Bowel Obstruction - Puyallup Surgical Consultants
standard-title Bowel Obstruction

Bowel Obstruction

Bowel Obstruction

About the Condition

Bowel obstruction is a blockage that keeps food or liquid from passing through your small intestine or large intestine (colon). Bowel obstruction may be caused by fibrous bands of tissue in the abdomen (adhesions) which form after surgery, inflamed or infected pouches in your intestine (diverticulitis), hernias and tumors.

Without treatment, the blocked parts of the intestine can die, leading to serious problems. However, with prompt medical care, bowel obstruction often can be successfully treated.

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Signs and Symptoms

Signs and symptoms of bowel obstruction include:

  • Crampy abdominal pain that comes and goes
  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Inability to have a bowel movement or pass gas
  • Swelling of the abdomen (distention)

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Risk Factors

Diseases and conditions that can increase your risk of bowel obstruction include:

  • Abdominal or pelvic surgery often causes adhesions — a common intestinal obstruction
  • Crohn’s disease can cause the intestine’s walls to thicken, narrowing the passageway
  • Cancer in your abdomen, especially if you’ve had surgery to remove an abdominal tumor or radiation therapy

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Diagnostic Process

Tests and procedures used to diagnose intestinal obstruction include:

  • Physical exam. Your doctor will ask about your medical history and your symptoms. He or she will also do a physical exam to assess your situation. The doctor may suspect intestinal obstruction if your abdomen is swollen or tender or if there’s a lump in your abdomen. He or she may listen for bowel sounds with a stethoscope.
  • Imaging tests. To confirm a diagnosis of intestinal obstruction, your doctor may recommend an abdominal X-ray or CT scan. These tests also help your doctor determine if the obstruction is paralytic ileus or a mechanical obstruction, and if the obstruction is partial or complete.

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Treatment Options

Treatment for bowel obstruction depends on the cause of your condition, but generally requires hospitalization.

Hospitalization to stabilize your condition

When you arrive at the hospital, the doctors will first work to stabilize you so that you can undergo treatment. This process may include:

  • Placing an intravenous (IV) line into a vein in your arm so that fluids can be given
  • Putting a nasogastric (NG) tube through your nose and into your stomach to suck out air and fluid and relieve abdominal swelling
  • Placing a thin, flexible tube (catheter) into your bladder to drain urine and collect it for testing

Treatment for partial mechanical obstruction

If you have mechanical obstruction in which some food and fluid can still get through (partial obstruction), you may not need further treatment after you’ve been stabilized. Your doctor may recommend a special low-fiber diet that is easier for your partially blocked intestine to process. If the obstruction does not clear on its own, you may need surgery to relieve the obstruction.

Treatment for complete mechanical obstruction

If nothing is able to pass through your intestine, you’ll usually need surgery to relieve the blockage. The procedure you have will depend on what’s causing the obstruction and which part of your intestine is affected. Surgery typically involves removing the obstruction, as well as any section of your intestine that has died or is damaged.

Alternatively, your doctor may recommend treating the obstruction with a self-expanding metal stent. The wire mesh tube is inserted into your colon via an endoscope passed through your mouth or colon. It forces open the colon so the obstruction can clear. Stents are generally used to treat people with colon cancer or to provide temporary relief for people who are at high risk of emergency surgery. You may still need surgery, once your condition is stable.

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