What’s the Buzz

The Bee Healthy Blog

What is a Bowel Obstruction & How Is It Treated?

Key Takeaways

  • A bowel obstruction is where a part of the digestive tract gets blocked, preventing food and fluid from moving through the bowel (small intestine or large intestine). 
  • Treatment options include intravenous fluids and hydration, a nasogastric tube through the nose and into the stomach to relieve abdominal distention (bloating), a catheter, a low-fiber diet, surgery, or even a metal stent.

  • Common causes are scar tissue forming after abdominal surgery, hernias, bowel cancer, intussusception, inflammatory bowel disease, diverticulitis, volvulus, impacted feces, or swallowed foreign objects.

A bowel obstruction, also called intestinal obstruction, is a condition where a part of the digestive tract gets blocked, preventing food and fluid from moving through the bowel (small intestine or large intestine). It can occur due to various causes, ranging from post-surgical scarring to inflammatory bowel diseases

Small and large bowel obstructions are a medical emergency and need to be treated promptly to prevent life-threatening complications. Please continue reading to find out more.

What is an intestinal obstruction?

An intestinal obstruction or bowel obstruction is a blockage that prevents food and waste material (stool) from moving through the bowel (intestines). There are different types of bowel obstructions:

  • Part of your intestine involved: A small bowel obstruction involves the small intestine (80% of the cases). A large bowel obstruction occurs in the large intestine or colon.

  • Partial or complete blockage: Some stool and liquid can pass through when there is a partial blockage. But when the bowel is completely blocked, not even gas can pass through.

  • Simple (non-strangulated) versus complicated (strangulated) bowel obstruction: In a strangulated bowel obstruction, blood flow to the bowel is cut off. This can cause tissue death in a part of your intestine or result in peritonitis, which is a life-threatening infection of the abdominal cavity.

What causes bowel obstructions?

Common causes of intestinal obstruction are:

  • When scar tissue forms after previous abdominal surgery, resulting in intestinal adhesions. Multiple abdominal surgeries are risk factors for adhesive small bowel obstruction. 

  • Hernias, when parts of the intestine protrude through a weak spot in the abdominal wall.

  • Bowel cancer, where a tumor presses on the bowel.

  • Intussusception (where one part of the intestine slides into an adjacent part like a telescope). This is common in children.

  • Inflammatory bowel disease (Crohn's disease or ulcerative colitis).

  • Diverticulitis.

  • Volvulus (when a part of the intestine twists on itself).

  • Impacted feces.

  • Swallowed foreign (non-food) objects.

Note: Paralytic ileus is called intestinal pseudo-obstruction because it can appear very similar to intestinal obstruction. However, there is no physical blockage present in the intestinal wall. Rather, paralytic ileus occurs due to problems with the nerves or muscles that prevent normal contractions in the muscle wall of the intestines. Without bowel wall contractions, food and fluid cannot move along the digestive system. Pseudo bowel obstruction or paralytic ileus can be a complication of abdominal or pelvic surgery, infections, disorders affecting the nerves and muscles such as Parkinson’s disease, and certain medications such as anticholinergics, opioids, and antidepressants that affect the nerves and muscles.

How do you know if you have a blockage in your bowels?

Signs and symptoms of a bowel obstruction include:

  • Severe abdominal pain (pain in the belly)

  • Severe cramping sensations

  • Swelling or bloating of the abdomen

  • Constipation 

  • Inability to pass gas or have bowel movements

  • Nausea and vomiting

  • Loss of appetite

  • Malaise (feeling unwell)

Do you still poop with a small bowel obstruction?

It may be possible to poop with a small bowel obstruction if the blockage is partial. However, if there is a complete obstruction in the digestive tract, you will be unable to poop or even pass gas. 

Can a bowel obstruction go away by itself?

A partial bowel obstruction may clear on its own. However, you should seek medical care for symptoms of intestinal obstruction. Your doctor may ask you to eat a special low-fiber diet that is easier for a partially blocked bowel to process while you wait for the blockage to clear. 

Complete bowel obstructions usually require a stay in the hospital and surgical treatment to clear the blockage.

Partial and total intestinal blockages can cause tissue death and permanent damage if the bowel’s blood supply is cut off. You should see your doctor without delay if you have severe pain in the abdomen or other unusual symptoms, such as the inability to have a bowel movement (pass stool and/or gas). 

How do you clear a blocked bowel?

There are various treatment options to clear a blocked bowel. The choice of treatment depends on the cause and severity of your intestinal obstruction and your medical history. Your doctor can make a diagnosis of intestinal obstruction based on your symptoms, physical examination, and imaging studies. Most people with bowel obstructions require a stay in the hospital and stabilization measures such as:

  • An IV line for intravenous fluids and hydration.

  • A nasogastric tube that goes through your nose and into your stomach to suck out air and fluid and relieve abdominal distention (bloating).

  • A catheter in your urinary bladder to drain urine.

Treatment for a partial bowel obstruction

After stabilization, your healthcare providers may take a watch-and-wait approach. They may recommend a low-fiber diet and wait to see if the partial bowel obstruction clears on its own. If it doesn’t, you may need surgery. 

Treatment for a complete intestinal obstruction

If there is a complete blockage of your intestine, you’ll need surgery. This typically involves removing the section of the intestine that is blocked along with any section where there is tissue damage or tissue death. 

Another option is to place a metal stent in the intestine to keep it open. This is done using an instrument called an endoscope that is passed through your mouth into your colon. A stent is typically used for bowel obstruction due to colon cancer. It may also be used as a temporary measure if emergency surgery is too dangerous until you are stable enough to have a surgical procedure. 

Treatment for intussusception

In children with intussusception, a barium or air enema is used both to diagnose and treat the condition. 

Treatment for paralytic ileus (pseudo-obstruction)

If you have a paralytic ileus, your doctors may monitor you for 1-2 days in the hospital to see if it gets better after the underlying cause is treated. For example, if your paralytic ileus is due to a medication, they will discontinue the medication. You may have a nasogastric tube and IV line placed to provide bowel rest and nutrition. 

Doctors can also prescribe medications called prokinetic agents to help muscle wall contractions in the intestines. 

Decompression of the colon (large intestine) may be done to relieve distention. This can be done through colonoscopy or more invasive surgery. 

 

References:

  1. https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/symptoms-causes/syc-20351460

  2. https://www.ncbi.nlm.nih.gov/books/NBK441975/

  3. https://www.ncbi.nlm.nih.gov/books/NBK448079/

  4. https://www.ncbi.nlm.nih.gov/books/NBK441888/