Intestinal Obstruction

Intestinal obstruction is a blockage that keeps food or liquid from passing through your small intestine or large intestine (colon). Intestinal obstruction may be caused by fibrous bands of tissue in the abdomen (adhesions) which form after surgery, inflamed or infected pouches in your intestine (diverticulitis), hernias and tumors.

Without treatment, the blocked parts of the intestine can die, leading to serious problems. However, with prompt medical care, intestinal obstruction often can be successfully treated.

Signs and symptoms of intestinal obstruction include:

  • Crampy abdominal pain that comes and goes
  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Inability to have a bowel movement or pass gas
  • Swelling of the abdomen (distention)

Mechanical obstruction of the small intestine

Common causes of mechanical obstruction, in which something physically blocks the small intestine, include:

  • Intestinal adhesions bands of fibrous tissue in the abdominal cavity that can form after abdominal or pelvic surgery
  • Hernias portions of intestine that protrude into another part of your body
  • Tumors in the small intestine
  • Inflammatory bowel diseases, such as Crohn’s disease
  • Twisting of the intestine (volvulus)
  • Telescoping of the intestine (intussusception)
  • Mechanical obstruction of the colon

Mechanical obstruction is much less common in the colon. Potential causes include:

  • Colon cancer
  • Diverticulitis a condition in which small, bulging pouches (diverticula) in the digestive tract become inflamed or infected
  • Twisting of the colon (volvulus)
  • Impacted feces
  • Narrowing of the colon caused by inflammation and scarring (stricture)
  • Paralytic ileus: Paralytic ileus can cause signs and symptoms of intestinal obstruction, but doesn’t involve a physical blockage. In paralytic ileus, muscle or nerve problems disrupt the normal coordinated muscle contractions of the intestines, slowing or stopping the movement of food and fluid through the digestive system. Paralytic ileus can affect any part of the intestine. Causes can include:
  • Abdominal surgery
  • Pelvic surgery
  • Infection
  • Certain medications, including antidepressants and pain medications that affect muscles and nerves
  • Muscle and nerve disorders, such as Parkinson’s disease

Risk factors

Diseases and conditions that can increase your risk of intestinal obstruction include:

  • Abdominal or pelvic surgery often causes adhesions a common intestinal obstruction
  • Crohn’s disease can cause the intestine’s walls to thicken, narrowing the passageway
  • Cancer in your abdomen, especially if you’ve had surgery to remove an abdominal tumor or radiation therapy

Treatment

Treatment for intestinal obstruction depends on the cause of your condition, but generally requires hospitalization.

Hospitalization to stabilize your condition

When you arrive at the hospital, the doctors will first work to stabilize you so that you can undergo treatment. This process may include:

  • Placing an intravenous (IV) line into a vein in your arm so that fluids can be given
  • Putting a nasogastric (NG) tube through your nose and into your stomach to suck out air and fluid and relieve abdominal swelling
  • Placing a thin, flexible tube (catheter) into your bladder to drain urine and collect it for testing

Treatment for partial mechanical obstruction

If you have mechanical obstruction in which some food and fluid can still get through (partial obstruction), you may not need further treatment after you’ve been stabilized. Your doctor may recommend a special low-fiber diet that is easier for your partially blocked intestine to process. If the obstruction does not clear on its own, you may need surgery to relieve the obstruction.

Treatment for complete mechanical obstruction

If nothing is able to pass through your intestine, you’ll usually need surgery to relieve the blockage. The procedure you have will depend on what’s causing the obstruction and which part of your intestine is affected. Surgery typically involves removing the obstruction, as well as any section of your intestine that has died or is damaged.

Alternatively, your doctor may recommend treating the obstruction with a self-expanding metal stent. The wire mesh tube is inserted into your colon via an endoscope passed through your mouth or colon. It forces open the colon so the obstruction can clear. Stents are generally used to treat people with colon cancer or to provide temporary relief for people who are at high risk of emergency surgery. You may still need surgery, once your condition is stable.

Treatment for paralytic ileus

If your doctor determines that your signs and symptoms are caused by paralytic ileus, he or she may monitor your condition for a day or two in the hospital. Paralytic ileus is often a temporary condition that gets better on its own.

If paralytic ileus doesn’t improve within several days, your doctor may prescribe medication that causes muscle contractions, which can help move food and fluids through your intestines. If paralytic ileus is caused by an illness or medication, the doctor will treat the underlying illness or stop the medication.