Bowel Obstruction

Causes of Bowel Obstruction

Common causes include:

• Adhesions (scar tissue) from previous abdominal surgery

• Hernias trapping part of the intestine

• Tumours of the bowel

• Inflammatory bowel disease

• Volvulus (twisting of the bowel)

• Intestinal strictures or narrowing

In post-surgical patients, adhesions are the most frequent cause.

Symptoms of Bowel Obstruction

Symptoms vary depending on the location and severity of the blockage and may include:

• Abdominal pain or cramping

• Abdominal bloating or distension

• Nausea and vomiting

• Constipation or inability to pass gas

• Loss of appetite

Sudden, severe pain or persistent vomiting may indicate a complete obstruction and requires urgent medical attention.

Types of Bowel Obstruction

• Partial obstruction – Some intestinal contents can still pass; symptoms may be intermittent.

• Complete obstruction – No passage of contents; typically presents with severe symptoms.

• Small bowel obstruction – More common and often related to adhesions or hernias.

• Large bowel obstruction – Frequently associated with tumours or volvulus and carries higher risk of perforation.

 

Diagnosis

Diagnosis involves a combination of clinical assessment and imaging studies, including:

• Physical examination

• Blood tests to assess dehydration or infection

• CT scan to identify the site, cause, and severity of obstruction

• X-rays in selected cases

Imaging is critical to guide treatment decisions.

Treatment Options

Treatment depends on the cause and severity of the obstruction.

Non-Surgical Management

May be appropriate for selected partial obstructions and includes:

• Hospital admission and bowel rest

• Intravenous fluids

• Nasogastric tube for decompression

• Close monitoring

Surgical Treatment

Surgery is required when there is a complete obstruction, worsening symptoms, or signs of bowel compromise. The procedure may involve:

• Releasing adhesions

• Repairing a hernia

• Removing a tumour or damaged bowel segment

 

Potential Complications

Untreated bowel obstruction can lead to:

• Bowel ischemia (loss of blood supply)

• Perforation of the intestine

• Infection or sepsis

• Long-term digestive problems

Prompt treatment significantly reduces these risks.

Recovery and Follow-Up

Recovery depends on the cause and treatment approach:

• Short hospital stay for uncomplicated cases

• Gradual reintroduction of diet

• Temporary activity restrictions

• Follow-up to monitor recurrence risk

Patients with previous abdominal surgery may require long-term monitoring.

When to Seek Urgent Medical Attention

Immediate medical assessment is required if you experience:

• Severe or worsening abdominal pain

• Persistent vomiting

• Abdominal swelling with inability to pass stool or gas

• Fever or signs of infection