Clearing an intestinal blockage requires immediate medical attention as treatments range from bowel rest (no solids, IV fluids) and nasogastric tubes for simple cases, to stents or emergency surgery for complete obstructions or complications like perforation, with a doctor determining the best approach based on the cause and severity. Home remedies like warm compresses, gentle movement, and probiotics might help partial blockages but are not substitutes for professional care, especially if symptoms worsen.
Bowel obstruction surgery is a major procedure, but since it can be a life-or-death situation, the pros often outweigh the cons for many people. However, the cause of the obstruction is considered alongside a patient's age and overall health.
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.
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.
Complete obstructions usually require immediate surgery. Partial bowel obstructions may require treatments to stabilize your condition, followed by nonsurgical solutions, like bowel rest.
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).
Most patients recovering from a bowel resection return to normal activities within a few months. However, dietary and lifestyle changes may be necessary depending on the underlying condition. Patients who had surgery due to inflammatory bowel disease or cancer may require ongoing medical management and follow-up care.
Symptoms
Surgery to remove part of the bowel is a major operation and there are certain risks known to be associated with it. These include the risks of surgery in general, the risks particularly associated with bowel surgery and the risks of anaesthetic described in more detail over the page.
The most common causes of intestinal obstruction in adults are:
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.
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.
Without any fluids (either as sips, ice chips or intravenously) people with a complete bowel obstruction most often survive a week or two. Sometimes it's only a few days, sometimes as long as three weeks. With fluids, survival time may be extended by a few weeks or even a month or two.
The doctor made a large cut, called an incision, in your belly to take out part of the intestine. You are likely to have pain that comes and goes for the next few days after bowel surgery. You may have bowel cramps, and your cut (incision) may hurt.
The surgery can be performed laparoscopically (via keyhole) or may be done as open surgery in an emergency. If the two pieces of bowel left are healthy, then the ends will be stitched together, or you may be given an ileostomy where the small bowel is routed through an opening cut into your abdomen.
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.
The period of observation in patients managed medically ranged from 2 to 12 days (average: 6.9 days), while for those who underwent surgery, the range was 1 to 14 days (average 5.4 days).
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)
Going home. Depending on the type of operation you have had, you will probably be ready to go home 2 to 7 days after surgery. Before leaving hospital, you will be given an appointment for your post-surgery check-up.
Treatments include the following:
Your doctor may do: An abdominal X-ray, which can find blockages in the small and large intestines. A CT scan of the belly, which helps your doctor see whether the blockage is partial or complete.
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.
Your surgeon makes a cut in your belly to see your intestines. Sometimes, the surgery can be done using a laparoscope, which means smaller cuts are used.