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Definition
Intestinal obstruction is a blockage of your small intestine or colon that prevents food and fluid from passing through. Intestinal obstruction can be caused by many conditions, including fibrous bands of tissue in the abdomen (adhesions), hernias and tumors.
Intestinal obstruction can result in an array of uncomfortable signs and symptoms, including abdominal pain and swelling, nausea, and vomiting. If left untreated, intestinal obstruction can cause the blocked parts of your intestine to die. This tissue death can lead to perforation of the intestine, severe infection and shock. However, with prompt medical care, intestinal obstruction can often be successfully treated.
Symptoms
Signs and symptoms of intestinal obstruction include:
- Crampy abdominal pain that comes and goes
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Inability to have a bowel movement or pass gas
- Swelling of the abdomen (distention)
When to see a doctor
Because of the serious complications that can develop from intestinal obstruction, seek immediate medical care if you develop the signs or symptoms listed above.
Causes
Many conditions can cause intestinal obstruction. Intestinal obstruction can occur as the result of a "mechanical" obstruction — when something, such as a hernia or tumor, is physically blocking your intestine. Or intestinal obstruction can occur as the result of a condition in which your intestines don't function properly. This type of intestinal obstruction is called paralytic ileus (pseudo-obstruction).
Mechanical obstruction of the small intestine
Common causes of mechanical obstruction in the small intestine include:
- Intestinal adhesions — bands of fibrous tissue in the abdominal cavity that often form after abdominal or pelvic surgery
- Hernias — portions of intestine that protrude into another part of your body
- Tumors in the small intestine
- Inflammatory bowel diseases, such as Crohn's disease
- Twisting of the intestine (volvulus)
- Telescoping of the intestine (intussusception)
Mechanical obstruction of the colon
Mechanical intestinal obstruction is much less common in the colon than in the small intestine. Causes of mechanical colonic obstruction can include:
- Colon cancer
- Diverticulitis — a condition in which small, bulging pouches (diverticula) in the digestive tract become inflamed or infected
- Twisting of the colon (volvulus)
- Impacted feces
- Narrowing of the colon caused by inflammation and scarring (stricture)
Paralytic ileus
Paralytic ileus can cause signs and symptoms of intestinal obstruction, but doesn't involve an actual obstruction. In paralytic ileus, the intestines don't function properly due to muscle or nerve problems. Movement of the intestines is greatly reduced or absent, making it difficult for food and fluid to flow smoothly through the digestive system.
Paralytic ileus can affect any part of the intestine. Causes can include:
- Abdominal surgery
- Pelvic surgery
- Infection
- Certain medications
- Muscle and nerve disorders, such as Parkinson's disease
Risk factors
Diseases and conditions that can increase your risk of intestinal obstruction include:
- Abdominal or pelvic surgery, which often causes adhesions — a common cause of intestinal obstruction
- Crohn's disease — an inflammatory condition that can cause the intestine's walls to thicken, narrowing its passageway
- Cancer within your abdomen, especially if you've had surgery to remove an abdominal tumor or radiation therapy
Complications
If left untreated, intestinal obstruction can cause serious, life-threatening complications, including:
- Death of the affected intestine. Intestinal obstruction can cut off the blood supply to the affected portion of your intestine. If left untreated, lack of blood causes the intestinal wall to die. Tissue death can result in a tear (perforation) in the intestinal wall, which can lead to infection.
- Infection in the abdominal cavity. Peritonitis is the medical term for infection in the abdominal cavity. It's a life-threatening condition that requires immediate medical and surgical attention.
Preparing for your appointment
Emergency medical care is required to treat intestinal obstruction. As a result, you may not have much time to prepare for your appointment. If you have time before your appointment, make a list of your signs and symptoms so that you can better answer your doctor's questions.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:
- When did you begin experiencing abdominal pain or other symptoms?
- Did your symptoms come on all of a sudden or have you had symptoms like these before?
- Is your pain continuous?
- Have you experienced nausea, vomiting, fever, blood in your stool, diarrhea or constipation?
- Have you had surgery on your abdomen?
- Have you had radiation to your abdomen?
Tests and diagnosis
Tests and procedures used to diagnose intestinal obstruction include:
- Physical exam. Your doctor will ask about your medical history and your symptoms. He or she will also do a physical exam to assess your situation. The doctor may suspect intestinal obstruction if your abdomen is swollen or tender or if there's a lump in your abdomen.
- Imaging tests. To confirm a diagnosis of intestinal obstruction, your doctor may recommend abdominal X-ray or computerized tomography (CT) scans. These tests also help your doctor determine if the obstruction is paralytic ileus or if it's a mechanical obstruction, and if it's a partial or a complete obstruction.
Treatments and drugs
Treatment for intestinal obstruction depends on the cause of your condition.
Hospitalization to stabilize your condition
Treatment for intestinal obstruction requires hospitalization. When you arrive at the hospital, the doctors will first work to reverse your medical condition and stabilize you so that you can undergo treatment. This may include:
- Placing an intravenous (IV) line into a vein in your arm so that fluids can be given
- Putting a nasogastric (NG) tube through your nose and into your stomach to suck air and fluid out to relieve abdominal swelling
- Placing a thin, flexible tube (catheter) into your bladder to drain urine and collect it for testing
Treatment for a partial mechanical obstruction
If you have mechanical obstruction in which some food and fluid can still get through (partial obstruction), you may recover after you've been stabilized in the hospital. You may not require further treatment. Your doctor may also recommend a special low-fiber diet that is easier for your partially blocked intestine to process. If the obstruction does not clear on its own, you may need surgery to relieve the obstruction.
Treatment for a complete mechanical obstruction
Complete obstruction, in which nothing can pass through your intestine, usually requires surgery to relieve the blockage. The procedure you undergo will depend on what's causing the obstruction and which part of your intestine is affected. Surgery typically involves removing the obstruction, as well as any section of your intestine that has died.
Treatment for paralytic ileus
If your doctor determines that your signs and symptoms are caused by paralytic ileus, he or she may monitor your condition for a day or two in the hospital. Paralytic ileus is often a temporary condition that gets better on its own. If paralytic ileus doesn't improve within several days, your doctor may prescribe medication that causes muscle contractions, which can help move food and fluids through your intestines.
Last Updated: 2010-09-18
