obstruction diagnosed?

Your doctor will ask you questions about your symptoms, other digestive problems you’ve had, and any surgeries or procedures you’ve had in that area. He or she will check your belly for tenderness and bloating.

Your doctor may do:

  • An abdominal X-ray, which can find blockages in the small and large intestines.
  • A CT scan of the belly, which helps your doctor see whether the blockage is partial or complete.

How is it treated?

Most bowel obstructions are treated in the hospital.

In the hospital, your doctor will give you medicine and fluids through a vein (IV). To help you stay comfortable, your doctor may place a tiny tube called a nasogastric (NG) tube through your nose and down into your stomach. The tube removes fluids and gas and helps relieve pain and pressure. You will not be given anything to eat or drink.

Most bowel obstructions are partial blockages that get better on their own. The NG tube may help the bowel become unblocked when fluids and gas are removed. Some people may need more treatment. These treatments include using liquids or air (enemas) or small mesh tubes (stents) to open up the blockage.

Surgery is almost always needed when the intestine is completely blocked or when the blood supply is cut off. You may need a colostomy or an ileostomy after surgery. The diseased part of the intestine is removed, and the remaining part is sewn to an opening in the skin. Stool passes out of the body through the opening and collects in a disposable ostomy bag. In some cases, the colostomy or ileostomy is temporary until you have recovered. When you are better, the ends of the intestine are reattached and the ostomy is repaired.

If your blockage was caused by another health problem, such as diverticulitis, the blockage may come back if you don’t treat that health problem.

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