Diagnosing and Treating Bowel Obstruction
A change in bowel movements, nausea, and a bloated abdomen are all signs of bowel obstruction,
a condition that tends to strike people in certain circumstances, such as those recovering
from abdominal surgery.
Bowel obstruction is not a common problem for most people.
“A bowel obstruction is a very generic term,” says Jay Pasricha, MD, professor of gastroenterology
at the Stanford School of Medicine in Stanford, Calif.
“Technically it’s the small bowel or intestine and the large bowel or intestine.
You could have obstruction of either one of those regions of the gastrointestinal tract.”
What Causes Bowel Obstruction?
When something blocks the bowel, it is a bowel obstruction.
An obstructed bowel can have many causes.
These are usually due to:
-Cancer -Scarring from previous surgery
-Scarring from radiation therapy -Scarring from endometriosis
Besides a physical blockage, says Dr. Pasricha, there are also the pseudo-obstructions.
These are “a failure of the bowel itself to be able to push things down.
It can behave like a mechanical obstruction although it is not due to anything physically"
obstructing the bowel.
Bowel Obstruction Symptoms
Obstructed bowel symptoms depend on the cause of the obstruction, where the obstruction
is located, and how long it has taken for the obstruction to cause problems.
“In general, the lower down the obstruction occurs, the longer it takes to really manifest
itself,” says Pasricha.
“There is a lot of capacity of the bowel to expand and adapt.
Eventually the contents start backing up.”
Here are the most common bowel obstruction symptoms:
-Distended (swollen or bloated) abdomen -Nausea
-Vomiting — color and texture of vomit may help diagnose the obstruction
-Change in bowel habits -Constipation
-Very thin stools -Blood in the stool, especially likely if
cancer is a cause
In general, Pasricha advises people with some of these symptoms, especially nausea, constipation,
and abdominal bloating, and no other obvious cause for those symptoms, to contact their
doctor for an evaluation.
Although bowel obstruction can take a long time to create serious problems in most people,
it can require urgent attention.
“If you have unrelieved obstruction, there is a risk of ischemia [decrease in the blood
supply] and that can be fatal,” warns Pasricha.
Diagnosing Bowel Obstruction
Diagnosis of bowel obstruction is not difficult, says Pasricha.
The diagnostic process will include:
1 Description of symptoms.
Give your doctor a detailed description of the bowel obstruction symptoms that are causing
you concern.
2 Medical history.
Tell your doctor about any recent surgeries or medical treatments as well as ongoing health
conditions and medications or supplements you are taking.
3 Physical examination.
Your doctor may want to examine your abdomen and any other parts of your body where you
are experiencing pain or discomfort.
4 Imaging tests.
“To diagnose [bowel obstruction], you rely on imaging,” says Pasricha.
Your doctor may use an X-ray or CT (computed tomography) scan.
5 Colonoscopy.
If your doctor suspects that the obstruction is in the large bowel, he may order a colonoscopy.
You will be sedated for this test while your doctor inserts a camera at the end of a thin
tube into your colon.
This allows him to see inside the colon.
Treating Bowel Obstruction
“For most mechanical obstructions [scarring, cancer] the real treatment is surgery, but
a lot of patients with post-operative obstruction due to adhesions sometimes can be managed
by putting a tube through the nose down into the bowel,” say Pasricha.
This decompresses the bowel, allowing it to get untwisted.
This may not solve the original problem causing the obstruction, but it is often a first step,
even for patients who are going to have surgery.
The length and ease of recovery depends on the cause, warns Pasricha.
Older people may find recovery takes longer.
Additionally, some people who tend to develop obstructions as a result of scarring from
abdominal surgery can experience repeated obstructions.
“Typically, if it is a mild to moderate obstruction caught early in time, they usually
recover well,” he says.