What is a Bowel Obstruction?
A bowel obstruction is when a section of the bowel (either the small or the large intestine) becomes totally or partially blocked, so that stool cannot pass through it. Bowel obstructions can happen to just about anyone, but they are a common complication of Crohn's disease.Types of Obstruction
Mechanical obstruction: In this type of obstruction, the stool moving through the intestines is physically blocked, much like household plumbing may be blocked. A blockage could be caused by:- Hernia
- Scar tissue (adhesions)
- Impacted stool
- Gallstones
- Tumor
- Abnormal tissue growth
- Intussusception (a section of the bowel slides in to itself, similar to when a telescope is closed)
- Twist or kink in the intestines (volvulus)
- Ingested foreign body (swallowing a nonfood item)
Treating a Bowel Obstruction
An obstruction is a serious condition and may be treated in the hospital. In some cases, it is necessary to decompress the intestine. This is accomplished by inserting a nasogastric (NG) tube in to the stomach, which alleviates distention and vomiting. If inserting the NG tube does not help in relieving the blockage, surgery may be necessary. Surgery may also be necessary if some of the tissue in the intestine has died.Complications
If not treated, a bowel obstruction could lead to more serious problems, such as the death of the bowel tissue. If part of the bowel dies, it could result in infection and/or gangrene. The intestine can also perforate (get a hole in it), which is a medical emergency and will require surgery.Symptoms
An obstruction can cause the complete absence of stool or gas (obstipation), because no stool can pass through the intestine. Or it can cause diarrhea, because only liquid stool can pass beyond the point of obstruction. Other symptoms are intense pain and cramping, abdominal fullness and abdominal bloating. The symptoms of a bowel obstruction are:- A feeling of fullness in the abdomen
- Bad breath
- Bloating (distention)
- Constipation
- Diarrhea
- Pain and cramping
- Vomiting
Diagnosis
The diagnosis of a bowel obstruction is made through both a physical exam and diagnostic tests.Bowel sounds. The bowel normally makes some sounds, such as gurgling and clicking, which can be heard at irregular intervals by using a stethoscope. If an obstruction is present, a health care provider may hear high-pitched sounds while listening to the abdomen. If the obstruction has been present for some time, there may be no bowel sounds at all.
X-Ray (abdominal radiograph). This is normally the first test that is used to determine if there is an obstruction. A radiologist or other specialist can determine if the x-ray shows the signs of a bowel obstruction.
Barium enema. This test used to be used to determine the location of the obstruction. This method, however, is not always good for showing whether an obstruction is caused by something pressing on the bowel.
Upper GI with small bowel series. Much like the barium enema, this test used to be used to help pinpoint the obstruction, especially if it was in the upper gastrointestinal tract. This is almost never used for diagnosis anymore.
Abdominal CT scan. This is the primary test used for bowel obstruction.
Preventing Obstructions
Some causes of obstructions are not preventable, such as those where there is no mechanical reason for the obstruction. In cases where the obstruction is caused by another condition, such as a tumor or a hernia, treating the underlying problem can help prevent the development of an obstruction.Sources:
Ros PR, Huprich JE, Bree RL, Foley WD, Gay SB, Glick SN, Heiken JP, Levine MS, Rosen MP, Shuman WP, Greene FL, Expert Panel on Gastrointestinal Imaging. "Suspected small bowel obstruction." American College of Radiology 2005. 12 Oct 2008.
A.D.A.M. "Intestinal obstruction." A.D.A.M., Inc 23 Jul 2008. 30 Jul 2009.
