A bowel obstruction is a complete or partial blockage in any part of the intestine. This condition causes symptoms such as difficulty passing stool or gas, abdominal swelling, nausea, and abdominal pain that may get worse over time.
A bowel obstruction prevents the normal movement of digested food through the intestines. As a result, stool, intestinal gas, and digestive fluids build up, which increases pressure inside the intestines and raises the risk of serious complications like intestinal perforation, widespread infection, or tissue death.
Whenever a bowel obstruction is suspected, immediate medical attention is necessary to confirm the diagnosis and start treatment. Treatment usually includes intravenous fluids, a nasogastric tube, or surgery, depending on the severity of the blockage.
Common symptoms
The main symptoms of a bowel obstruction include:
- Cramping abdominal pain that gets worse over time
- Difficulty passing stool or gas
- Abdominal swelling
- Nausea and vomiting
- Loss of appetite
The severity of symptoms depends on the cause and seriousness of the obstruction. Fever may also develop if the intestine ruptures. Symptoms can vary based on the location of the blockage. For example, nausea and vomiting are more common with a small bowel obstruction, while abdominal swelling and constipation are more frequent with a large bowel obstruction.
A bowel obstruction is a medical emergency. If symptoms are present, prompt evaluation in the emergency room is required.
Can you still have a bowel movement with a bowel obstruction?
In some cases, a bowel obstruction is partial, which means some material can still pass through. In these situations, it may still be possible to pass gas, and in rare cases, diarrhea can occur. Symptoms may be milder, but persistent abdominal discomfort is common.
Confirming a diagnosis
A gastroenterologist or general practitioner may suspect a bowel obstruction based on symptoms, medical history, and a physical exam, which includes feeling the abdomen for any changes. The doctor may also use a stethoscope to listen for bowel sounds that indicate whether the intestines are working properly.
To confirm the diagnosis, imaging tests such as a contrast-enhanced CT scan are usually ordered. These tests help identify the cause, the location of the blockage, and whether it is complete or partial.
Possible causes
The main causes of a bowel obstruction include:
- Intestinal adhesions after abdominal surgery
- Intestinal scars from previous surgery or infections, known as intestinal bands
- Inguinal or umbilical hernias
- Inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis
- Twisting of the intestine, called volvulus
- Diverticulitis
Intestinal tumors, especially in the large intestine, are another possible cause. Other causes include a buildup of worms, post-radiation enteritis from cancer treatment, intussusception, or paralysis of the intestinal muscles, known as paralytic ileus.
Treatment options
Treatment for a bowel obstruction depends on the location and severity of symptoms and is always performed in a hospital to prevent complications. Home treatments like laxatives can make the condition worse and should be avoided.
The main treatments for a bowel obstruction include:
1. Intravenous fluids
IV fluids are given to improve hydration and help move stool and fluids through the intestine. This is especially important if dehydration is present due to vomiting or diarrhea. Intestinal rest is also necessary, so eating and drinking are stopped until the problem is resolved.
2. Nasogastric tube
A nasogastric tube is used to remove excess gas and fluids, which relieves pressure in the intestine and reduces abdominal swelling. It also helps control vomiting and lowers the risk of breathing in vomit.
3. Enema
An enema may be recommended for children with intussusception to help reposition the intestine. Barium or air enemas are typically used in these cases.
4. Surgery
Surgery is needed for complete or severe obstructions and is considered an emergency due to the risk of intestinal ischemia, which is a loss of blood flow that can lead to gangrene or perforation. Strangulated hernias also require emergency surgery.
Possible complications
Prompt treatment of a bowel obstruction is essential to prevent complications such as:
- Dehydration
- Intestinal rupture or perforation
- Widespread infection (sepsis)
- Death of part of the intestine
- Abdominal abscess
- Aspiration pneumonia
These complications can be life-threatening, leading to inflammation, severe infection, and multiple organ failure. For this reason, any suspicion that the intestines are not working properly should be evaluated by a healthcare professional to identify and treat any underlying problems.