Bowel Obstruction

A bowel obstruction is a partial or complete blockage in the intestines that prevents gas, fluids, or solids from moving through the intestines normally. Blockage may occur in the small intestine (small-bowel obstruction) or the large intestine (colonic obstruction or large-bowel obstruction). In severe cases, the bowel's blood supply may be cut off. This is called ischemic bowel or bowel strangulation and requires emergency treatment. A bowel obstruction can be caused by tumors, twisting or narrowing of the intestines, or scar tissue, these are called mechanical obstructions. Obstructions can also occur because of inflammation or infection or as a side effect of certain medicines. These are called nonmechanical obstructions and are not included in this topic. In the small intestine, obstructions are most often caused by scar tissue. Other causes include hernias, Crohn's disease, and cancer. In the large intestine, obstructions are most often caused by cancer. Other causes are severe constipation from a hard mass of stool and twisting or narrowing of the intestine that may occur because of diverticulitis or inflammatory bowel disease. A blockage can also occur if one part of the intestine folds like a telescope into another part, which is called intussusception. A small-bowel obstruction may cause cramping abdominal pain, which may be severe if the blood supply is cut off, vomiting or bloating. Symptoms of a large-bowel obstruction include abdominal pain, which may be severe if the blood supply is cut off or bloating. A partial blockage of either intestine may cause occasional diarrhea. A complete obstruction will cause constipation and a noticeable lack of gas leaving the body. Treatment for a partial blockage in either the small or large intestine usually takes place in the hospital. Treatment involves monitoring you closely and making you more comfortable while waiting to see whether the blockage goes away on its own. You usually are not allowed to eat or drink. You will probably receive fluids by IV to keep your blood pressure normal and prevent dehydration. You may have a thin tube called a nasogastric tube placed in your nose and down into your stomach to remove fluids and gas. For partial obstructions, nonsurgical treatments are usually tried first. These may include using liquids or air (enemas), small mesh tubes (stents), or medicine to open up the blockage. Surgery is almost always needed for a complete obstruction of the small or