Bowel Obstruction

What is a bowel obstruction?

• You have a bowel obstruction when part of your intestines (bowels) is blocked. Your bowel is a long, coiled tube found inside your abdomen (stomach). It is made up of your small and large intestines. Your small bowel absorbs the nutrients from the food that you eat and leaves the waste. The large bowel removes the waste from your body through your anus. Your anus is the opening where the stool from your bowel movements (BM) leaves your body. A bowel obstruction can happen in any part of your small or large bowels.
  
  
• When your bowels are completely blocked, nothing can pass through. If your bowels are partially blocked, only small amounts of air, water, or food may pass through. Having your bowel obstruction treated may decrease your pain. You may not feel sick to your stomach or throw up as much. You may be able to have normal BMs and your bowels may be less likely to become damaged.

What causes a bowel obstruction?

A bowel obstruction may be caused by any of the following:

• Adhesions: Adhesions are bands of scar tissue that may form after a previous surgery. An adhesion attaches your bowel to a nearby organ or to the wall of your abdomen. This may pull your bowel out of place and cause an obstruction.
  
  
• Tumors: With cancer, you may have tumors (growths) that block your bowels. Your bowel may also be blocked by tumors that do not have cancer in them. These are called benign tumors.
  
  
• Bowel structure: Changes to the shape of your bowels may cause a bowel obstruction. A portion of your bowel may slide or fold into another portion of your bowel. This is called intussusception. If your bowel has a volvulus (becomes twisted), then your bowel may become blocked. If your abdomen muscles become weak, then part of your bowel may bulge through. This is called a hernia. If the bowel becomes trapped, then your hernia may cause an obstruction.
  
  
• Certain diseases: Certain diseases may cause a bowel obstruction. Crohn's disease may cause the passageway of your bowel to become narrow. If the passageway becomes too narrow, then your bowel will become obstructed. Stones from your gallbladder may build up in your bowel and cause it to be blocked. Your gallbladder is an organ found in the right side of your abdomen near your stomach. A bowel obstruction may also be caused by infections caused by germs such as bacteria and parasites (worms).
  
  
• Medical treatments: You may take certain medicines that may cause your bowel to become obstructed if used for awhile. These include pain medicines called nonsteroidal inflammatory drugs (NSAIDs). A medicine called potassium chloride may also cause a bowel obstruction. Radiation therapy for cancer may damage your bowels and cause an obstruction. Ask your caregiver for information about these treatments.

What are the signs and symptoms of a bowel obstruction?

You may have one or more of the following:

• Cannot have a BM.
  
  
• Upset stomach or vomiting (throwing up).
  
  
• Back pain.
  
  
• Stomach pain.
  
  
• Swollen or full abdomen, even if you have not recently eaten.
  
  
• Dizziness.
  
  
• Sleepiness.
  
  
• Trouble breathing.

How is a bowel obstruction diagnosed?

Your caregiver will ask about your medical history and do a physical exam. He will ask if you have had bowel surgery or a bowel disease. He will also ask if you have noticed changes in your bowel habits. He may ask you if you have lost a lot of weight recently. Your caregiver may check if you have lost a lot of body fluid. You may also need any of the following:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Digital rectal exam (DRE): During a DRE, your caregiver will put a gloved finger inside your anus to feel for lumps in your rectum. Your rectum is the lower part of your bowel just behind your anus. He will use lubrication, which is a gel-like substance that helps his finger gently enter your anus. He may remove a sample of your stool and send it to a lab to test it for blood.
  
  
• Imaging tests: Your caregiver may do one or more tests to take pictures of your bowels. Before taking the pictures, you may be given dye through an intravenous (IV) tube in your vein. The dye may help your caregiver see the pictures better. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to shellfish or have other allergies.
  
  
  • Computed tomography: During computed tomography (CT), a special x-ray machine uses a computer to take pictures of your abdomen. This test may show your caregiver where you have an obstruction. It may also help your caregiver know why you have an obstruction. A CT may also help detect cancer and see what stage it is in.
    
    
  • Contrast studies: Your caregiver may do a contrast study. During a contrast study, your caregiver will put a liquid through a tube in your nose, mouth, or anus. The liquid helps your stomach and bowels show up better in x-rays.
    
    
  • Magnetic resonance imaging: During magnetic resonance imaging (MRI), pictures are taken of your abdomen. Your caregiver uses these pictures to look for a bowel obstruction or tumors. An MRI may help identify what is blocking your bowel. An MRI may be a good imaging option for pregnant women. You will need to lie still during an MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury.
    
    
  • Ultrasound: An abdominal ultrasound is a simple test that looks inside of your abdomen. Sound waves are used to show pictures of your abdomen on a TV-like screen. An ultrasound may show your caregiver the part of your bowel that is twisted or folded into itself.
    
    
  • X-rays: You may need abdominal and chest x-rays. Abdominal x-rays take pictures of the organs inside your abdomen. These are used to look for what may be causing your obstruction. Chest x-rays may be taken to look for problems with your heart and lungs.

How is a bowel obstruction treated?

You may need to rest your bowels. You may get fluid and nutrition through an IV tube. You may not be allowed to eat food or drink liquid. Ask your caregiver for more information about any of the following treatments:

• Antibiotics: Antibiotic medicine may be given to help treat or prevent an infection in your bowels.
  
  
• Enema: An enema is special liquid or air that is put through your bowel. Increased pressure against a partial blockage may cause it to open up.
  
  
• Paracentesis: This procedure is also called an abdominal or peritoneal tap. During a paracentesis, caregivers use a needle to remove extra fluid or put special medicine in your abdomen. Removing extra fluid may help you breathe easier and feel more comfortable. The fluid may be sent to a lab and checked for signs of infection or other problems.
  
  
• Surgery: Your caregiver may do an open surgery where he makes a cut in your abdomen so he can directly see your bowel. He may also do a laparoscopy. With laparoscopy, small incisions (cuts) will be made on your abdomen. Your caregiver will insert the scope and special tools through these cuts to remove your blocked bowel. During surgery, your caregiver may decide to switch your laparoscopy to an open surgery. Your surgery may be done all at once or it may be done in stages at different times.
  
  
  • Colostomy: A colostomy is a procedure to make a stoma (opening) between your bowel and your abdomen wall. It may be done before you have surgery to remove your blocked bowel. A colostomy can be used to remove air or fluid from your bowel. It may also help your caregiver check your condition before surgery. With a colostomy, stool comes out of the stoma into a sealed bag. Your stool may be watery, depending on which part of the large bowel was used for the colostomy. The stoma may be closed several days after surgery once your bowel has healed.
    
    
  • Stents: A stent is a small metal tube that widens the area of your bowel that is blocked. Your caregiver inserts the stent into your bowel using a scope (a long, thin bendable tube). A stent can open the bowel to let air and food pass through. Your caregiver may use a stent to help decrease your symptoms before your surgery. During surgery, your caregiver will usually remove the stent.
  
  
• Tubes:
  
  
  • Nasogastric (NG) tube: An NG tube is put into your nose, and passes down your throat until it reaches your stomach. Food and medicine may be given through an NG tube if you cannot take anything by mouth. The tube may instead be attached to suction if caregivers need to keep your stomach empty.
    
    
  • Gastrostomy tube: A gastrostomy is also called G-tube, feeding tube, or PEG tube. The tube is used to give you liquids, food, and medicine. The tube may also be used to let air or fluids out of your stomach. This small, flexible tube goes into your stomach through a small cut in your abdomen. Your caregiver may also insert the tube using an endoscope (a long, thin, bendable tube). The endoscope is passed through the mouth and down into your stomach.

When should I call my caregiver?

Call your caregiver if:

• You throw up after you eat.
  
  
• You have frequent, watery bowel movements.
  
  
• You have a fever (high body temperature) or chills.
  
  
• Your back or stomach hurts.
  
  
• You feel dizzy.
  
  
• You abdomen is swollen or feels full, even if you have not recently eaten.
  
  
• You are losing weight without trying.
  
  
• You have questions or concerns about your condition, treatment, or medicine.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You cannot have a BM or you throw up every time after you eat or drink.
  
  
• You have severe (very bad) pain in your abdomen.
  
  
• You have bleeding from your rectum that does not stop.
  
  
• You have a fast and pounding heartbeat.
  
  
• You have chest pain.
  
  
• You have trouble breathing.

Where can I find more information?

Contact the following for more information:

• American College of Gastroenterology
  6400 Goldsboro Rd., Ste 450
  Bethesda , MD 20817
  Phone: 1- 301 - 263-9000
  Web Address: http://www.gi.org
  

• International Foundation for Functional Gastrointestinal Disorders
  P.O. Box 170864
  Milwaukee , WI 53217
  Phone: 1- 414 - 964-1799
  Phone: 1- 888 - 964-2001
  Web Address: http://www.iffgd.org
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Bowel Obstruction