A bowel obstruction is a blockage in the small or large intestine that prevents contents from passing normally through the digestive tract. Bowel obstructions can cause a range of symptoms depending on the location and severity of the blockage.
What are the symptoms of a bowel obstruction?
Some common symptoms of a bowel obstruction include:
- Abdominal pain and cramping
- Bloating and abdominal distension
- Nausea and vomiting
- Constipation and inability to pass gas or stool
- Feeling that you need to have a bowel movement but nothing happens
The abdominal pain from a bowel obstruction often comes and goes in waves. It may start out mild and become more intense over time. The location of pain can depend on where the blockage is occurring. For example, a small bowel obstruction may cause pain around the umbilicus or mid-abdomen. A large bowel obstruction may cause lower abdominal pain.
Bloating and distension can occur as contents back up behind the site of obstruction. Nausea and vomiting may happen as the digestive system struggles to move contents past the blocked area. Vomiting may be more prominent with upper intestinal obstructions.
Constipation and inability to pass gas are also common with bowel obstructions. You may feel like you need to have a bowel movement and strain or bear down, but nothing comes out.
What causes a bowel obstruction?
Some common causes of bowel obstructions include:
- Adhesions – Scar tissue from previous abdominal surgery can cause bands of tissue called adhesions that wrap around the intestine and cause an obstruction.
- Hernias – Part of the intestine can protrude through a weak area in the abdominal muscle wall and become pinched or trapped, causing an obstruction.
- Tumors – Cancerous tumors in the abdomen, such as ovarian or colon cancer, can compress or grow into the intestinal wall and cause obstruction.
- Diverticulitis – Inflammation and infection of diverticula or pouches that form in the intestinal lining can cause obstruction.
- Volvulus – When a section of the intestine twists around itself, it can cause a closed-loop bowel obstruction.
- Intussusception – When part of the intestine telescopes into itself, similarly to a collapsing telescope.
- Foreign bodies – Objects that are swallowed or enter the digestive tract, such as food blockages, bezoars, gallstones, or foreign objects in children.
- Strictures – Narrowed segments of intestine due to infection, inflammation, or radiation therapy scarring.
In some cases, the cause of a bowel obstruction cannot be identified. This is known as idiopathic bowel obstruction.
Who is at risk for a bowel obstruction?
Certain factors that can increase risk for bowel obstruction include:
- Previous abdominal or pelvic surgery
- History of abdominal cancer or radiation therapy
- Diverticulitis
- Hernias
- Crohn’s disease or other inflammatory bowel diseases
- Intestinal adhesions during pregnancy
- Swallowing foreign objects (more common in children)
- Family history of bowel obstructions
Newborns and younger children may be more susceptible to intussusception causing obstruction. Older adults are also at increased risk, possibly due to decreased intestinal mobility or other age-related changes.
When should you seek emergency care for a possible bowel obstruction?
Seek immediate medical attention if you experience:
- Severe, unrelenting abdominal pain
- Bloating or swelling of the abdomen
- Vomiting bile or green material
- High fever with vomiting
- Inability to have a bowel movement or pass gas for an extended time
- Signs of shock such as fast heart rate, rapid breathing, dizziness, cold clammy skin
These signs can indicate a complete intestinal obstruction and increased risk for bowel perforation, infection, and other life-threatening complications. Do not wait to see if symptoms resolve on their own. Seek emergency medical care right away.
How is a bowel obstruction diagnosed?
To diagnose a bowel obstruction, doctors may use:
- Medical history – Discussion of symptoms, risk factors, previous surgeries, etc.
- Physical exam – Abdominal tenderness, swelling, hernias.
- Blood tests – Signs of infection or electrolyte imbalances.
- Abdominal x-ray – Can often detect intestinal dilation and air-fluid levels caused by an obstruction.
- CT scan – Provides detailed images of the intestinal obstruction and surrounding tissues.
- Contrast studies – Barium or water-soluble contrast agents are used to visualize the intestine with x-ray or CT imaging.
Identifying the location and cause of obstruction can help guide treatment approaches.
How are bowel obstructions treated?
Treatment options for bowel obstructions may include:
- Nasogastric tube – Inserted through the nose into the stomach to help decompress and drain bowel contents.
- IV fluids – Given to prevent dehydration and maintain fluid and electrolyte balance.
- Pain medication – To help manage abdominal pain and discomfort.
- Bowel rest – Refraining from oral intake to rest the gastrointestinal tract.
- Surgery – Required for complete obstructions that do not resolve with other measures. Surgery relieves the obstruction by cutting obstructing bands of tissue, removing part of the diseased intestine, bypassing the obstruction with a stoma, or other techniques depending on the cause.
- Antibiotics – If infection is present.
For partial obstructions, supportive medical therapy may allow the obstruction to resolve over time as swelling decreases and the intestines are able to push contents through. Surgery is often required for complete intestinal obstructions.
What are the possible complications of untreated bowel obstruction?
Potential complications of leaving a bowel obstruction untreated include:
- Bowel ischemia – Compromised blood flow can damage intestinal tissue.
- Bowel perforation – Holes form in the intestinal wall that allow digestive contents to leak into the abdominal cavity.
- Sepsis – Life-threatening bacterial infection in the bloodstream.
- Dehydration and electrolyte disturbances
- Kidney failure
Bowel obstructions that are not addressed properly can become medical emergencies requiring intensive hospital care. Early diagnosis and management is key to preventing complications.
How can bowel obstructions be prevented?
While not all bowel obstructions can be avoided, some preventive measures include:
- Eating fruits, vegetables, whole grains, and fiber to maintain soft bowel movements.
- Avoiding dehydration and constipation.
- Preventing abdominal hernias with proper lifting techniques and weight management.
- Getting routine colonoscopies for colorectal cancer screening.
- Treating and preventing infections like diverticulitis.
- Early intervention for Crohn’s disease and related conditions.
- Discouraging swallowing of inedible objects in those at risk.
People with a history of bowel obstructions may need to take extra precautions and promptly report recurring or worsening symptoms. Catching potential obstructions early can improve outcomes.
Key Points
- Bowel obstructions cause symptoms like abdominal pain, bloating, vomiting, and constipation.
- Common causes include adhesions, hernias, tumors, diverticulitis, intestinal twisting, and foreign objects.
- Seek emergency care for high fever, unrelenting pain, vomiting bile, or signs of shock.
- Diagnosis often involves x-rays, CT scans, or contrast studies of the intestine.
- Treatment may include fluids, decompression, pain medication, bowel rest, or surgery.
- Prompt management is vital to prevent life-threatening complications.
- Prevention focuses on maintaining bowel health and addressing risk factors.
| Cause | Mechanism |
|---|---|
| Adhesions | Scar tissue wrapping around intestine and blocking passage |
| Hernias | Part of intestine protruding and becoming trapped or pinched |
| Tumors | Mass compressing or infiltrating intestinal wall |
| Diverticulitis | Inflamed intestinal pouches obstructing lumen |
| Volvulus | Twisted loop of intestine blocking passage |
| Intussusception | Part of intestine collapsing into itself like a telescope |
| Foreign bodies | Swallowed objects blocking intestinal lumen |
| Strictures | Scar tissue narrowing a segment of intestine |
This table summarizes some common causes of bowel obstruction and the mechanisms by which they block the intestinal tract.
Conclusion
Bowel obstructions can be life-threatening if not treated promptly. Being aware of the signs and symptoms along with your personal risk factors allows you to seek timely care when concerning problems arise. Advances in diagnostic tools and surgical techniques have improved outcomes for people with bowel obstructions. But prevention and early management remain key. Maintaining good communication with your healthcare providers can help detect and address potential obstructions before they cause serious complications.