Intestinal Obstruction

What is an intestinal obstruction?

An intestinal obstruction is something blocking part of your intestines. It's also called a bowel obstruction or blockage. Normally, food you eat moves from your stomach into your intestines. As it passes through your small and large intestines, the food continues to be digested and the waste (stool) moves to your rectum. You then pass stool out of your body with a bowel movement.

An intestinal obstruction is something that partly or fully blocks this path. It may be scar tissue, a twisted part of an intestine, a growth, or an object. (If your intestine is blocked by hard stool, this is called fecal impaction instead of intestinal obstruction.) Sometimes a blockage can be caused by the intestinal muscles not working correctly to move waste through.

What causes an intestinal obstruction?

Many things can cause an intestinal obstruction. They include:

• Abdominal adhesions. These are bands of tissue that may grow abnormally between organs in the belly (abdomen). These bands of tissue may force your intestines out of place.

• Hernia. A hernia is a tear in the muscle wall of your abdomen. A hernia can cause a bulge or pocket that may block your intestines.

• Volvulus. This is when part of your intestine twists around itself. This creates a blockage.

• Intussusception. This is when one part of your intestine slides into another part. This narrows your intestine. But it may not block it.

• Scarring. When your body heals small cuts (wounds), scar tissue forms. This can happen inside your intestine as well. These scars can build up and create part or total intestinal blockages. Scarring can result from tears in your intestinal wall, pelvic surgery in your abdomen or pelvis, or infections.

• Inflammatory bowel disease (IBD). These are diseases that harm the tissue of the intestines. They include Crohn's disease and ulcerative colitis.

• Diverticulitis. Tiny pouches (diverticulae) can grow off the large intestine lining. These may become inflamed.

• Tumors. These are growths that may be cancer (malignant) or not cancer (benign). Either way, they can block your intestine partly or fully.

• Swallowed object. If you swallow an object that isn’t food and can’t be digested, it may cause part or full intestinal obstruction.

• Meckel diverticulum. This is an additional small pouch inside the intestine that some people are born with.

• Functional problems. This means there are problems with the muscle movements of the intestine. There may not be an actual blockage, but the intestines are not contracting correctly to move waste through. This can be caused by things like recent abdominal surgery, an abdominal infection, a muscle or nerve disorder, and the use of some medicines, such as opioids.

Who is at risk for an intestinal obstruction?

You're more at risk if you have any of the below:

• Abdominal or pelvic surgery, which may cause scar tissue, adhesions, or a hernia

• Diverticulitis

• Cancer

• Inflammatory bowel disease

• Swallowed object

• Past radiation

What are the symptoms of an intestinal obstruction?

Symptoms can be a bit different for each person. They can include:

• Severe belly pain

• Severe belly cramping

• Upset stomach (nausea) or vomiting

• Feelings of fullness or swelling in your belly

• Loud gurgling sounds from your belly

• Feeling gassy, but being unable to pass gas

• Unable to pass stool (constipated)

Many of these symptoms may be caused by other health problems. See your healthcare provider for a diagnosis.

How is an intestinal obstruction diagnosed?

Your healthcare provider will ask about your symptoms and health history. They'll give you a physical exam. The physical exam may include pressing on areas of your belly.

You may also have an imaging test to help your provider see inside your belly. You may have 1 of these:

• Abdominal X-ray

• Barium contrast study

• CT scan

• MRI

• Contrast fluoroscopy

How is an intestinal obstruction treated?

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is, and what's causing the obstruction. Types of treatments include:

• Bowel rest. For a simple blockage, you may need to have only fluids and no solids to eat. This stops the bowel from moving.

• Bowel decompression. This treatment removes gases and fluids filling the colon. A thin tube called a nasogastric, or NG, tube is put into your nose and down into the stomach.

• Surgery. You may need surgery if other treatment doesn't remove the blockage. Your provider may use a small, flexible tube to keep your intestine open. Or the surgery may be done to remove the blockage and repair the intestine. You'll need surgery right away if your intestinal obstruction is more complex. This could be from a tear (perforation) in the intestine or a problem with blood flow. If any part of the bowel looks unhealthy or dead, it will be cut out and the healthy ends will be sewn back together

Talk with your healthcare providers about the risks, benefits, and possible side effects of all treatments.

What are possible complications of an intestinal obstruction?

Possible complications include:

• Nausea and vomiting

• Abdominal pain

• Inability to pass stool or even gas

• Loss of appetite

• Fever

• Infection

• Tear (perforation) of the intestine

• Death of intestinal tissue causing need for emergency removal of that part of intestine

• Death (rare)

How to manage intestinal obstruction

Follow your healthcare provider’s instructions. If they've told you to change your diet as part of your treatment, stick to the eating plan. The goal of the diet is to reduce the work that your digestive tract has to do, while still giving you the nutrition you need.

When should I call my healthcare provider?

Call the healthcare provider if you have:

• Symptoms that don’t get better, or that get worse

• New symptoms

Key points about intestinal obstruction

• An intestinal obstruction is something blocking the flow of juices and stool through part of your intestines.

• Many things can cause an intestinal obstruction. They include scar tissue, hernia, or growths.

• Symptoms can include severe pain, cramping, and vomiting.

• You may have an imaging test to help your healthcare provider see inside your belly.

• Types of treatments include bowel rest, bowel decompression, and surgery.

• Stick to any diet changes your healthcare provider advises.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.