Bowel obstruction is a serious medical condition where something either fully or partially blocks part of the intestine; it requires prompt attention and appropriate treatment. The treatment for a bowel obstruction varies depending on the underlying cause. If you or a loved one has symptoms of a bowel obstruction, you’re not alone. We understand the discomfort and concern that come with this condition, and we’re here to help you navigate your treatment options with confidence.
Types of Bowel Obstruction
Bowel obstructions are classified depending on which intestine is affected – you can read more about large, small and pseudo obstructions below.
Small Bowel Obstruction
Approximately 80% of obstructions occur in the small intestine, which connects to the stomach at one end and the large intestine at the other. Its role is to move food and water along to your large intestine, and break it down. Common causes include scar tissue, hernia or cancer blocking the small intestine, causing the obstruction.
Large Bowel Obstruction
A large bowel obstruction occurs when part or all of the large intestine, also known as the colon, is blocked, and waste can’t move through the bowel correctly and out of the body.
Pseudo-obstruction
In pseudo-obstructions, you have symptoms of bowel obstructions without an actual obstruction. It can be caused by problems with your gastrointestinal muscles or your nerves, or it could be a symptom of certain medications.
How is bowel obstruction diagnosed?
Accurate diagnosis is the first step towards effective treatment. As a bowel obstruction is a medical emergency, diagnosis usually happens quickly. It may happen alongside treatment.
Diagnosis may involve the following tests:
1. Medical History and Physical Exam
Diagnosis starts by discussing symptoms, medical history, and any previous surgeries or conditions that might contribute to a bowel obstruction. A thorough physical exam helps identify signs of obstruction, such as abdominal distension and tenderness.
2. Imaging Tests
Abdominal X-rays can reveal signs of obstruction, such as gas patterns and dilated bowel loops. Additionally, CT scans can provide comprehensive information about the location and cause of the obstruction, and Ultrasounds are also used in order to visualise the bowel and identify blockages.
3. Laboratory Tests:
Blood tests can help assess overall health, detect infections, and evaluate the severity of the obstruction. Also, electrolyte tests can detect imbalances in electrolytes that can indicate dehydration and other complications associated with bowel obstruction.
How is a bowel obstruction treated?
The treatment for a bowel obstruction will depend on what is causing it. For a total mechanical blockage, surgery will most likely be required. Most bowel obstructions will need some form of hospital intervention to relieve the problem. If you suspect that you have a bowel obstruction, you should seek medical advice as soon as possible to avoid the situation becoming life-threatening.
Bowel Obstruction: Conservative Treatments
Watchful Waiting
If a paralytic ileus is suspected, then your condition may be monitored for a few days to see if it resolves on its own accord. You may experience pain, nausea, vomiting, and cramping. Most cases of ileus just require the bowel to be rested. You will be given fluids via a drip to keep you hydrated.
Nasogastric Tube (NG Tube)
In order to help you feel more comfortable and release any pressure, your doctor may insert a small tube through your nose and down into your stomach. The tube will remove any fluids or gas trapped in your stomach and relieve any pain and vomiting. You will not be able to have anything to eat or drink to avoid adding any pressure or bulk to the blockage.
Self Management
If you have a partial blockage, self-management can be effective. First, stop consuming solid foods, but continue drinking liquids to help move the obstruction along. Additionally, taking over-the-counter pain relief can alleviate discomfort, and using a warm compress can provide additional soothing. However, if the pain becomes severe or too difficult to manage, you should seek medical help immediately.
Bowel Obstruction Medicinal Treatments
Therapeutic Enema
A barium or enema may be used to diagnose and treat an intussusception. (This is the name given to a condition where the bowel gets folded.) During the procedure, air or a liquid containing a dye is injected through the rectum into the bowel. The air or liquid will create pressure in the large bowel, which will hopefully push out the folded piece of bowel. This is not always successful, and further surgery may be required.
Bowel Obstruction Surgical Treatments
For a total blockage or severe stricture, surgery will be required to rectify the problem. Several surgical procedures can be performed depending on the cause of the blockage. It is common for someone with a chronic illness, such as Crohn’s or Ulcerative Colitis, to require surgery to relieve blocked or narrowed intestines. Some of the surgical procedures may require you to have a stoma in the form of a colostomy or ileostomy in some cases temporarily.
Stents
Stents are metal tubes that can expand to open up the bowel to allow stool to flow through past the obstruction. This procedure may be used if you are considered not fit for surgery.
Small bowel resection
A small bowel resection is when the diseased or blocked part of the small bowel is surgically removed. The surgery can be performed laparoscopically (via keyhole) or may be done as open surgery in an emergency. If the two pieces of bowel left are healthy, then the ends will be stitched together, or you may be given an ileostomy where the small bowel is routed through an opening cut into your abdomen. You will then need to wear a colostomy bag over the top to collect the waste.
Large bowel resection
The blocked or diseased part of your colon or large bowel may be removed surgically if you have a total blockage. The surgery can be performed laparoscopically (via keyhole) or may be done as open surgery in an emergency. If the two pieces of bowel left are healthy, then the ends will be stitched together, or you may be given a colostomy where the colon is routed through an opening cut into your abdomen. You will then need to wear a colostomy bag over the top to collect the waste.
Ileocecal resection
Surgery involves removing the cecum, or beginning of the colon, along with the end of the small intestine. A healthy end of the small intestine is then attached to the colon. During this procedure, your appendix may also need to be removed.
Strictureplasty
This operation may be performed on patients with Crohn’s disease, as this mostly affects the small bowel. Crohn’s disease can cause narrowing or strictures which can block the bowel and cause extreme pain. A strictureplasty is when the narrowed section is cut and sewn horizontally to widen the intestine.
Further information on bowel obstruction
Further information and downloads can be found in the RESOURCES section. Living with a bowel condition or caring for someone with a bowel condition can affect you emotionally and socially; sometimes it can help to speak to others who understand your situation.
The Bladder & Bowel Community Support Group is available 24 hours a day and will allow you to connect with those who share your condition. Start your own topic today or just follow one that interests you.
THE INFORMATION ON THIS PAGE IS A GUIDE ONLY. IT IS IMPORTANT THAT YOU SPEAK TO YOUR GP OR A QUALIFIED HEALTH PROFESSIONAL BEFORE UNDERTAKING ANY TREATMENTS.