Medical News Today: What is bowel obstruction?

A bowel obstruction is a blockage in the small or the large intestine. It is a potentially dangerous condition and has several causes.

Someone with a full obstruction will find passing a stool or gas difficult, if not impossible. A partial obstruction can cause diarrhea.

Obstructions cause a buildup of food, gastric acids, gas, and fluids. As these continue to build up, pressure grows.

This can result in a rupture, or split. Whatever was behind the blockage can enter the abdominal cavity and spread bacteria. This can be fatal.

In this article, we examine the symptoms and causes of a bowel obstruction. We also take a look at how doctors can treat this condition and what people can do to prevent it from occurring.

Symptoms

Bowel obstructions can be painful and distressing. Symptoms include:

• vomiting
• diarrhea
• bloating
• constipation
• cramping
• decreased appetite
• inability to pass stools or gas
• nausea
• severe pain
• swollen belly

Vomiting and diarrhea are early signs of bowel obstruction. Recognizing these symptoms means that a person can seek treatment before the condition progresses.

If a fever develops after some of these symptoms, speak to a doctor. It can be a sign of a split in the bowel.

Causes

There are many possible causes of bowel obstruction. The different causes are either mechanical or non-mechanical.

Mechanical obstructions are physical barriers that prevent or restrict the flow of matter through the bowels. These include:

• adhesions, or tissue that can develop after abdominal or pelvic surgery
• diverticulitis
• a foreign object, if swallowed
• gallstones, though this is a rarer cause of obstruction
• hernias
• impacted stools
• infection
• inflammatory bowel diseases (IBDs)
• intussusception, which is when a segment of the bowel pushes into the next segment, making it collapse
• meconium plug, which is the first stool that newborns pass
• tumors
• a twisted bowel

Some refer to non-mechanical obstructions as ileus, or paralytic ileus. These occur when something disrupts the working of the entire digestive system.

The large and small bowels move in coordinated contractions. If something interrupts this process, a non-mechanical obstruction can occur. If a doctor is able to detect and treat the cause, the bowel obstruction is usually a short-term issue.

Some long-term, or chronic, medical conditions may cause a non-mechanical obstruction, however.

Causes of non-mechanical bowel obstructions include:

• abdominal or pelvic surgery
• diabetes
• electrolyte imbalances
• hypothyroidism
• Hirschsprung’s disease, a condition wherein nerve cells are missing from the end of the bowel
• infections
• some nerve and muscle disorders, such as Parkinson’s disease
• opioid medication

Risk factors

Some conditions and events increase the risk of a bowel obstruction occurring. If a person’s intestines have not developed properly, they will be more prone to blockages.

Other risk factors for developing a bowel obstruction include:

• cancer, especially in the abdomen
• Crohn’s disease or other IBDs, which can thicken the walls of the intestines
• previous abdominal or pelvic surgery, which may increase the risk of adhesions
• radiation therapy

When to see a doctor

If severe abdominal pain develops, a person should contact their doctor immediately.

Bowel obstruction can have serious consequences. A person should seek medical advice if any of the symptoms listed above occur. It is especially important to see a doctor if any of these symptoms occur after surgery.

Diagnosis

Diagnosis tends to begin with a physical examination. An obstruction can cause a hard lump in the abdomen, which a doctor may be able to feel.

The doctor will also ask questions and look at a person’s medical history.

A doctor can use a stethoscope to check a person’s bowel activity. A lack of regular bowel sounds, or the sounds being unusually quiet, can suggest a bowel obstruction.

Depending on individual cases, a doctor may recommend further tests. These can include:

• blood tests to check levels of electrolytes, liver and kidney function, and blood counts
• endoscopy, in which a doctor uses a special camera to look inside the gut
• CT scan
• X-rays

Doctors may use administer a substance called contrast via an enema. Contrast allows doctors to view the bowels more clearly when carrying out imaging tests.

Treatment

Treatment for bowel obstruction depends on the cause and how severe the blockage is.

A total mechanical obstruction usually requires surgery. Most cases of bowel obstruction need some form of medical intervention.

Treatment options for bowel obstruction can include:

• Medication. Opioids can lead to constipation. If this occurs, laxatives and stool softeners will help.
• Observation. Ileus may need monitoring for a few days and often resolves with time. During this time, people should limit food and drink to stop further buildup. Doctors can provide fluid intravenously to keep people hydrated.
• Nasogastric tube. This is a narrow tube that goes up the nose and into the stomach. It removes fluid and gas trapped in the stomach, relieving pressure. This eases pain and vomiting.
• Surgery. Surgeons can remove blocked or damaged sections of the bowel. In cases of IBDs, a strictureplasty may be necessary. Here, a surgeon will widen a narrowed section of bowel by cutting and sewing.
• Therapeutic enema. A nurse or doctor will push a medication or tap water into the bowel to try to relieve stool impaction, which can happen in severe constipation.

Medication may help ease discomfort due to a bowel obstruction. This can include:

• antinausea medicines to prevent vomiting
• pain relief medication
• antibiotics to fight bacterial infection

Diet and lifestyle changes

Simple changes to diet and lifestyle can help lower the risk of bowel obstructions. They will also help with recovery after an episode of obstruction.

Aging slows down the digestive system. As a result, people may want to make changes to their diet later in life to balance this out.

Suggested diet changes include:

• eating smaller portions more often
• chewing food well
• avoiding large amounts of high-fiber foods, such as wholegrain cereals and nuts
• cutting down on caffeine, which can irritate the bowel
• avoiding tough or stringy foods, such as celery or dried meat
• peeling fruit and vegetables to make them easier to digest
• cooking food until it softens
• focusing on eating moist dishes, such as those with sauces

Several lifestyle changes can help boost digestive health. Steps to consider include:

If a person has trouble with bowel movements, stool softeners can help. These are available to buy over the counter from many stores and online.

Complications

A bowel obstruction can lead to other issues, such as:

• dehydration
• electrolyte imbalance
• tissue death in the bowels
• abscess within the abdomen
• kidney failure
• a hole in the bowel, which could lead to infection
• pulmonary aspiration, wherein a person inhales solids such as vomit
• sepsis, a potentially fatal blood infection

People who have had surgery for obstructions are also at risk of other complications, including:

• adhesions
• bowel paralysis
• nerve damage
• short bowel syndrome, a condition in which part of the bowel is lost or does not work properly
• wound reopening

A bowel obstruction can interrupt blood flow in the area. This can cause some of the complications listed above.

At worst, it can lead to multiple organ failure and death. As a result, it is important to treat a bowel obstruction as soon as possible.

Prevention

Healthful lifestyle choices are a great way to lower the risks of bowel obstruction. Even low levels of exercise will help keep the bowels healthy.

There are many products available to help keep bowel movements regular, including laxatives and stool softeners. Keep something in the medicine cabinet to deal with occasional constipation. Soft fruits, such as figs and peaches, are good natural alternatives.

Act fast if passing stools or gas becomes difficult. The sooner treatment begins, the lower the risk of a bowel obstruction occurring.

Summary

A bowel obstruction occurs when part of the small or large intestine becomes blocked. It is vital to take this condition seriously and seek immediate medical attention.

In extreme cases, bowel obstruction can be deadly if left untreated. It can lead to some serious complications.

A person can dramatically lower their risk of developing an obstruction by eating well, keeping active, and staying hydrated.

The outlook for a bowel obstruction depends on its cause. In most cases, bowel obstruction is treatable. For some of the more serious causes, there are a lot of treatment options available.