Intestinal Obstruction
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Intestinal obstruction is a blockage that keeps food or liquid from passing through your small intestine or large intestine (colon). Causes of intestinal obstruction may include fibrous bands of tissue (adhesions) in the abdomen that form after surgery; hernias; colon cancer; certain medications; or strictures from an inflamed intestine caused by certain conditions, such as Crohn's disease or diverticulitis.
Symptoms
Signs and symptoms of intestinal obstruction include:
Crampy abdominal pain that comes and goes
Loss of appetite
Constipation
Vomiting
Inability to have a bowel movement or pass gas
Swelling of the abdomen
The most common causes of intestinal obstruction in adults are:
Intestinal adhesions — bands of fibrous tissue in the abdominal cavity that can form after abdominal or pelvic surgery
Hernias — portions of intestine that protrude into another part of your body
Colon cancer
In children, the most common cause of intestinal obstruction is telescoping of the intestine (intussusception).
Other possible causes of intestinal obstruction include:
Inflammatory bowel diseases, such as Crohn's disease
Diverticulitis — a condition in which small, bulging pouches (diverticula) in the digestive tract become inflamed or infected
Twisting of the colon (volvulus)
Impacted feces
Diagnosis
Physical exam.
Treatment
Treatment for intestinal obstruction depends on the cause of your condition, but generally requires hospitalization.
Hospitalization to stabilize the condition
This process may include:
Placing an intravenous (IV) line into a vein in arm so that fluids can be given
Putting a tube through nose and into stomach (nasogastric tube) to suck out air and fluid and relieve abdominal swelling
Placing a thin, flexible tube (catheter) into bladder to drain urine and collect it for testing
Treating intussusception
A barium or air enema is used both as a diagnostic procedure and a treatment for children with intussusception. If an enema works, further treatment is usually not necessary.
Treatment for partial obstruction
If you have an obstruction in which some food and fluid can still get through (partial obstruction), you may not need further treatment after you've been stabilized. Your doctor may 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 complete obstruction
If nothing is able to pass through your intestine, you'll usually need surgery to relieve the blockage. The procedure you have 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 or is damaged.
Alternatively, recommend treating the obstruction with a self-expanding metal stent. The wire mesh tube is inserted into your intestine via an endoscope passed through your mouth or colon. It forces open the intestine so that the obstruction can clear.
Stents are generally used to treat people with colon cancer or to provide temporary relief in people for whom emergency surgery is too risky.