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Bowel Obstruction

Bowel obstruction is a serious medical condition where the normal movement of food, fluid, and gas through the intestines becomes partially or completely blocked.

It can affect the small or large intestine, and it may develop gradually or come on very suddenly. Early diagnosis and prompt treatment are essential to prevent complications such as damage to the bowel, infection, or perforation (a tear in the bowel wall).

What Is a Bowel Obstruction?

A bowel obstruction happens when food, fluid, and gas can no longer move through your intestines as they should. This can affect the small bowel or large bowel, and it can come on gradually or very suddenly.

The blockage can be physical — something actually blocking the bowel — or the bowel can simply stop working properly on its own. Both types need prompt medical attention.

What causes it?

There are several known causes of bowel obstruction:

Cause What this means
Scar tissue (adhesions) The most common cause, usually following previous abdominal surgery.
Hernia Part of the bowel can become trapped in a hernia and blocked.
Tumours Growths inside or around the bowel can cause a blockage.
Volvulus A twist in the bowel that cuts off the normal flow of contents.
Inflammatory bowel disease Conditions like Crohn’s disease can cause narrowing of the bowel.
Strictures/narrowing Scarring or inflammation can narrow the bowel over time.

Symptoms to look out for

Symptoms can vary depending on where the blockage is and how severe it is. Common symptoms include:

  • Abdominal pain or cramping
  • Bloating or a swollen abdomen
  • Nausea and vomiting
  • Inability to pass stool or wind
  • Loss of appetite

If you develop sudden, severe pain or persistent vomiting, this may indicate a complete obstruction. Seek emergency medical care immediately.

Types of bowel obstruction

  • Partial obstruction – Some intestinal contents can still pass; symptoms may come and go.
  • Complete obstruction – Nothing can pass; this typically causes severe symptoms.
  • Small bowel obstruction – More common, often related to adhesions or hernias.
  • Large bowel obstruction – Frequently associated with tumours or volvulus, and carries a higher risk of perforation.

How is it diagnosed?

Your medical team will assess you using a combination of:

  • A physical examination of your abdomen
  • Blood tests to check for signs of infection or dehydration
  • A CT scan to locate the blockage and understand its cause and severity
  • X-rays, in some cases

Treatment options

Treatment depends on the cause and severity of the obstruction. Your surgeon will discuss which option is most appropriate for you.

Non-surgical treatment

Used for some partial blockages. This usually involves:

  • Admission to hospital and resting the bowel
  • Fluids given through a drip
  • A tube to relieve pressure on the bowel

Close monitoring throughout your stay

Surgical treatment

Required for complete blockages or worsening symptoms. Surgery may involve:

  • Releasing scar tissue (adhesions)
  • Repairing a hernia
  • Removing a tumour or damaged section of bowel

This may be carried out using a laparoscopic (keyhole) or open approach.

What to expect during recovery

Recovery varies depending on the cause and the treatment you needed. In general, you can expect:

  • A hospital stay, which may be short for straightforward cases
  • A gradual return to eating and drinking
  • Some activity restrictions while you heal
  • Follow-up appointments to check your recovery and monitor for any recurrence

If you have had previous abdominal surgery, you may need longer-term monitoring, as scar tissue can cause further problems over time.

Key messages about bowel obstruction

  • If left untreated, a bowel obstruction can lead to serious problems including damage to the bowel (ischaemia), perforation, and infection (sepsis).
  • Prompt treatment greatly reduces these risks. Please do not delay seeking help if your symptoms are severe or worsening.
⚠ Seek urgent medical help if you experience:

  • Severe or worsening abdominal pain
  • Persistent vomiting
  • A swollen abdomen with no passage of stool or wind
  • Fever or signs of infection

Why Mr. Spyros Panagiotopoulos?

Mr Spyros Panagiotopoulos is a leading consultant in General and Metabolic/Bariatric Surgery at King’s College Hospital in London. He has extensive experience handling various general surgery emergencies, ensuring patients receive thorough care and safe, evidence-based treatment.

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