Recovery from a non-surgical bowel obstruction (often partial or pseudo-obstruction) usually involves a few days to a week of bowel rest in the hospital with IV fluids and NG tube decompression, allowing the blockage to resolve spontaneously, with patients going home to a soft diet and rest for several days to weeks as they regain normal bowel function, though severe cases or signs of strangulation require urgent surgery.
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.
Intussusception is the most common cause of intestinal blockage in children younger than 3 years old. The cause of most cases of intussusception in children is unknown. Though intussusception is rare in adults, most cases of adult intussusception are the result of an underlying medical condition, such as a tumor.
Review current medications in line with cause of obstruction – for example avoiding constipating medications (such as Amitriptyline, Ondansetron – though the latter may be used for nausea in cases of complete obstruction), use of prokinetic/laxatives if partial obstruction/avoid if complete.
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.
Signs and Symptoms of Bowel Obstruction
In small bowel obstruction, abdominal pain is often on and off and cramping, but it can get better when you vomit. Vomiting tends to happen more often, be in larger amounts, and have a green or yellow color.
As the obstruction gets worse, your symptoms may happen more often and become more severe. You may have frequent vomiting, extreme bloating, and intense abdominal pain. These are signs of a complete obstruction, in which stool and gas are mostly or totally blocked from leaving the body.
Major drugs
Opioids and anti-emetics: usually dopamine antagonists (e.g. haloperidol) can be administered (intravenously or subcutaneously) to relieve pain and nausea. Antimuscarinic/anticholinergic drugs (e.g. atropine, scopolamine): are used to manage colicky pain due to smooth muscle spasm and bowel wall distension.
More frequently, the term 'faeculent vomiting' is used by healthcare staff, sometimes loosely, to describe vomits that are unpleasant smelling and brown in colour, but it is vanishingly rare that the vomit includes actual faeces.
Do not take this medication with any of the following:
The upper limit of normal diameter of the bowel is generally accepted as 3cm for the small bowel, 6cm for the colon and 9cm for the caecum (3/6/9 rule).
Children who are impacted are often unable to pass any formed poos at all. They tend to pass loose, mushy or semi-solid poos, sometimes numerous times per day. They may also pass small hard bits of stools. They often do this without any awareness and so will deny it has happened.
What are the signs a bowel obstruction is clearing? You should be able to pass normal amounts of stool and gas if your bowel obstruction has cleared. You should also see your symptoms of pain, nausea or vomiting improve. Your obstruction may be cleared when you are back on a regular schedule with bowel movements.
Most people with bowel obstruction need prompt treatment in the hospital. Complete obstructions usually require immediate surgery. Partial bowel obstructions may require treatments to stabilize your condition, followed by nonsurgical solutions, like bowel rest. It all depends on how severe the obstruction is.
Your healthcare provider might recommend that you not eat until your symptoms improve or limit you to clear liquids. After this, a “low-residue” diet may be advised to try to get things moving. This diet includes foods and liquids such as yogurt that will not add to the blockage.
These treatments include using liquids or air (enemas) or small mesh tubes (stents) to open up the blockage. Surgery is almost always needed when the intestine is completely blocked or when the blood supply is cut off. You may need a colostomy or an ileostomy after surgery.
Red Vomit (hematemesis)
When you have a significant amount of vomit that is bright red in color or resembles coffee grounds, you should contact your doctor immediately. This can be the result of multiple conditions including, but not limited to: Liver failure. Cancer of the stomach, pancreas, or esophagus.
Pseudo-obstruction
Common symptoms include:
Eat a low-residue diet to make it easier for your body to pass stools. Take a walk after meals to help stimulate bowel movements. Drink plenty of water each day to soften stools and make them easier to pass.
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.
Symptoms of bowel obstruction
pain, that is usually a colicky tummy pain. feeling sick. vomiting large amounts, including undigested food or bowel fluid. not opening your bowels or passing wind (constipation)
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 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).