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. Other causes of a blockage may include:
Inflammation of the bowel from conditions such as Crohnâ€™s disease or diverticulitis
Twisting of the bowel
A hard lump of bowel movement (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
What can I expect in the hospital?
Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:
You will be checked often by the hospital staff.
Your heart rate, blood pressure, and temperature will be checked regularly.
Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
Your healthcare provider will ask about your medical history and symptoms, and perform a physical exam. The following tests may also be done:
Blood tests to check for infection or blood loss
Tests of bowel movements to check for blood or infection
Tests to look for abnormalities in the intestine and abdomen, which may include:
X-rays: Pictures of the inside of the abdomen and the intestines to check for a blockage
Computed tomography (CT) scan: A series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the intestines
Upper gastrointestinal (GI) endoscopy (EGD): A test in which a thin, flexible, lighted tube is put through your mouth, into your stomach and intestine to look for a blockage. Sometimes one or more pieces of tissue are removed to help make a diagnosis. This is called a biopsy.
Sigmoidoscopy or colonoscopy: A test in which a thin, flexible tube and tiny camera is put into the rectum and up into the colon to look for a blockage. Sometimes a biopsy will be done to help make a diagnosis.
Barium enema: An X-ray taken of the belly after barium is inserted through your rectum to show the walls of the intestine and any possible problems
Ultrasound scan: Sound waves are used to show pictures of the inside of your belly and intestines
Laparoscopy, which uses a small lighted tube put into the belly through a small cut to look at the organs and tissues inside your abdomen and pelvic cavity. Sometimes a biopsy may be done to help make a diagnosis.
The treatment for an intestinal obstruction depends on its cause.
You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
You may not be allowed to eat a regular diet until after the cause of the intestinal obstruction is found and treated.
You may have a tube put through your nose down into your stomach, called a nasogastric or NG tube. The tube may be used to give fluids or medicine, or with suction to help remove fluid and air and relieve pressure in your stomach and intestine.
You may have a tube inserted into your rectum, called a rectal tube, to help fix an obstruction caused by a twisted bowel and relieve pressure in the intestine from bowel gas.
If the blockage is a hard lump of stool near the anus, it may be possible to remove it with an enema or a gloved finger. This may require several enemas and may be very uncomfortable.
Your provider may prescribe medicine to:
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
You may need surgery to treat the intestinal obstruction. Surgery may include:
Ladd procedure: If the obstruction is caused by a twist in the intestine, the surgeon may straighten it out and tack it down so it cannot twist again. The appendix is usually removed during this surgery to prevent future problems. If the blood supply to part of the intestine was blocked by the twist, a section of intestine may need to be removed.
Colon resection: Surgery to remove the section of colon that was blocked or twisted. The ends of the intestine are then sewn back together
Colostomy: Surgery to remove a section of the colon. The healthy part of the remaining colon is attached to an opening in the wall of the abdomen. Bowel movements then pass through this opening instead of the rectum. They are collected in a bag outside the body. After the remaining colon heals, the colostomy can sometimes be reversed. This means that you will have a second surgery to rejoin the ends of the colon to each other and will no longer have a colostomy.
Lymphectomy: Surgery to remove lymph nodes in the abdomen if the blockage was caused by cancer to check if the cancer has already spread. It also allows the pathologist to determine the stage of the cancer accurately. This will allow your healthcare providers to determine if you need more treatment after you recover from surgery.
What can I do to help?
You will need to tell your healthcare team if you have new or worsening:
Change in bowel habits, such as pain, mucus, diarrhea, constipation, or other intestinal problems
or belly pain that goes away and then comes back worse than it was
Nausea or vomiting
Blood in your bowel movements
Blood in your vomit
Redness, swelling, pain, warmth, or drainage from your surgical wound
Fever, chills, or muscle aches.
Ask questions about any medicine or treatment or information that you do not understand.
How long will I be in the hospital?
How long you are in the hospital depends on many factors. The average amount of time to stay in the hospital with an intestinal obstruction is 6 days.
Developed by RelayHealth.
Acute Care Advisor 2015.1 published by RelayHealth. Last modified: 2014-12-19 Last reviewed: 2014-11-20
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Intestinal Obstruction: References
Feldman, M, Friedman, L, & Brandt, L. (2010). Sleisenger and Fordtran’s gastrointestinal and liver disease [9th ed.]. Retrieved from http://www.mdconsult.com/.
Vincent, Jean-Louis, Abraham, Edward, Moore, Frederick A. Moore, Kochaneik, Patrick M., and Fink, Mitchell P. (2011). Ileus and Mechanical Bowel Obstruction. Textbook of Critical Care, 6th ed.; 106, 806-807, Philadelphia: Elsevier Saunders. Retrieved from http://www.clinicalkey.com.
US Department of Health & Human Services. (2012) National and regional estimates on hospital use for all patients from the HCUP nationwide inpatient sample. Agency for healthcare research and quality website. Retrieved 07/22/2014 from http://hcupnet.ahrq.gov/HCUPnet.jsp