Bowel Obstruction: Symptoms, Causes, and Treatment

How we reviewed this article: · Healthline

An intestinal obstruction happens when your intestines become blocked so that digested foods and fluids buildup. If not treated, a blockage can lead to a dangerous rupture.

Digested food particles must travel through 25 feet or more of intestines as part of normal digestion. These digested wastes are constantly in motion.

However,

intestinal obstruction

can put a stop to this. An intestinal obstruction occurs when your small or large intestine is blocked. The blockage can be partial or total, and it prevents passage of fluids and digested food.

If intestinal obstruction happens, things will build up behind the site of the blockage. This buildup includes:

food

fluids

gastric acids

gas

If enough pressure builds up, your intestine can rupture, leaking harmful intestinal contents and bacteria into your abdominal cavity. This is a life threatening complication.

There are many potential causes of intestinal obstruction. Often, this condition can’t be prevented. Early diagnosis and treatment are crucial. An untreated intestinal obstruction can be fatal.

Intestinal obstruction causes a wide range of symptoms, including:

severe

bloating

abdominal pain

decreased appetite

nausea

vomiting

inability to pass gas or stool

constipation

diarrhea

severe abdominal cramps

abdominal swelling

Some symptoms may depend on the location and length of time of the obstruction. For example, vomiting is an early sign of small intestine obstruction. Vomiting may also occur with an obstruction of your large intestine, if it’s ongoing.

A partial obstruction can result in smaller stools, sometimes preceded by diarrhea, while a complete obstruction can make you unable to pass gas or stool.

Intestinal obstruction may also cause serious infection and inflammation of your abdominal cavity, known as

peritonitis

. This occurs when a portion of your intestine has ruptured. It leads to fever and increasing abdominal pain. This condition is a life threatening emergency requiring surgery.

An obstruction can be partial, which may get better without surgery. A complete blockage is more likely to need intestinal surgery.

Mechanical obstructions

Mechanical obstructions are when something physically blocks your intestine. In the small intestine, this can be due to:

adhesions, which are made of fibrous tissue that can develop after any abdominal or pelvic surgery or after severe inflammation

volvulus, or twisting of the intestines

intussusception

, a “telescoping,” or pushing, of one segment of intestine into the next section

malformations of the intestine, often in newborns, but can also occur in children and teens

tumors within your small intestine

gallstones

, although they rarely cause obstructions

swallowed objects, especially in children

hernias

, which involve a portion of your intestine pushing outside the muscle or tissue in your body or into another part of your body

inflammatory bowel disease, such as

Crohn’s disease

Although less common, mechanical obstructions can also block your colon, or large intestine. This can be due to:

stool stuck in your colon or rectum (

impacted stool

)

adhesions from pelvic infections or surgeries

ovarian cancer

colon cancer

meconium plug in newborns (meconium is the stool babies first pass)

volvulus and intussusception

diverticulitis

, the inflammation or infection of bulging pouches of intestine

stricture, a narrowing in the colon caused by scarring or inflammation

intestinal parasites

Nonmechanical obstruction

Your small and large intestines normally work in a coordinated system of movement. If something interrupts these coordinated contractions, it can cause a functional intestinal obstruction.

This is generally known as a nonmechanical obstruction. If it’s a temporary condition, it’s referred to as an

ileus

. It’s called a pseudo-obstruction if it becomes chronic, or long-term.

Causes for an ileus include:

abdominal or pelvic surgery

infections, such as gastroenteritis or

appendicitis

some medications, including

opioid pain medications

electrolyte imbalances

Intestinal pseudo-obstruction can be caused by:

Parkinson’s disease

,

multiple sclerosis

, and other nerve and muscle disorders

Hirschsprung’s disease, a disorder in which there’s a lack of nerves in sections of the large intestine

disorders that cause nerve injury, such as

diabetes mellitus

hypothyroidism

, or an underactive thyroid gland

First, a doctor may push on your abdomen to examine it. They then listen with a stethoscope to any sounds being made. The presence of a hard lump or particular kinds of sounds, especially in a child, may help determine whether an obstruction exists.

Other tests include:

blood tests to check for: blood counts

liver and kidney function

levels of electrolytes

X-rays

CT scan

colonoscopy

, a flexible tube with a light that your doctor uses to look at your large intestine

enema with contrast

Treatment depends on the location and severity of the obstruction. Do not attempt to treat the problem at home. The appropriate treatment depends on the type of intestinal obstruction.

For partial obstructions or an ileus, it may be possible to treat by simply resting the bowels and getting

intravenous (IV) fluids

. Bowel rest means you’ll be given nothing to eat, or clear liquids only, during that time. If the cause of the obstruction is known, your doctor treats that as well.

Treating dehydration is important. A doctor may give you IV fluids to correct your electrolyte imbalance. A catheter may be inserted into your bladder to drain urine.

A tube may need to be passed through your nose and down into your throat, stomach, and intestines to relieve:

pressure

swelling

vomiting

If your problem is due to the use of narcotic pain medications, your doctor can prescribe medication that reduces the effect of the narcotics on your bowels.

Surgery will be required if these measures fail or if your symptoms become worse. Treatment in this case typically requires a hospital stay. You’ll be given IV fluids, because in addition to relieving dehydration, they help prevent shock during surgery.

A severe complication of a bowel obstruction can be permanent damage to your intestine. If this occurs, a surgeon will perform an operation to remove the section of dead tissue and rejoin the two healthy ends of your intestine.

While prescription medications can’t treat the obstruction itself, they can help reduce your nausea until further treatments are performed. Examples of medications your doctor may prescribe include:

antibiotics to reduce infection

anti-nausea medicines to keep you from vomiting

pain relievers

You shouldn’t ignore the symptoms of an intestinal obstruction or attempt to treat an intestinal obstruction at home.

Treatment is essential to reduce complications such as:

dehydration

electrolyte imbalances

perforation

, or a hole that forms in your intestines, which leads to infections

kidney failure

If the obstruction is preventing blood from getting to a segment of intestine, this can lead to:

infection

tissue death

intestinal perforation

sepsis

, a life threatening blood infection

multiple organ failure

death

For some people with a chronic obstruction due to a stricture or narrowing of their intestine, a doctor may place a metal stent that expands inside the intestine using a long tube called an endoscope.

The stent is a wire mesh that holds open the intestine. The procedure may not require cutting into the abdomen, and it’s usually used if a person is not a candidate for traditional surgery.

Intestinal obstruction in infants typically arises from:

infections

organ diseases

decreased blood flow to the intestines (strangulation)

Some children experience the condition after having a

stomach flu

. This can cause inflammation in their intestines.

Intussusception is most common in children 2 years old and younger. This occurs when one part of their bowel collapses or slides into another part. As a result, their intestine becomes blocked.

Any type of intestinal obstruction is difficult to diagnose in infants because they can’t describe their symptoms. Instead, parents must observe their children for changes and symptoms that could indicate a blockage. These signs include:

abdominal swelling

drawing knees up to their chest

appearing overly drowsy

having a

fever

grunting in pain

passing stools that appear to have blood in them, known as a currant jelly stool

very loud crying

vomiting, particularly bile-like vomiting that is yellow-green

displaying signs of weakness

If you notice these symptoms or other changes in your child, seek immediate medical attention.

Seek medical care if you have symptoms of an intestinal obstruction, especially if you’ve recently undergone abdominal surgery. Seek immediate medical attention if you experience:

abdominal bloating

severe constipation

loss of appetite

When left untreated, intestinal obstruction can cause the tissue in the affected part of your intestine to die. It can also lead to a hole, or perforation, in the wall of your intestine, severe infection, and shock.

Overall, the outlook of your condition depends on its cause. Most cases of intestinal obstruction are treatable. However, other causes, such as cancer, require long-term treatment and monitoring.