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.
Without treatment, the blocked parts of the intestine can die, leading to serious problems. However, with prompt medical care, intestinal obstruction often can be successfully treated.
The small intestine and colon are components of your digestive tract, which processes the foods you eat. The intestines extract nutrients from the foods. What isn't absorbed by the intestines continues along the digestive tract and is expelled as stool during a bowel movement. Diarrhea can be present due to abnormalities in the small intestine or the large intestine.
Signs and symptoms of intestinal obstruction include:
Because of the serious complications that can develop from intestinal obstruction, seek immediate medical care if you have severe abdominal pain or other symptoms of intestinal obstruction.
The most common causes of intestinal obstruction in adults are:
In children, the most common cause of intestinal obstruction is telescoping of the intestine (intussusception).
Other possible causes of intestinal obstruction include:
Intestinal pseudo-obstruction (paralytic ileus) can cause signs and symptoms of intestinal obstruction, but it doesn't involve a physical blockage. In paralytic ileus, muscle or nerve problems disrupt the normal coordinated muscle contractions of the intestines, slowing or stopping the movement of food and fluid through the digestive system.
Paralytic ileus can affect any part of the intestine. Causes can include:
Intussusception is a rare, serious disorder in which one part of the intestine slides inside an adjacent part.
Diseases and conditions that can increase your risk of intestinal obstruction include:
Untreated, intestinal obstruction can cause serious, life-threatening complications, including:
Tests and procedures used to diagnose intestinal obstruction include:
Treatment for intestinal obstruction depends on the cause of your condition, but generally requires hospitalization.
When you arrive at the hospital, the doctors stabilize you so that you can undergo treatment. This process may include:
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.
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.
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, your doctor may 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. You may still need surgery, once your condition is stable.
If your doctor determines that your signs and symptoms are caused by pseudo-obstruction (paralytic ileus), he or she may monitor your condition for a day or two in the hospital, and treat the cause if it's known. Paralytic ileus can get better on its own. In the meantime, you'll likely be given food through a nasogastric tube or an IV to prevent malnutrition.
If paralytic ileus doesn't improve on its own, your doctor may prescribe medication that causes muscle contractions, which can help move food and fluids through your intestines. If paralytic ileus is caused by an illness or medication, the doctor will treat the underlying illness or stop the medication. Rarely, surgery may be needed.
In cases where the colon is enlarged, a treatment called decompression may provide relief. Decompression can be done with colonoscopy, a procedure in which a thin tube is inserted into your anus and guided into the colon. Decompression can also be done through surgery.
Intestinal obstruction is usually a medical emergency. As a result, you may not have much time to prepare for an 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.
Your doctor is likely to ask you a number of questions, including: