Bowel Obstructions

Overview

What Is a Bowel Obstruction?

A bowel obstruction, also known as an intestinal blockage, is a condition in which a problem in the small or large intestine prevents or severely slows the passage of digested food and waste through the gastrointestinal tract.

An intestinal obstruction can be due to a variety of factors, including physical issues like accidentally-swallowed items, hernias, tumors or scar tissue from previous abdominal or pelvic surgery (adhesions) and other issues.

Without medical treatment, bowel obstructions can lead to severe and even life-threatening gastrointestinal complications, including bowel tissue death due to lack of blood supply and severe infection that can result in sepsis.

What Causes a Bowel Obstruction?

A bowel obstruction can be caused by a variety of factors, including:

• Hernia, which is a bulge or pocket in the wall of the abdomen caused by a split in the muscle
• Intussusception, which is a narrowing of the bowel caused by a segment of the intestine sliding into another portion of the intestine
• Abdominal adhesions, which is scar tissue that’s sometimes caused by previous abdominal surgery
• Meckel’s diverticulum, a condition present in about 2% of adults in which a small pouch develops in the intestine
• Volvulus, which is a blockage caused by the intestine twisting around itself
• Inflammatory Bowel Disease (IBD), including ulcerative colitis and Crohn’s disease
• Diverticulitis, which involves pouches that can develop in the lining of the small intestine
• Benign or cancerous tumors in the intestines or abdomen
• Swallowing foreign objects, including bones and other nonfood items, which can cause partial or complete bowel obstruction

Symptoms of a Bowel Obstruction

The symptoms of an intestinal obstruction can vary from patient to patient, with different symptoms depending on the location and severity of the intestinal obstruction. Common signs of a bowel obstruction include:

• Severe abdominal pain and cramping
• Unexplained vomiting
• Constipation
• Loss of appetite
• Feeling bloated or gassy but unable to pass gas
• Loud bowel sounds from inside the abdomen
• Feeling full even if you’ve only eaten a little
• Swelling of the abdomen

Who Is at Increased Risk for Developing A Bowel Obstruction?

Certain factors can increase your risk of developing bowel obstructions. These risk factors may include:

• Previous pelvic or abdominal surgery, which can lead to adhesions
• Cancer in the abdomen
• Crohn’s disease
• Diverticulosis
• Inflammatory Bowel Disease (IBD)
• Swallowing a foreign object
• Chronic constipation

How is a Bowel Obstruction Diagnosed?

Diagnosing a bowel obstruction usually involves a thorough physical examination and imaging tests.

During the physical examination, the doctor will likely ask about the symptoms you’re experiencing, including any severe pain you might be experiencing. The doctor will likely use a stethoscope to listen for sounds inside the abdomen that may indicate you have a bowel obstruction. The doctor may also press on the abdomen in several places to see if there is tenderness, swelling or a mass that can be felt through the skin.

Which Tests Are Used to Diagnose a Bowel Obstruction?

Depending on the results of the physical exam, you may be asked to complete certain tests to fully diagnose a bowel obstruction. These may include:

• Abdominal X-rays
• CT Scans
• MRI Scans
• Abdominal Ultrasound
• Colonoscopy, in which a long, flexible camera is used to examine the lower bowel
• Barium swallow study
• Contrast fluoroscopy, which is a special kind of “video X-ray” that can show movement of barium through the digestive tract.

Barium Swallow Study and Bowel Obstruction

A barium swallow study is sometimes used to diagnose an intestinal obstruction. It’s a special type of test that uses barium and X-ray imaging to create detailed views of your gastrointestinal (GI) tract. Barium is used during a barium swallow test because it is “radio-opaque,” meaning it absorbs X-rays. Because of this property, barium appears white on an X-ray image. This makes any tissues coated in barium more visible in X-rays.

During a barium swallow study, you’ll be asked to drink a chalky liquid containing barium sulfate. As the liquid coats the inside of the esophagus and stomach, it makes those structures show up more clearly on an X-ray. This allows the radiologist to more easily see any issues in your GI tract.

Bowel Obstruction Treatment Options

How Do You Clear a Bowel Obstruction?

Patients with a partial obstruction or minor bowel obstruction are usually treated through what’s called nasogastric decompression. During this procedure, a long, flexible device called a nasogastric tube is inserted up the nose, down the throat and into the digestive tract.

This allows physicians to relieve any trapped gas and fluids while reducing pressure from the intestines. The procedure, along with medication, can usually resolve a less-severe bowel obstruction.

If a bowel obstruction is due to chronic conditions like ulcerative colitis or Crohn’s, your doctor will likely work with you to better control these conditions through medication, dietary changes and other steps.

Surgical Treatment Options for Intestinal Blockage

If a bowel obstruction is due to issues like a perforation of the intestine, hernia or tumor, or if it’s causing life-threatening symptoms, surgery to relieve the intestinal obstruction may be necessary. The type of surgery will depend on the cause and location of the obstruction. In some cases, the surgeon may need to remove a section of the intestine. In other cases, they may be able to repair the obstruction without removing any tissue.

After surgery, patients are typically monitored to make sure any bowel obstructions have been fully cleared and that no complications have occurred. This may involve blood tests, additional imaging tests and physical exams.