Bowel Obstruction

Topic Overview

What is a bowel obstruction?

A bowel obstruction happens when either your small or large intestine is partly or completely blocked. The blockage prevents food, fluids, and gas from moving through the intestines in the normal way. The blockage may cause severe pain that comes and goes.

This topic covers a blockage caused by tumors, scar tissue, or twisting or narrowing of the intestines. It does not cover ileus, which most commonly happens after surgery on the belly (abdominal surgery).

What causes a bowel obstruction?

Tumors, scar tissue (adhesions), or twisting or narrowing of the intestines can cause a bowel obstruction. These are called mechanical obstructions .

In the small intestine, scar tissue is most often the cause. Other causes include hernias and Crohn's disease, which can twist or narrow the intestine, and cancer, which can cause tumors. A blockage also can happen if one part of the intestine folds like a telescope into another part, which is called intussusception.

In the large intestine, cancer is most often the cause. Other causes are severe constipation from a hard mass of stool and twisting or narrowing of the intestine caused by diverticulitis or inflammatory bowel disease.

What are the symptoms?

Symptoms include:

• Cramping and belly pain that comes and goes. The pain can occur around or below the belly button.
• Vomiting.
• Bloating.
• Constipation and a lack of gas, if the intestine is completely blocked.
• Diarrhea, if the intestine is partly blocked.

Call your doctor right away if your belly pain is severe and constant. This may mean that your intestine's blood supply has been cut off or that you have a hole in your intestine. This is an emergency.

How is a bowel obstruction diagnosed?

Your doctor will ask you questions about your symptoms and other digestive problems you've had. He or she will check your belly for tenderness and bloating.

Your doctor may do:

• An abdominal X-ray, which can find blockages in the small and large intestines.
• A CT scan of the belly, which helps your doctor see whether the blockage is partial or complete.

How is it treated?

Most bowel obstructions are treated in the hospital.

A partial blockage may go away on its own, or you may need treatments that don't require surgery (nonsurgical treatments). These treatments include using liquids or air (enemas), small mesh tubes (stents), or medicine to open up the blockage. You will stay in the hospital while waiting to see if the blockage goes away. If these treatments don't work, you'll need surgery to remove the blockage.

Surgery is almost always needed when the intestine is completely blocked or when the blood supply is cut off. Surgery is often done laparoscopically. This means that the surgeon uses a lighted scope and tools inserted through a few small cuts rather than making a large cut.

If your blockage was caused by another health problem, such as diverticulitis, the blockage may come back if you don't treat that health problem.

Frequently Asked Questions

Learning about a bowel obstruction:	What is a bowel obstruction? What are the symptoms? What is an incarcerated hernia?
Being diagnosed:	How will my doctor diagnose a bowel obstruction? What happens during the physical exam? Are there conditions with similar symptoms? What is ileus?
Getting treatment:	How is a bowel obstruction treated? What is the treatment for a bowel obstruction caused by twisting of the intestine? What is the treatment for a bowel obstruction caused by inoperable cancer?
Ongoing concerns:	Will I need to make any lifestyle changes?

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Author:	Monica Rhodes	Last Updated: May 7, 2009
Medical Review:	Kathleen Romito, MD - Family Medicine Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
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