Mechanical Bowel Obstruction
A mechanical bowel obstruction is a partial or complete blockage in the intestine, which is also called the bowel. Blockages can occur at any point along the small or large bowel. They are more common in the small bowel. When the bowel is blocked, food and liquid cannot pass through. Over time, food, liquid, and gas build up in the area above the blockage.
Mechanical Bowel Obstruction
Most small bowel blockages are due to adhesions. An adhesion is a band of scar tissue that causes the bowel to attach to the abdominal wall or other organs. Most large bowel obstructions are caused by tumors.
Specific causes of bowel obstructions include:
- Bowel inflammation or swelling
- Foreign matter in the intestines
- Impacted feces
- Volvulus—twisting of the intestine
- Intussusception —when the intestine pulls inward into itself
- Scar tissue from a previous abdominal or pelvic surgery, particularly gynecologic or gastrointestinal operations
Factors that increases your chance of getting a bowel obstruction include anything that is likely to cause scar tissue or a blockage, such as:
Symptoms of a bowel obstruction include:
- Abdominal pain
- Abdominal swelling
- Abdominal cramps
- Severe constipation; inability to pass gas or stool
- Foul breath odor
Complications from an untreated obstruction can include strangulation, which is cutting off the blood supply to part of the intestine.
You will be asked about your symptoms and medical history. A physical exam will be done. A stethoscope will be placed on your abdomen to listen for bowel sounds. If the normal bowel sounds are absent, or if high pitched, tinkling sounds are present, it may be an indication of bowel obstruction.
Your bodily fluids may need to be tested. This can be done with:
- Blood tests
- Urine tests
Images may need to be taken. This can be done with abdominal x-rays, such as:
Bowel obstructions can be serious, even fatal. If your doctor thinks you have a bowel obstruction, you will be hospitalized and treated. Your treatment will depend on what part of your bowel is blocked and what is causing the blockage.
Possible treatments include the following:
- Nasogastric tube—This involves the passage of a narrow tube through your nose and down into the stomach to suction out fluids that have become trapped above the blockage.
- IV fluids—Vomiting and diarrhea can cause dehydration and imbalances in your body fluids; if you are dehydrated, you will be given fluids and electrolytes.
- Medications—You may be given antibiotics or pain medication through an IV or through the nasogastric tube.
- Removal of fecal impaction—If fecal matter is causing the obstruction, it can be removed; your doctor will insert a gloved finger into your rectum to loosen and remove the feces.
- Endoscopy—A thin, lighted tube is inserted through the rectum and into the large intestine to straighten out the intestines.
- Surgery—Depending on the cause of the obstruction, you may need surgery. Surgery can:
During surgery, the blocked part of the bowel may be removed. The remaining sections will then be joined together. You will probably need a nasogastric tube temporarily after surgery. In addition, you may need antibiotics and pain medication during recovery.
Prevention of bowel obstruction depends on the cause. Some bowel obstructions cannot be prevented. The following actions may help reduce your risk of a bowel obstruction:
- Treat hernias promptly before they can cause a blockage.
To lessen the chance of fecal impaction and diverticulitis:
- Eat plenty of fiber -rich foods.
- Drink plenty of fluids.
- Exercise regularly.
American College of Gastroenterology
National Institute of Diabetes and Digestive and Kidney Diseases
The College of Family Physicians of Canada
Abdominal adhesions and bowel obstruction. University of California, San Francisco website. Available at: http://surgery.ucsf.edu/conditions--procedures/bowel-obstruction.aspx. Accessed December 18, 2014.
Colonic ileus. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 12, 2014. Accessed December 18, 2014.
Jackson P, Raiji M. Evaluation and management of intestinal obstruction. Am Fam Physician. 2011 Jan 15;83(2):159-165.
Last reviewed December 2014 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.