Intestinal Obstruction

Intestinal obstruction, also called bowel obstruction, is a blockage of the small or large intestine that prevents food or stool from moving through the intestines.

A blockage can be partial or complete and can be caused by many factors, most commonly abdominal adhesions from surgery – which are fibrous bands of tissue that form between tissue and organs. Without treatment, intestinal obstructions can lead to serious medical problems, and in cases of complete intestinal obstruction, emergency surgery is required to remove the blockage and damaged tissue.

The general surgeons affiliated with Memorial Hermann have extensive experience performing abdominal surgery, and specialize in removing intestinal blockages in a safe, minimally invasive manner, which can allow you to get back to an active life faster.

According to a global study by the National Center for Biotechnology Information (NCBI) in 2015, approximately 3.2 million cases of intestinal obstruction were diagnosed. The condition can affect both males and females, regardless of age, and the most common causes of intestinal obstruction include:

• adominal adhesions (fibrous bands that form between tissue and organs) caused by prior abdominal or pelvic surgery
• Hernias
• Tumors

Some additional causes of obstruction can include:

• Diverticulitis
• Inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis
• Foreign bodies such as gallstones
• Twisted bowel (volvulus)
• Telescoping of one segment of the bowel into another (intussusception).Common in children, telescoping occurs when one segment of the bowel slides inside of another segment.
• Fecal impaction – a hard piece of stool stuck in the colon or rectum

Intestinal blockages can occur even in those who live otherwise healthy lifestyles. However, there are certain factors that can increase your risk of intestinal obstruction, including:

• Chronic constipation from a high-fat, low-fiber diet
• Prior abdominal or pelvic surgery
• Inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis
vA prior bowel obstruction
• History of hernia or cancer

It’s the job of your intestines to move digested food, stomach juices and stool from the stomach to the colon. An intestinal obstruction occurs when this process is hindered by a blockage – either partial or complete.

Consider scheduling an appointment with your primary care physician if you are experiencing any of these symptoms of intestinal obstruction:

• Intermittent abdominal pain and cramping
• Loss of appetite
• Constipation
• Vomiting
• Inability to have a bowel movement or to pass gas
• Abdominal swelling or bloating

In some cases, intestinal obstruction can cause serious and debilitating acute abdominal pain. If you experience sudden, severe abdominal pain in addition to any of the above symptoms, seek emergency medical attention, immediately, by calling 911 or visiting an Emergency Room.

Some patients suffering from a partial or complete bowel obstruction may decide not to seek treatment, believing that the problem will solve itself. The truth is: intestinal obstruction is a serious condition and prolonged obstruction can cause serious complications, and possibly death.

Other serious complications include:

• Acute intestinal ischemia and infarction, a medical emergency resulting from a sudden reduction in intestinal blood flow. In severe cases, the bowel tissues can die from lack of blood flow.
• Bowel perforation (also known as ruptured bowel), can cause a medical emergency called diffuse peritonitis – an inflammation or infection of the lining of the perineum which lines the inner wall of the abdominal cavity
• Sepsis, an inflammatory autoimmune response triggered by infection that can cause injury to tissue and internal organs.

If you believe you may be experiencing symptoms of an intestinal obstruction, schedule an appointment with your primary care physician. At the appointment, he or she will perform a physical exam, looking for abdominal swelling, tenderness or a mass, and may listen to your abdomen through a stethoscope.

Your doctor will also ask you some questions about your medical history and your symptoms, so it’s important to answer these questions as accurately as you can.

Be prepared to answer the following:

• When did you first notice your symptoms?
• How severe is your pain? Where is it located?
• Did this pain arise quickly or gradually?
• Have you been diagnosed with an intestinal blockage before? Were you treated for this condition?
• Do you have a history of abdominal surgeries, hernia or cancer?

To confirm a diagnosis of intestinal obstruction, your doctor may order diagnostic tests including an X-ray, a computerized tomography (CT) scan or an ultrasound. In certain cases, your doctor may perform a barium enema by inserting air or barium into the colon through the rectum. This diagnostic procedure often can correct intussusception in children.

Treatment varies based on the type and cause of the intestinal obstruction, but the condition almost always requires hospitalization.

Partial Intestinal Obstruction

If you’re diagnosed with a partial blockage, it may be treated through a variety of non-surgical means. For some patients, a special low-fiber diet may be prescribed in order to flush out the obstruction. In other cases, a nasogastric (NG) tube is inserted through a nostril and into the stomach to siphon away fluid and release pressure on the blockage.

Using these methods, a partial blockage can resolve itself in a few days. If it doesn’t, however, surgery may be required to clear the obstruction.

Complete Intestinal Obstruction

A complete intestinal obstruction may require surgery to remove the blockage and damaged intestinal tissue. Depending on your condition, there are several types of surgical procedures, including:

• Colectomy – the surgical removal of part or all of the colon
• Colostomy – the connection of the bowel to an exterior adhesive drainage bag
• Lysis of adhesions – scar tissue is surgically removed to free up the trapped bowel
• Small bowel resection – the removal of all or part of the small bowel

Small bowel resection surgery is a procedure which can be performed laparoscopically, which involves specialized equipment and a laparoscope (thin, flexible camera) used by the surgeon to view the inside of the abdominal cavity. Because laparoscopic surgery only involves a few small incisions, it can result in fewer complications and a shorter recovery period.

If a patient is unable to undergo surgery, a stent may be inserted into the colon to enlarge the colon and allow the obstruction to pass.

For a full list of the minimally invasive surgical procedures offered, visit the Robotic and Minimally Invasive Procedures page.

The skilled general surgeons affiliated with Memorial Hermann specialize in abdominal surgeries for the treatment of intestinal obstruction.

Schedule an appointment today with a Memorial Hermann-affiliated physician using our online ScheduleNow portal or by calling (713) 222-CARE.

If you are experiencing sudden or severe abdominal pain, seek emergency medical attention immediately by calling 911 or visiting an emergency room.