Bowel obstruction describes a blockage in the bowels.
The bowels can become blocked for many reasons. When the bowels become blocked, the food and fluids taken in through the mouth become trapped inside the gut. Eventually, this leads to symptoms in an affected person.
Bowel obstruction can be caused by many different things. These include:
The symptoms and their severity depend on where in the bowels the blockage is located. Symptoms are also determined by the underlying cause, and may include:
The person's medical history and physical exam often suggest a bowel obstruction. Standard x-rays of the abdomen are most commonly used to confirm the diagnosis. In some cases, other tests may be needed to find the cause of the blockage. For example, a special x-ray test called an abdominal CT scan may be used if diverticulitis is suspected.
Usually, nothing can be done to prevent a bowel obstruction. A person who has had an obstruction from hard stools may be given stool softeners to prevent a repeat obstruction.
The bowel may develop a tear, called an intestinal perforation, or have its blood supply cut off. A lack of blood supply to the bowel can cause the tissue to die. A condition know as gangrene may develop as a result. These are both serious complications that may result in severe infections and death.
A bowel obstruction is not contagious, and poses no risks to others.
A person with a bowel obstruction may require fluid through an intravenous line, or IV. This is a needle that is placed in a blood vessel in the arm or had to deliver fluids directly into the blood stream. Antibiotics may be needed as well.
A nasogastric tube is often put through the nose into the stomach to help decompress the bowels. The person is usually advised not to eat or drink anything. An enema, or fluid injected into the bowel to cause the bowels to move, may be used for hard stool.
Sometimes a procedure called endoscopy is used if volvulus is the cause. This involves inserting a small tube through the anus and into the bowel. The tube allows the bowel to decompress and untwist itself in some cases. Surgery may be required to fix an obstruction. This may involve destroying scar tissue wrapped around the bowel or even removing a segment of the bowel.
Antibiotics may cause allergic reactions, stomach upset or other side effects. This depends on the antibiotic used. Surgery carries a risk of bleeding, infection and even death.
If the bowels become unblocked and the underlying condition is corrected, the person is often cured. Once an individual can eat and have bowel movements, he or she is usually able to leave the hospital. Someone with cancer may die, even after the blockage is corrected, if treatment for the cancer is unsuccessful.
If the underlying cause of the bowel obstructiion is fixed, no further monitoring may be needed. Repeated x-rays may be done in some cases. Any new or worsening symptoms should be reported to the healthcare provider.
Author:Adam Brochert, MD
Editor:Slon, Stephanie, BA
Reviewer:Melissa Sanders, PharmD
Cecil Textbook of Medicine, 1996, Bennett et al.