Yes, many bowel obstructions, especially partial ones, can be cleared without surgery using supportive hospital care like bowel rest, IV fluids, and nasogastric tubes (NG tubes) for decompression; some may even resolve spontaneously, though complete blockages or those with complications like strangulation usually need immediate surgery. Nonsurgical treatments also include endoscopic stents or therapeutic enemas to open the blockage, and treating underlying causes like Crohn's disease with medication.
Key Takeaways
Most of the time, complete blockages require a stay in the hospital and possibly surgery. But if your bowel is only partly blocked, your doctor may tell you to wait until it clears on its own and you are able to pass gas and stool. If so, there are things you can do at home to help make you feel better.
Without any fluids (either as sips, ice chips or intravenously) people with a complete bowel obstruction most often survive a week or two.
Bowel obstructions usually cause cramping abdominal pain, vomiting and inability to pass bowel motions (faeces or poo) or gas. A bowel obstruction is an emergency and needs treatment in hospital to prevent serious complications. You may need surgery or another procedure to remove the blockage.
Pseudo-obstruction
The 3-6-9 rule is a guideline for interpreting abdominal X-rays to detect bowel obstruction, stating normal upper limits are 3 cm for the small bowel, 6 cm for the large bowel (colon), and 9 cm for the cecum; diameters exceeding these suggest dilation, a key sign of obstruction, with larger measurements increasing the risk of rupture (e.g., >6cm small bowel, >9cm cecum).
Robotic surgery for colon cancer is a recent development that's not yet widely available. Miniature robotic arms are inserted through a few tiny openings in your abdomen. It has similar benefits to minimally invasive and endoscopic colon surgery, but the procedure tends to take longer and cost substantially more.
Symptoms
If the obstruction blocks the blood supply to the intestine, it may cause infection and tissue death (gangrene). Risks for tissue death are related to the cause of the blockage and how long it has been present. Hernias, volvulus, and intussusception carry a higher gangrene risk.
It all depends on how severe the obstruction is. Treatment may include: Intravenous (IV) fluids: You may need IV fluids and electrolytes to treat dehydration. Nasogastric tube: You may need a nasogastric tube to suction out fluids and air backed up from the blockage.
Multidetector CT has a sensitivity and specificity of 95% for the diagnosis of high-grade SBO and is less accurate in partial obstruction (4,6–8). As with radiography, the hallmark is dilated (> 2.5 cm) proximal small bowel with decompressed distal small bowel and colon (Table 2, Fig 7) (15).
The most common symptoms of fecal impaction are as follows: Abdominal pain (often after meals) The ongoing urge to pass stool. Liquid stool (most often means stool is leaking around the impacted mass)
Intestinal Obstruction Specialists and Care Centers
Certainly, there have been cases of immobile small bowel bezoars with impaction, massive bleeding, or perforation. Thus, we believe that conservative treatment using Coca-Cola coupled with endoscopic manipulation may be an appropriate choice for treating cases of small bowel bezoars.
If your doctor suspects you may have a bowel obstruction, he or she will likely order an imaging test such as a CT scan. A CT scan is a series of X-rays and can show where the intestine is blocked. For some obstructions, a barium enema or colonoscopy may be used alongside or in place of a CT scan.
CT colonography, also known as virtual colonoscopy, uses low dose radiation CT scanning to obtain an interior view of the colon (the large intestine). This area is otherwise only seen with a more invasive procedure where the doctor inserts an endoscope into the rectum and passes it through the entire colon.
For many Americans, the prospect of a colonoscopy is unnerving and patients often find comfort knowing sedation will make the procedure as simple as a brief nap. Around the world, however, up to 80 percent of routine colonoscopies are done without any sedation at all.
A patient stays in the hospital for 3 to 7 days with the average of 4 days. You will begin to have bowel movements 2 to 5 days after this operation. Initially the movements are liquid and may occur 10 or more times a day.
Abdominal Pain and Cramping
Abdominal pain or cramping is a common symptom. The pain can be mild or very severe. It may stay the same or change. This pain happens because the bowel tries to move stuff past the blockage.
Obstruction is due to benign causes (adhesion, radiation enteritis, internal hernia) occurs in 18–38% of cases. Ten percent to 30% of patients will have relief of obstruction with nonoperative management alone, and about 40% will eventually require surgery.
Clinicians should consider a foreign body or bezoar in the differential for unexplained intermittent bowel obstruction symptoms. Phytobezoars can occur from undigested plant or food material, and generally require endoscopic evaluation for diagnosis and potential treatment.
SBO presents with hallmark symptoms of abdominal pain, vomiting, distension, and obstipation. The pathophysiology includes bowel distension, impaired venous return, mucosal ischemia, bacterial translocation, and, in severe cases, necrosis, perforation, and peritonitis.
Most bowel obstructions are partial blockages that get better on their own. The NG tube may help the bowel become unblocked when fluids and gas are removed. Some people may need more treatment. These treatments include using liquids or air (enemas) or small mesh tubes (stents) to open up the blockage.