Bowel Obstruction: Small Bowel

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KEY POINTS

• A small bowel obstruction is a blockage anywhere inside your small intestine. A blockage may stop all food, gas, or fluids from passing through or just make it harder to pass through and into the large intestine.
• Treatment depends on what is causing the blockage and how bad it is. Treatment may include changes in your diet, medicine, or surgery.
• If a blockage is not treated, it can become a life-threatening medical emergency.

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What is a small bowel obstruction?

A small bowel obstruction is a blockage anywhere inside your small intestine. The small intestine starts at the end of the stomach and ends where the small and large intestine (also called the colon) connect. A blockage may stop all food, gas, or fluids from passing through or just make it harder to pass through and into the large intestine.

If a blockage is not treated, it can become a life-threatening medical emergency.

What is the cause?

Common causes of a blockage are:

• Bands of scar tissue that can form after you have surgery or radiation treatment to your belly. These scars may grow between parts of your bowel and trap loops of bowel.
• 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

Sometimes the blockage cuts off blood flow to part of your intestines. When this happens, some tissue dies and leaves holes in your intestines. This allows bacteria to leak into your bloodstream, which can cause a life threatening infection.

What are the symptoms?

The first signs of a blockage may be a change in bowel habits, such as little or no gas, or no bowel movements. Other symptoms may include:

• Cramping, swelling and pain in your belly that comes and goes
• Nausea or vomiting

If your intestine is only partly blocked, you may have diarrhea.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you.

Tests may include:

• Blood tests
• X-rays of your belly
• CT scan, which uses X-rays to show detailed pictures of your intestines
• Small bowel series, which uses X-rays and barium to show the small intestine. Barium is a liquid that helps your intestines show up well on the X-ray.

How is it treated?

Treatment depends on what is causing the blockage and how bad it is.

You may need to be treated in the hospital with an IV to give you fluids and medicines. You may also have a tube put through your nose and into your stomach to help drain fluid and gas.

If some food and liquid can still get through your intestine, you may not need other treatment. Your provider may recommend some changes in your diet to help prevent future problems.

You may need to have surgery to remove the cause of the blockage. This is more common with complete blockages. Sometimes this can be done with a laparoscopic surgery, which is done through several small cuts in the belly. A laparoscope is a lighted tube with a camera. Your provider can put the scope and tools into your belly through the small cuts.

Part of your intestine may also need to be removed.

How can I take care of myself?

Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent small bowel obstruction?

Exercise daily and eat a diet high in fiber and low in fat and cholesterol. If you are not used to high-fiber diets, start slowly. Drinking plenty of water helps your intestines to work normally.

Being active after any surgery or bowel injury may help prevent scars. If you have a hernia, ask your healthcare provider if repair of the hernia would help prevent a bowel obstruction.

If you have a health problem that caused the blockage, be sure you know what to do to manage that health problem and help keep you from having another blockage.