Bowel obstruction

What is a bowel obstruction?

A bowel obstruction refers to a blockage in the small or large intestines, which prevents food and liquid from moving normally through the bowel lumen.1

Common causes include:

  • Adhesion – people with a history of surgery to the abdomen are at higher risk of intestinal obstruction, with tissue scarring having the potential to adhere and form a blockage
  • Hernias
  • Gallstones
  • Foreign body if swallowed
  • Inflammatory bowel disease including Crohn’s disease
  • Colon stricture from repeated diverticulitis- a condition causing abnormal small pouches to form in the wall of the large intestine and colon
  • Colorectal cancer
  • Twisted bowel

If intestinal obstruction remains untreated, it has the potential to progress to more serious conditions including electrolyte imbalances, kidney failure, dehydration and peritonitis caused by perforation of the intestines.1

 

Signs and symptoms of bowel obstruction

The symptoms that you experience will depend on the area and cause of the bowel obstruction. Symptoms will generally occur within hours of the obstruction forming.

Signs and symptoms of bowel obstruction may include: 2

  • Repeated vomiting
  • Nausea
  • Bloating, cramping and abdominal pain
  • Inability to pass gass
  • Sudden changes in bowel motions such as diarrhoea or constipation (due to obstruction)
  • Abdominal distention
  • Loss of appetite

Diagnosis

Bowel obstruction diagnosis involves a number of tests. Your clinician may perform a physical examination of your abdomen or you may undergo an x-ray or a CT scan, which can provide a clearer picture of the cause and site of obstruction; or a colonoscopy if colonic or rectal obstruction is suspected, a procedure which involves inserting a camera on a flexible tube into the rectum to endoscopically examine the large intestines.1 If small bowel obstruction due to adhesion is suspected, a technique known as a Gastrografin follow-through can be used to identify the site and degree of obstruction and improve resolution of the adhesive obstruction without surgery.

Treatment

Treatment for bowel obstruction will depend on the cause, severity and location of the obstruction. A complete obstruction usually requires surgery.

Treatment may require:

  • Decompression of bowel – where a small flexible tube (known as a nasogastric tube) is inserted through the nose into the stomach to decompress the bowel and relieve symptoms including cramping, bloating and vomiting
  • Fluid replacement – intravenously provides fluid and electrolytes
  • Surgery – where the blocked or damaged part of the bowel is removed (resection) or detoured (bypass)

References

For a full list of references, click here.
  1. Mayo Clinic (2019). Intestinal obstruction. Accessed 21 November 2019 at https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/symptoms-causes/syc-20351460
  2. healthdirect. (2019). Bowel obstruction. Retrieved on 18 November 2019 from https://www.healthdirect.gov.au/bowel-obstruction

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