Intestinal Obstruction Discharge Information

What is an intestinal obstruction?

An intestinal obstruction is a blockage of the small or large intestine (also called the small or large bowel). The blockage makes it hard for the contents of the bowel to pass through and out of the body. If the obstruction is only partly blocking the intestine, you may feel some relief of crampy belly pain and fullness as you pass liquid stool or gas. Sometimes the blockage cuts off blood flow to part of the bowel. When this happens, the bowel is said to be strangulated (or ischemic). The lack of blood flow can cause death of some of the tissue and can be life threatening.

The most common cause of an intestinal obstruction is scar tissue (adhesions) from previous surgeries. These scars may grow between parts of your bowel and trap loops of bowel. Other causes of a blockage may include:

• Tumors that block the intestine
• A hernia, which is part of the intestine that bulges through a weak area or gap in the muscles in your belly and may get trapped
• Inflammation of the bowel from conditions such as Crohn’s disease or diverticulitis
• Twisting of the bowel
• A hard lump of stool (fecal impaction)
• Intussusception, which is the intestine folding into itself, cutting off the flow of partly digested food and eventually cutting off blood flow to the tissues
• Narrowing of the bowel that has been present since birth

How can I take care of myself when I go home?

How long it takes to get better depends on the cause of your intestinal obstruction and the treatment you need. You may need to make dietary or other lifestyle changes to prevent future bowel obstructions.

Management

• Your provider will give you a list of your medicines when you leave the hospital.
  • Know your medicines. Know what they look like, how much you should take each time, how often you are to take them, and why you take each one.
  • Take your medicines exactly as your provider tells you to.
  • Carry a list of your medicines in your wallet or purse. Include any nonprescription medicines and supplements on the list.
  • Talk to your provider before you use any other medicines, including nonprescription medicines.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Treat or prevent side effects, such as nausea or constipation, from other treatments
  • Soften stool and reduce straining with a bowel movement
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.
• If you have had surgery without a colostomy, to care for your surgical wound:
  • Keep your surgical wound clean.
  • If you are told to change your dressing on your surgical incision, wash your hands before and after changing the dressing and after disposing of the dressing.
• If you have had a colostomy:
  • A part of your intestine will be connected to a new opening in your belly, called a stoma. Your bowel movements will empty through the stoma and collect in a disposable bag (pouch) outside your body.
  • You will need to learn to care for your colostomy. The stoma must be kept clean and pouches must be emptied regularly so that they do not become too heavy and leak. Be sure to follow the manufacturer’s directions for your type of pouch.
• Follow activity restrictions, such as not driving or operating machinery, as recommended by your healthcare provider or pharmacist, especially if you are taking pain medicines.
• Ask your provider about any changes you may need in your diet.
  • Eat a diet high in fiber and low in fat and cholesterol. If you are not used to high-fiber diets, begin slowly.
  • Drink plenty of water to help your intestines work well.
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Try to keep a healthy weight. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress. Exercise according to your healthcare provider's instructions.

Appointments

• Follow your provider's instructions for follow-up appointments.
• Keep appointments for any testing you may need.
• If you are age 50 or older, you should have colorectal cancer screening with a test for blood in the stool and a sigmoidoscopy, colonoscopy, or barium enema. You may need to start colorectal cancer screening earlier if a member of your immediate family has had colon polyps or colon cancer, especially if their cancer occurred before they were 50 years old.

Talk with your provider about any questions or concerns you have.

Call your healthcare provider if you have new or worsening:

• Change in bowel habits, such as pain, mucus, diarrhea, constipation, or other intestinal problems
• Bloating or pain in your belly that goes away and then comes back worse than it was
• Nausea or vomiting
• Blood in your bowel movements
• Blood in your vomit
• Signs of infection that may include:
  • The area around your surgical wound is more red or painful
  • The surgical wound area is very warm to touch
  • You have blood, pus, or other fluid coming from the surgical wound area
  • You have a fever higher than 101.5° F (38.6° C)
  • You have chills or muscle aches