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Mechanical Bowel Obstruction

Definition

A mechanical bowel obstruction is a partial or complete blockage in the intestine. Blockages can occur at any point along the small or large bowel. They are more common in the small bowel. When the bowel is blocked, food and liquid cannot pass through. Over time, food, liquid, and gas build up in the area above the blockage.
Mechanical Bowel Obstruction
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Causes

Most small bowel blockages are due to adhesions. An adhesion is a band of scar tissue that causes the bowel to attach to the abdominal wall or other organs. Most large bowel obstructions are caused by tumors.
Specific causes of bowel obstructions include:

Risk Factors

Factors that increases your chance of getting a bowel obstruction include anything that is likely to cause scar tissue or a blockage, such as:

Symptoms

Symptoms of a bowel obstruction include:
Complications from an untreated obstruction can include strangulation, which is cutting off the blood supply to part of the intestine.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. A stethoscope will be placed on your abdomen to listen for bowel sounds. If the normal bowel sounds are absent, or if high pitched, tinkling sounds are present, it may be an indication of bowel obstruction.
Your bodily fluids may need to be tested. This can be done with:
Images may need to be taken. This can be done with abdominal x-rays, such as:

Treatment

Bowel obstructions can be serious, even fatal. If your doctor thinks you have a bowel obstruction, you will be hospitalized and treated. Your treatment will depend on what part of your bowel is blocked and what is causing the blockage.
Possible treatments include the following:
During surgery, the blocked part of the bowel may be removed. The remaining sections will then be joined together. You will probably need a nasogastric tube temporarily after surgery. In addition, you may need antibiotics and pain medication during recovery.

Prevention

Prevention of bowel obstruction depends on the cause. Some bowel obstructions cannot be prevented. The following actions may help reduce your risk of a bowel obstruction:

RESOURCES

American College of Gastroenterology http://gi.org

National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

The College of Family Physicians of Canada http://www.cfpc.ca

References

Abdominal adhesions and bowel obstruction. University of California, San Francisco website. Available at: http://surgery.ucsf.edu/conditions--procedures/bowel-obstruction.aspx. Accessed December 18, 2014.

Acute intestinal pseudo-obstruction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 12, 2014. Accessed December 18, 2014.

Jackson P, Raiji M. Evaluation and management of intestinal obstruction. Am Fam Physician. 2011;83(2):159-165.

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