The term “bowel” refers to the intestine. Bowel obstruction refers to a blockage of the intestine due to any cause that affects the flow of bowel contents towards the rectum and anus. Intestinal obstruction could either be partial or complete. In partial obstruction, the contents of the bowel are able to move, albeit at a slower than normal rate. In complete obstruction, the flow of bowel contents stops altogether.
Partial obstruction of the bowel usually develops gradually over a period of weeks or months. For example, a rectal cancer that grows slowly can cause partial bowel obstruction that is characterized by constipation and thin stools. Complete bowel obstruction is characterized by impaction of stools. It is common in hernia of the small intestine that results in intestinal strangulation.
Signs and Symptoms
Some of the common symptoms of bowel obstruction are nausea, abdominal cramps, rumbling sounds emanating from the bowels, and no release of gas. Individuals who have abdominal cancer, intestinal hernia, diverticulosis, history of abdominal surgery, and chronic bowel diseases should suspect bowel obstruction if the common symptoms mentioned above are present.
Ingestion of a foreign object can also cause bowel obstruction. If bowel obstruction is suspected, immediate medical treatment must be sought. Bowel obstruction can lead to life-threatening complications such as gangrene in the intestine within a few hours. This condition may cause death in a couple of days. Sometimes, bowel paralysis (known as ileus) could occur with symptoms that are similar to that of bowel obstruction. However, there is no mechanical bowel obstruction in the case of ileus. Abdominal surgery is a frequent cause of bowel paralysis.
Symptoms of Small Intestine Blockage
The following are some of the possible symptoms that may appear in small bowel obstruction:
- Abdominal cramps, mostly in the upper or middle abdominal regions.
- Tenderness in the abdomen.
- Transient rumbling sounds emanating from the bowels.
- Constipation during the late stages of small bowel obstruction.
- Diarrhea during the early stages of small bowel obstruction.
- Rapid heart rate
Symptoms of Large Intestine Blockage
The main symptoms of large bowel obstruction are the following:
- Lower abdominal distension
- Abdominal cramps in the lower left side of the abdomen.
- Rumbling sounds emanating from the bowels.
- Chronic constipation
- Thin stools
Causes of Small Bowel Obstruction
Intestinal obstruction could occur in both the small intestine as well as in the large intestine. Small bowel obstruction has the following potential causes:
- Malignant abdominal tumors
- Abdominal adhesions that may form after radiotherapy or abdominal surgery.
- Hernia of the intestine that leads to intestinal strangulation.
- Crohn’s disease
- Gallstones that may become trapped in the intestine.
Causes of Large Bowel Obstruction
Obstruction of the large intestine could occur due to the following causes:
- Colorectal cancer
- Twisted colon or volvulus (common in toddlers and infants).
- Impaction of stools (common in people who consume antacids containing calcium for a long period of time and in bedridden patients).
Read more on blocked colon.
Complications of Bowel Obstruction
Complete bowel obstruction frequently causes serious and potentially-lethal complications. These life-threatening complications include the following conditions:
- Aspiration pneumonia caused by swallowing vomit.
- Gangrene in the intestine caused by twisted bowels and strangulated arteries.
- Inflammation of the peritoneal lining of the abdominal cavity (peritonitis) caused by intestinal perforation.
- Spread of infection throughout the body through the bloodstream (sepsis).
Read more on blocked rectum.
Diagnosis of Bowel Obstruction
A physician may suspect the presence of bowel obstruction based on the occurrence of some characteristic symptoms and a physical examination. However, definitive diagnosis of bowel obstruction requires further investigations. Some of investigative tools used in the diagnosis of bowel obstruction include:
- CT scans: Computerized tomography (abbreviated as CT) scans can reveal the presence of any adhesions or masses in the abdomen that could be causing bowel obstruction.
- X-rays: Sites of intestinal obstruction can be revealed through contrast X-rays with a barium meal. The presence of trapped fluids and air above the point of obstruction can also be revealed through X-rays.
- Ultrasound: Abdominal ultrasound can be helpful in excluding bowel obstruction as a cause of the symptoms.
- Sigmoidoscopy or colonoscopy: Large bowel obstruction can be revealed through sigmoidoscopy or colonoscopy. These techniques could also help in partially resolving large bowel obstructions.
The following are some of the conditions that may present with similar symptoms to bowel obstruction:
- Food poisoning
- Severe constipation
- Acute pancreatitis
- Disorders of the gallbladder
- Pancreatic cancer
- Acute appendicitis
- Urinary tract infection
- Gastroparesis (slow gastric emptying)
- Severe abdominal bloating due to multiple causes.
- Acute ischemic colitis (blood clot in the arteries of the intestine)
- Painful menstruation
- Ovarian torsion or cancer
- Pelvic adhesions
- Abdominal adhesions
- Pelvic inflammatory disease
The symptoms of irritable bowel syndrome are not the same as that of intestinal obstruction but many people with IBS-C sometimes think that an obstruction may be a cause of the symptoms.
Treatment of Bowel Obstruction
The treatment of bowel obstruction typically requires the patient to be hospitalized. Due to the life-threatening complications that could arise quickly, bowel obstruction should be treated as a medical emergency. When treatment begins early, prognosis is good. However, delay in treatment could be potentially fatal.
Small bowel obstruction can be treated with non-surgical methods. A tube can be inserted through the nose and lowered down into the bowels to aspirate the accumulated fluids. Nutrients and fluid may be given through the intravenous route. Antibiotics and painkillers are also frequently required.
Large bowel obstruction is usually treated through surgical procedures. This is especially the case in children. Laparoscopy can be used to treat abdominal adhesions caused by surgery. Enema can be helpful in removing impacted stools. However, in some cases, impacted stools may need to be removed manually.
The time required to recover from bowel obstruction depends entirely on the underlying cause and the procedure used to treat the condition.
Home remedies for intestinal obstruction
Home remedies do not treat intestinal obstruction. One should always treat intestinal obstruction as a medical emergency and seek appropriate medical treatment. However, dietary changes like including foods that are high in fiber and drinking lots of water can help in preventing constipation. Avoiding stress and leading a physically active lifestyle can also help in preventing diverticulosis and constipation.
If a person has a family history of colorectal cancer, regular colonoscopy is recommended (especially after 40 years of age).