What is bowel obstruction?

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The term bowel obstruction refers to blockages in the intestines that are not the result of fecal matter. Common causes include:

• twisting of the intestines
• tumors
• scar tissue from surgery

Obstructions result in a buildup of food, gastric acids, gas, and fluids. As these continue to accumulate, pressure in the bowel increases. This can result in a rupture or split. Whatever was behind the blockage can enter the abdominal cavity and spread bacteria.

Bowel obstructions can vary in severity. Some only partially obstruct the intestines, while others cause complete blockages.

There are many causes of bowel obstructions, ranging from infections to surgery complications.

Most bowel obstructions require treatment. Medication may treat mild cases, while surgery is necessary in around 20% of cases. Severe obstructions may eventually cause an intestinal rupture if left untreated. Medication and bowel rest may treat mild cases.

Bowel obstructions can be painful and distressing. Symptoms include:

• nausea and vomiting
• diarrhea
• bloating
• constipation
• cramping
• decreased appetite
• inability to pass stools or gas
• severe pain
• abdominal swelling

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, it can be a sign of an infection, and a person should consult a doctor.

Bowel obstructions can vary depending on the severity of the blockage.

Complete obstructions

Severe bowel obstruction can entirely block part of the intestine. This may stop all solids, liquids, and gases from passing through the digestive system.

Someone with a complete obstruction will find passing a stool or gas difficult, if not impossible.

Partial obstructions

A partial bowel obstruction is typically less severe. These obstructions block some, but not all, of the intestine. This will slow the progress of solids, liquids, and gases through the digestive system but will not stop them entirely.

A partial bowel obstruction may cause discomfort, bloating, and diarrhea.

Pseudo-obstruction

Intestinal pseudo-obstruction is a rare condition that causes the symptoms of bowel obstruction without the presence of a blockage.

It occurs when muscle or nerve issues prevent the normal movement of food, liquids, and gas through the intestines.

There are many possible causes of bowel obstruction. They are either mechanical or nonmechanical.

Mechanical obstructions

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

• adhesions, or scar tissue from surgery
• foreign objects
• gallstones, although this is a rarer cause of obstruction
• hernias
• infection
• inflammatory bowel disease (IBD)
• intussusception, which is when a segment of the bowel pushes into the next segment, making it collapse
• tumors
• a twisted bowel

Nonmechanical obstructions

The large and small bowels move in coordinated contractions. If something interrupts this process, a nonmechanical obstruction can occur.

If a doctor can detect and treat the cause, bowel obstruction is usually a short-term issue.

Some people refer to nonmechanical obstructions as adynamic or paralytic ileus.

Causes of nonmechanical bowel obstructions include:

• scarring from abdominal or pelvic surgery
• diabetes
• electrolyte imbalances
• hypothyroidism
• Hirschsprung’s disease, a condition where nerve cells are missing from the end of the bowel
• nerve and muscle disorders, such as Parkinson’s disease
• severe infection or illness
• general anesthesia
• certain pain relief medications

Some conditions and events increase the risk of a bowel obstruction occurring, such as:

• cancer, especially in the abdomen
• Crohn’s disease
• ulcerative colitis
• previous abdominal or pelvic surgery, which may increase the risk of adhesions
• radiation therapy

Bowel obstructions and age

People of any age may experience full or partial bowel obstructions. However, obstructions can carry additional complications in younger children and older adults.

Bowel obstructions are a common reason for intensive care admission in newborns. Abnormal formation of the intestines can often cause obstruction in younger children. For example, intussusception is most common in babies aged under 2 years.

Small bowel obstructions are also a common emergency condition in older adults. Obstructions due to malignant tumors are more common in this population as well. The higher prevalence of additional health complications in older adults can alter treatment programs for bowel obstructions.

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

Bowel obstruction can have serious consequences. An individual should seek medical advice if they experience any symptoms of a bowel obstruction.

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. During their initial examination, the doctor will also assess 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 unusually quiet sounds 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 scans
• X-rays
• contrast enemas

Differential diagnosis

Some conditions may cause similar symptoms to a bowel obstruction. These include:

• appendicitis
• abdominal hernias
• diverticulitis
• colonic polyps

During their assessment, doctors will seek to eliminate all these potential causes before diagnosing bowel obstruction.

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

• dehydration
• tissue death in the bowels
• abscess within the abdomen
• kidney failure
• intestinal tears
• pulmonary aspiration
• sepsis

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

• abdominal adhesions
• bowel paralysis
• nerve damage
• short bowel syndrome
• wound reopening

At worst, it can lead to multiple organ failure and death. That is why it is important to treat bowel obstructions as soon as possible.

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

Dietary and lifestyle changes

Simple changes to a person’s diet and lifestyle can help them digest food more easily and lower the impact of bowel obstructions.

Dietary changes that may help a person who has bowel obstructions include:

• eating smaller portions more often
• avoiding large amounts of high fiber foods, such as whole grain cereals and nuts
• focusing on eating soft or liquid meals
• limiting the intake of caffeine, which can irritate the bowels
• avoiding tough or stringy foods, such as celery or dried meat

Exercising regularly and staying hydrated can also aid regular digestive function.

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

Tumors, scar tissue from surgery, and abnormalities in a person’s intestinal development can all cause bowel obstructions.

Bowel obstructions can lead to severe complications. In extreme cases, they can cause intestinal ruptures and be deadly if a person does not receive timely treatment.

Individuals can 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.

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