Understanding an Intestinal Obstruction | Johns Hopkins Medicine

An intestinal obstruction means that something is blocking your intestine. Food and stool may not be able to move freely.

When your intestine works normally, digested food moves from your stomach to your rectum. Along the way, your body breaks food down into usable parts and turns the rest to feces (stool). You eventually eliminate it through a bowel movement.

An intestinal obstruction may partially or completely block this natural process. A complete blockage is an emergency and needs medical attention right away.

Among the many possible reasons for an intestinal obstruction are:

  • Abdominal adhesions. These are growths of tissue in bands that may force your intestines out of place.

  • Hernia. A hernia is a split in the muscle wall of your abdomen. Hernias can cause bulges and pockets. These may block your intestine.

  • Volvulus. A volvulus happens when part of your intestine twists around itself. This creates a blockage.

  • Intussusception. This condition means that a segment of your intestine slides into another segment. This narrows but may not block your intestine.

  • Scarring. When your body heals small cuts (wounds), scar tissue forms. This can happen inside your intestine as well. These scars can build up and create partial or total intestinal blockages. Scarring can result from tears in your intestinal wall, belly (abdominal) or pelvic surgery, or infections.

  • Inflammatory bowel disease. Crohn’s disease and ulcerative colitis are 2 examples.

  • Diverticulitis. Tiny pouches (diverticulae) can grow off the large intestine lining. These may become inflamed.

  • Tumors. Growths may be cancer or harmless (benign). Either way, they can block your intestine completely or partially.

  • Foreign objects. Nonfood objects that you swallow on purpose or accidentally may cause partial or complete intestinal obstruction.

  • Meckel diverticulum. About 2 in 100 people are born with this additional small pouch inside the intestine.

Symptoms

Symptoms of intestinal obstruction are:

  • Severe pain in your belly

  • Severe cramping sensations in your belly

  • Throwing up

  • Feelings of fullness or swelling in your belly

  • Loud sounds from your belly

  • Feeling gassy, but being unable to pass gas

  • Constipation (being unable to pass stool)

Who’s at risk

You may be at risk of an intestinal obstruction if you have:

  • Abdominal surgery. This can increase the risk for scar tissue or other growths. They also increase the risk for hernias.

  • Diverticulosis. This condition means that something irritates the lining of the intestine. It may cause inflammation, infection, and scarring, which can lead to blockage.

  • Cancer

  • Inflammatory bowel disease

  • Swallowed foreign objects

  • Chronic constipation

Diagnosis

To diagnose your condition, your healthcare provider will consider your overall health and health history. He or she will ask you about your symptoms. Tell your provider where your pain is and how strong it is. Also tell your provider if you have had changes in your bowel movements or appetite. Tell your provider if you have any other unusual symptoms, such as digestive sounds or a feeling of being bloated.

Your provider will give you a physical exam. You may also need certain tests. These may include:

  • Abdominal X-ray

  • Barium contrast study

  • CT scan

  • MRI

  • Contrast fluoroscopy

Treatment

The treatment your healthcare provider recommends will depend on what is causing the blockage. For a simple blockage you may need to have only fluids and no solids to eat. Your provider will work to fix any metabolic problems. You may have an intestinal decompression. This is usually done with a nasogastric tube. You may also have bowel rest.

You will need surgery right away if your intestinal obstruction is more complicated. This could be from a tear (perforation) in the intestine or a problem with blood flow. You may also need surgery if other treatment does not remove the blockage. The goal is to remove the blockage and repair your organs.

Your provider also might recommend using a small, flexible tube to keep your intestine open, instead of having more invasive surgery.

Complications

Complications are problems caused by your condition. Complications of intestinal obstruction include:

  • Pain

  • Constipation

  • Loss of appetite

  • Inability to keep food or fluids down

  • Fever

  • Infection

  • Tear (perforation) of the intestine

  • Death (rare)

Prevention

Abdominal adhesions that occur after surgery may be prevented if your medical team takes certain measures. These include keeping the incision site moist instead of dry. Discuss in advance what steps your medical team can take to reduce your risk for adhesions after surgery.

When to call the doctor

Get medical help right away if you have symptoms of intestinal obstruction. These include severe abdominal pain, vomiting, and inability to pass stool.

How to manage or live with this condition

Follow your doctor’s instructions. If he or she has told you to change your diet as part of your treatment, stick to the new plan. The goal of the diet is to reduce the work that your digestive tract has to do, while still giving you the nutrition you need.

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