What is bowel obstruction?
The bowel, or intestine, is the part of the digestive tract that absorbs nutrients and fluid from foods we eat. The residue of digested food passes through the bowel and is excreted during elimination, the final stage of digestion. This process can be interrupted or halted by the presence of a bowel obstruction, which is a blockage that prevents the passage of intestinal contents. The cause of the blockage can be mechanical, meaning that there is a physical obstruction. Mechanical blockage may be caused by scar tissue, adhesions, entrapment through a hernia, foreign bodies, gallstones, tumors, impacted feces, and volvulus (twisting of the intestines). Treatment for mechanical obstruction generally involves removing the source of the blockage, if possible.
Ileus, a malfunctioning of the synchronized contractions of the bowel, is another type of obstruction. Causes of ileus include electrolyte imbalances, gastroenteritis (inflammation or infection of the stomach and intestines), appendicitis, surgical complications, and obstruction of the mesenteric artery, which supplies blood to the abdomen. Certain drugs and medications can cause ileus, such as opioids and sedatives, which slow down peristalsis, the contractions that propel food through the digestive tract.
Bowel obstruction can produce symptoms, such as a distended abdomen, fullness, gas, painful spasms, constipation, diarrhea, nausea with or without vomiting, and foul-smelling breath. Treatment options include surgical placement of a tube through the stomach or nose to alleviate the distension and remove the obstruction. Some forms of bowel obstruction, such as those caused by paralytic ileus, may go away on their own.
Bowel obstruction is a serious medical condition that should be evaluated immediately by a health care provider. Seek immediate medical care (call 911) if you develop symptoms of bowel obstruction, such as abdominal pain, distension, or bloating, and are unable to eliminate feces or pass gas.
What are the symptoms of bowel obstruction?
Common symptoms of bowel obstruction
Symptoms of bowel obstruction primarily affect the gastrointestinal tract and include:
- Abdominal swelling, distension or bloating
- Foul-smelling breath
- Nausea with or without vomiting
- Stomach pain and spasms
Symptoms that might indicate a serious condition
Bowel obstruction can be a serious condition that should be evaluated immediately in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have these serious symptoms including:
What causes bowel obstruction?
A bowel obstruction occurs when there is a blockage that prevents the passage of intestinal contents that should be excreted. Blockages can be mechanical or caused by ileus.
Mechanical causes of bowel obstruction
Mechanical obstructions are physical blockages due to various causes including:
Adhesions (scar tissue from previous surgery or infections)
Diverticulitis (inflammation of small pouches of the bowel)
Intussusception (sliding of part of the intestine into an adjacent part)
Volvulus (twisting of the intestines)
Causes of ileus
Ileus, a malfunctioning of the movement of the bowel, is another type of obstruction. Causes of ileus include:
Certain drugs and medications, such as opioids and sedatives, which slow down peristalsis, the contractions that propel food through the digestive tract
Gastroenteritis (inflammation or infection of the stomach and intestines)
Obstruction of the mesenteric artery, which supplies blood to the abdomen
Recent abdominal surgery
A number of factors increase the risk of developing bowel obstruction. Diseases and tumors of the gastrointestinal tract are risk factors associated with bowel obstruction including:
Opioid drug use
Prior surgeries or radiation therapy that created scar tissue or adhesions
Recent general anesthesia
How is bowel obstruction treated?
Treatment of bowel obstruction begins with seeking medical care from your health care provider, who will likely admit you to the hospital for treatment. Treatment usually involves placing a tube through the nose or stomach to alleviate the symptoms. In some cases, surgery is needed to clear the obstruction or treat the underlying cause.
Treatment to relieve the swelling or distension
The following measures are often used in the treatment of abdominal swelling from bowel obstruction:
- Dietary restrictions to allow the obstruction to pass
- Intravenous fluids to provide nutrients
- Placement of a nasogastric tube to release the air and drain the fluid
Treatment for a mechanical obstruction
Surgery may be required to treat a mechanical obstruction. Procedures may include:
- Surgery to reposition or remove strangulated intestinal tissue
- Surgery to remove the obstruction
Treatment for obstruction caused by paralytic ileus
The following methods may be used to treat obstruction related to paralytic ileus:
- Medication to induce peristalsis (intestinal contractions)
- Monitoring in the hospital
- Nasogastric tube placement
Complications of untreated bowel obstruction can be serious or even life threatening. You can help minimize your risk of serious complications by following the treatment plan that you and your health care professional design specifically for you. Complications of bowel obstruction include: