Bowel Obstruction: Symptoms, Causes, Diagnosis and Treatment

Intestinal obstruction is a medical condition where the normal flow of food through the digestive system is disrupted, leading to a buildup of food or fluids. This can occur for various reasons, including tumors, scar tissue, and inflammation of the intestines. 

To diagnose an intestinal obstruction, healthcare professionals may conduct a physical exam, take a patient’s medical history, and employ imaging tests such as X-rays or ultrasounds. Symptoms of intestinal obstruction typically include abdominal pain, cramping, constipation, and vomiting. 

It is important to seek medical attention if you suspect an intestinal obstruction, as timely diagnosis and treatment are crucial to prevent serious complications. The treatment options depend on the severity and cause of the obstruction. 

In some cases, conservative treatments are recommended, such as IV fluids, electrolyte management, and insertion of a nasogastric tube to relieve pressure. However, in more severe cases, surgery may be necessary to remove the obstruction or a portion of the intestine.

Symptoms of Intestinal Obstruction

Intestinal obstruction refers to a partial or complete blockage in the small or large intestine, which can prevent digested products from passing through normally. 

This condition can cause a range of symptoms, some of which may vary depending on the severity of the blockage and the location within the intestine. 

Pain and Cramping

One of the primary symptoms of intestinal obstruction is abdominal pain that is crampy, which comes and goes. The pain is usually centered around the navel or the upper abdomen but can also be felt throughout the abdomen. 

Severe, steady pain may indicate a more serious complication, such as strangulation of the affected intestine.

Nausea and Vomiting

Nausea and vomiting are other common symptoms of intestinal obstruction. The severity and frequency of vomiting can vary.

In some cases, the vomitus may include a green or yellow-green color, indicating the presence of bile.

Bloating and Gas

Intestinal obstruction can also cause bloating or gas. The swelling of the abdomen may be accompanied by an inability to pass gas.

Gas buildup can contribute to the discomfort and bloating sensation.

Constipation and Diarrhea

Depending on the degree of the obstruction, an individual may experience constipation or an inability to have a bowel movement. 

In cases of partial obstruction, it’s possible for some individuals to develop diarrhea as liquids can still pass through the blockage.

Fever and Dehydration

In some cases, intestinal obstruction can lead to fever, which is often a sign of infection or inflammation. Dehydration may also occur due to the loss of fluids from vomiting and an inability to absorb water and electrolytes in the intestine properly. 

Causes and Risk Factors

There are several possible reasons for the development of intestinal obstructions. Knowing the primary causes and risk factors can aid in diagnosing and preventing such a condition.

Adhesions and Scar Tissue

Adhesions are bands of scar tissue that may form after abdominal or pelvic surgery. These bands can cause the intestines to become tangled or kinked, leading to obstruction. 

An earlier abdominal surgery is the leading risk factor for small bowel obstruction in the United States.

Hernias

Hernias occur when segments of the intestine break through a weakened section of the abdominal wall. 

These protrusions can interrupt normal intestinal function and cause a partial or complete blockage. Both small and large bowel obstructions can result from hernias.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, can lead to intestinal obstruction due to inflammation and strictures. 

Strictures, or narrowings of the intestine, can be caused by illnesses such as Crohn’s disease or diverticulitis and are a frequent cause of obstructions.

Tumors and Cancer

Colon cancer and other neoplasms can also initiate intestinal obstruction. As the tumor grows, it can block the passage of gas or stool through the intestine. 

In some cases, a bowel obstruction can be the first sign of a tumor, even before any other symptoms of cancer are present.

Other Causes

Besides the mentioned factors, there are other less common causes of intestinal obstructions, such as certain medications, an accumulation of fecal matter, or twisting of the intestines. 

As individuals age, they may become more susceptible to bowel obstruction due to lifetime exposure to various risk factors. It is essential to discuss any concerns or symptoms with your healthcare provider for proper diagnosis and treatment.

Diagnosis and Tests

When suspecting an intestinal obstruction, doctors will utilize a range of diagnostic techniques to determine the right course of action. 

These tests aim to identify the cause and severity of the obstruction. The following are standard methods used in diagnosing intestinal obstructions:

Physical Examination

A physical examination is often the first step in diagnosing an intestinal obstruction. Your doctor will assess your abdomen for signs of swelling or tenderness and any lumps that may indicate a blockage.

Additionally, your doctor will ask about your medical history and any current symptoms you are experiencing. 

Abdominal X-Ray

An abdominal X-ray can provide a quick and straightforward method for detecting a potential obstruction. 

This imaging technique can reveal any abnormal positioning, blockages, or gas patterns within the intestines.

Computed Tomography (CT) Scan

A computed tomography (CT) scan offers a more detailed look at the gastrointestinal system. This advanced imaging technique can help identify the precise location of the obstruction, as well as any complications that may have arisen due to the blockage. 

It also helps in differentiating between partial and complete obstructions.

Ultrasound

In some cases, an ultrasound may be used to evaluate intestinal obstructions. 

This non-invasive imaging technique can aid in identifying any blockages, particularly in the small intestine, by presenting a real-time visualization of the gastrointestinal tract.

Colonoscopy

Lastly, a colonoscopy is a diagnostic tool that can be employed under certain conditions. This procedure involves inserting a flexible tube with a camera into the large intestine to examine its interior. A colonoscopy can provide insight into the cause of the obstruction, as well as any associated inflammation or lesions.

Treatment Options

When dealing with intestinal obstruction, there are several treatment options available depending on the severity and cause of the obstruction. 

These options can be broadly categorized into non-surgical treatment, surgery and stent placement, and decompression.

Non-surgical Treatment

For less severe cases of intestinal obstruction, non-surgical treatment methods may be employed. These involve:

Administering intravenous fluids to replace lost fluids and prevent dehydration caused by the blockage in the intestine.

Utilizing medications such as pain relievers, anti-nausea, and anti-inflammatory drugs as needed to alleviate symptoms and decrease inflammation.

Resting the bowel involves temporarily stopping oral intake, allowing the bowel to heal and any inflammation to subside.

Surgery and Stent Placement

In cases where non-surgical treatment is insufficient or the obstruction is severe, surgery may be necessary. Surgical options include:

Bowel resection involves removing the affected part of the intestine and then reconnecting the healthy sections.

In some cases, especially with large bowel obstructions, a stent can be inserted to maintain the lumen open and allow the passage of stool and gas.

If the obstruction is caused by intussusception (the telescoping of one part of the intestine into another), the surgeon may try to correct the issue through a laparotomy by gently returning the affected parts back to their original position.

Decompression

Decompression techniques may be used in conjunction with other treatments or as a stand-alone option. They primarily involve the use of a nasogastric tube to relieve pressure and trapped gas in the bowel. 

The nasogastric tube is inserted through the nose and into the stomach to help decompress the intestines, alleviating symptoms and discomfort caused by the obstruction.

Complications of Intestinal Obstruction

Intestinal obstruction can lead to several serious complications, including peritonitis, sepsis, bowel perforation, dehydration, and electrolyte imbalance. These complications can occur if the obstruction is not addressed in time and can lead to life-threatening situations.

Peritonitis

Peritonitis is the inflammation of the peritoneum, the thin lining of the abdominal cavity.

It can occur as a result of an intestinal obstruction when bacteria or partially digested food leaks into the abdominal cavity from a ruptured or perforated intestine. 

Some symptoms of peritonitis include severe abdominal pain, fever, nausea, and vomiting. 

Sepsis

Sepsis is a life-threatening complication where the body has an extreme response to an infection. In the case of an intestinal obstruction, the infection might originate from the blocked intestine, perforation, or peritonitis. 

Sepsis requires immediate medical attention, usually including intravenous fluids and antibiotics, to prevent end-organ damage and potential death.

Bowel Perforation

Bowel perforation occurs when there is a hole in the wall of the intestine. This can be caused by increased pressure on the intestine due to the obstruction or by damage from surgery or other medical procedures. 

Bowel perforation can lead to both peritonitis and sepsis, as bacteria and intestinal contents can leak into the abdominal cavity. Treatment usually requires surgery to repair the hole and remove any leaked material from the abdomen.

Dehydration and Electrolyte Imbalance

Electrolyte imbalance is another complication associated with intestinal obstruction. Electrolytes, such as sodium, potassium, and calcium, play a crucial role in various bodily functions, including nerve, heart, and muscle function. 

The body’s inability to pass fluids and electrolytes through the digestive system can lead to an imbalance, which might cause symptoms like weakness, dizziness, or confusion. 

An obstruction can lead to the improper absorption and excretion of these essential minerals, resulting in an imbalance. Treatment involves correcting the underlying obstruction, along with administering necessary fluids and electrolytes intravenously.

Prevention and Management

Preventing and managing intestinal obstruction involves a combination of dietary modifications, proper hydration, and regular physical activity. By adopting these practices, you can reduce the likelihood of obstruction and minimize discomfort and complications if an obstruction does occur.

Dietary Modifications

A well-balanced diet plays a crucial role in maintaining healthy digestion and preventing intestinal obstruction. Strive to include foods that are high in fiber as they help promote regular bowel movements and avoid constipation.

Incorporate fiber-rich foods into your diet, such as whole grains, whole-wheat bread, brown rice, and quinoa; fruits including apples, berries, and oranges; vegetables such as broccoli, spinach, and carrots; and beans and legumes like kidney beans, lentils, and chickpeas.

Be cautious with fiber intake, as too much too quickly can cause bloating and discomfort. 

Water Intake

Proper hydration is essential for preventing and managing intestinal obstruction. Drinking enough water helps soften stools, making them easier to pass through the intestines. 

Aim for at least eight cups of water per day, but remember that individual needs may vary depending on factors like age, activity level, and climate.

To increase water intake, carry a reusable bottle, drink a glass before meals, and enhance flavor by adding fruit juice or slices.

Keep in mind the importance of balancing water intake with fiber, as both work together to facilitate healthy digestion.

Regular Exercise

Engaging in regular exercise can assist in preventing intestinal obstruction, as physical activity stimulates bowel movements and promotes digestive health. 

Aim for 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity per week, combined with strength training exercises for all major muscle groups twice a week.

Physical activities beneficial for digestive health include walking, jogging, cycling, swimming, and practices like yoga or Pilates.

Remember to always consult with your healthcare provider before making significant lifestyle changes, especially if you have any pre-existing health conditions or concerns.

Frequently Asked Questions

What are common symptoms of an intestinal obstruction?

Intestinal obstructions can present various symptoms, including abdominal pain, bloating, nausea, vomiting, constipation, and an inability to pass gas. In some cases, diarrhea or blood in the stool may also occur. 

These symptoms can be accompanied by a reduced appetite and weight loss, as well as whole-body symptoms like fever and fatigue. It is essential to consult a healthcare professional if you experience these symptoms, as they may indicate an underlying health issue.

How can intestinal obstructions be prevented?

While it is not always possible to prevent intestinal obstructions, there are measures that can decrease their likelihood. Maintaining a healthy lifestyle, including a balanced diet rich in fiber, can help promote regular bowel movements and reduce the risk of blockages. 

Staying hydrated and avoiding foods that cause constipation or trigger inflammation in your specific case can also be beneficial. Additionally, timely treatment of any underlying conditions, such as hernias or inflammatory bowel disease, can help prevent obstructions from developing.

What methods are used to diagnose an intestinal obstruction?

A healthcare professional will typically start with a physical exam, asking about your medical history and current symptoms. They may assess your abdomen for swelling, tenderness, or lumps and listen for bowel sounds with a stethoscope. 

Further diagnostic tests, such as X-rays, CT scans, or ultrasounds, may be carried out to confirm the presence and location of an obstruction.

What are the leading causes of intestinal obstructions?

Intestinal obstructions can be caused by a variety of factors, such as fibrous bands of tissue (adhesions) forming in the abdomen after surgery, hernias, colon cancer, and certain medications.

Strictures resulting from an inflamed intestine caused by conditions like Crohn’s disease or diverticulitis also cause intestinal obstructions.

How is an intestinal obstruction treated?

Treatment for intestinal obstructions may vary depending on the severity and underlying cause. In some cases, non-surgical interventions such as nasogastric tubes, fluids, and medications may be utilized to relieve blockages and manage symptoms. 

In more severe instances, surgery may be required to remove the obstruction. 

What are the possible complications of untreated obstructions?

Untreated intestinal obstructions can lead to severe complications, including strangulation of the affected segment of the bowel, perforations, infection, or necrosis (death) of the tissue. These complications can be life-threatening and may necessitate emergency surgery. 

Early diagnosis and treatment are crucial for preventing complications and ensuring the best possible outcome for the patient.