Bowel Obstruction and Blockage

Intestinal obstruction causes a wide range of symptoms, including:

• severe bloating
• abdominal pain
• decreased appetite
• nausea
• vomiting
• inability to pass gas or stool
• constipation
• diarrhea
• severe abdominal cramps
• abdominal swelling

Some symptoms may depend on the location and length of time of the obstruction. For example, vomiting is an early sign of small intestine obstruction. Vomiting may also occur with an obstruction of your large intestine, if it’s ongoing.

A partial obstruction can result in smaller stools, sometimes preceded by diarrhea, while a complete obstruction can make you unable to pass gas or stool.

Intestinal obstruction may also cause serious infection and inflammation of your abdominal cavity, known as peritonitis. This occurs when a portion of your intestine has ruptured. It leads to fever and increasing abdominal pain. This condition is a life threatening emergency requiring surgery.

An obstruction can be partial, which may get better without surgery. A complete blockage is more likely to need intestinal surgery.

Mechanical obstructions

Mechanical obstructions are when something physically blocks your intestine. In the small intestine, this can be due to:

• adhesions, which are made of fibrous tissue that can develop after any abdominal or pelvic surgery or after severe inflammation
• volvulus, or twisting of the intestines
• intussusception, a “telescoping,” or pushing, of one segment of intestine into the next section
• malformations of the intestine, often in newborns, but can also occur in children and teens
• tumors within your small intestine
• gallstones, although they rarely cause obstructions
• swallowed objects, especially in children
• hernias, which involve a portion of your intestine pushing outside the muscle or tissue in your body or into another part of your body
• inflammatory bowel disease, such as Crohn’s disease

Although less common, mechanical obstructions can also block your colon, or large intestine. This can be due to:

• stool stuck in your colon or rectum (impacted stool)
• adhesions from pelvic infections or surgeries
• ovarian cancer
• colon cancer
• meconium plug in newborns (meconium is the stool babies first pass)
• volvulus and intussusception
• diverticulitis, the inflammation or infection of bulging pouches of intestine
• stricture, a narrowing in the colon caused by scarring or inflammation
• intestinal parasites

Nonmechanical obstruction

Your small and large intestines normally work in a coordinated system of movement. If something interrupts these coordinated contractions, it can cause a functional intestinal obstruction.

This is generally known as a nonmechanical obstruction. If it’s a temporary condition, it’s referred to as an ileus. It’s called a pseudo-obstruction if it becomes chronic, or long-term.

Causes for an ileus include:

• abdominal or pelvic surgery
• infections, such as gastroenteritis or appendicitis
• some medications, including opioid pain medications
• electrolyte imbalances

Intestinal pseudo-obstruction can be caused by:

• Parkinson’s disease, multiple sclerosis, and other nerve and muscle disorders
• Hirschsprung’s disease, a disorder in which there’s a lack of nerves in sections of the large intestine
• disorders that cause nerve injury, such as diabetes mellitus
• hypothyroidism, or an underactive thyroid gland

First, a doctor may push on your abdomen to examine it. They then listen with a stethoscope to any sounds being made. The presence of a hard lump or particular kinds of sounds, especially in a child, may help determine whether an obstruction exists.

Other tests include:

• blood tests to check for:
  • blood counts
  • liver and kidney function
  • levels of electrolytes
• X-rays
• CT scan
• colonoscopy, a flexible tube with a light that your doctor uses to look at your large intestine
• enema with contrast

Treatment depends on the location and severity of the obstruction. Do not attempt to treat the problem at home. The appropriate treatment depends on the type of intestinal obstruction.

For partial obstructions or an ileus, it may be possible to treat by simply resting the bowels and getting intravenous (IV) fluids. Bowel rest means you’ll be given nothing to eat, or clear liquids only, during that time. If the cause of the obstruction is known, your doctor treats that as well.

Treating dehydration is important. A doctor may give you IV fluids to correct your electrolyte imbalance. A catheter may be inserted into your bladder to drain urine.

A tube may need to be passed through your nose and down into your throat, stomach, and intestines to relieve:

• pressure
• swelling
• vomiting

If your problem is due to the use of narcotic pain medications, your doctor can prescribe medication that reduces the effect of the narcotics on your bowels.

Surgery will be required if these measures fail or if your symptoms become worse. Treatment in this case typically requires a hospital stay. You’ll be given IV fluids, because in addition to relieving dehydration, they help prevent shock during surgery.

A severe complication of a bowel obstruction can be permanent damage to your intestine. If this occurs, a surgeon will perform an operation to remove the section of dead tissue and rejoin the two healthy ends of your intestine.

While prescription medications can’t treat the obstruction itself, they can help reduce your nausea until further treatments are performed. Examples of medications your doctor may prescribe include:

• antibiotics to reduce infection
• anti-nausea medicines to keep you from vomiting
• pain relievers

You shouldn’t ignore the symptoms of an intestinal obstruction or attempt to treat an intestinal obstruction at home.

Treatment is essential to reduce complications such as:

• dehydration
• electrolyte imbalances
• perforation, or a hole that forms in your intestines, which leads to infections
• kidney failure

If the obstruction is preventing blood from getting to a segment of intestine, this can lead to:

• infection
• tissue death
• intestinal perforation
• sepsis, a life threatening blood infection
• multiple organ failure
• death

For some people with a chronic obstruction due to a stricture or narrowing of their intestine, a doctor may place a metal stent that expands inside the intestine using a long tube called an endoscope.

The stent is a wire mesh that holds open the intestine. The procedure may not require cutting into the abdomen, and it’s usually used if a person is not a candidate for traditional surgery.

Intestinal obstruction in infants typically arises from:

• infections
• organ diseases
• decreased blood flow to the intestines (strangulation)

Some children experience the condition after having a stomach flu. This can cause inflammation in their intestines.

Intussusception is most common in children 2 years old and younger. This occurs when one part of their bowel collapses or slides into another part. As a result, their intestine becomes blocked.

Any type of intestinal obstruction is difficult to diagnose in infants because they can’t describe their symptoms. Instead, parents must observe their children for changes and symptoms that could indicate a blockage. These signs include:

• abdominal swelling
• drawing knees up to their chest
• appearing overly drowsy
• having a fever
• grunting in pain
• passing stools that appear to have blood in them, known as a currant jelly stool
• very loud crying
• vomiting, particularly bile-like vomiting that is yellow-green
• displaying signs of weakness

If you notice these symptoms or other changes in your child, seek immediate medical attention.

Seek medical care if you have symptoms of an intestinal obstruction, especially if you’ve recently undergone abdominal surgery. Seek immediate medical attention if you experience:

• abdominal bloating
• severe constipation
• loss of appetite

You can connect to a primary care doctor in your area using the Healthline FindCare tool.

When left untreated, intestinal obstruction can cause the tissue in the affected part of your intestine to die. It can also lead to a hole, or perforation, in the wall of your intestine, severe infection, and shock.

Overall, the outlook of your condition depends on its cause. Most cases of intestinal obstruction are treatable. However, other causes, such as cancer, require long-term treatment and monitoring.