Clinical assessment of the leg for a suspected deep vein thrombosis

Bowel Obstruction

A bowel obstruction is a serious problem that happens when something fully or partly blocks either your large or small intestine. It's also known as an intestinal obstruction.

When your digestive system is hindered this way, it can be difficult or impossible to have a bowel movement or pass gas. You might also have stomach pain and a swollen belly.

Though the symptoms are similar, bowel obstruction isn't quite the same as fecal impaction. That's when a large, hard mass of poop gets stuck in your digestive tract. When your bowel is blocked by something other than hard stool, doctors call it a bowel obstruction.

A bowel obstruction is when a section of your intestine is fully or partially blocked. Doctors can use imaging tests to see the blockage. (Photo credit: ISM/SOVEREIGN)

Doctors divide bowel obstructions into two main types according to their location.  

Small bowel obstruction

About 80% of all bowel obstructions affect the small intestine. A blockage here can keep digested food from reaching your large intestine. 

Large bowel obstruction

A blockage in your large intestine can slow or stop the passage of poop out of your body.

In either intestine, a bowel obstruction can be:

Partial. When your bowel is only partly blocked, some gas, food, and liquid can still pass through it.  

Complete. This means nothing can get through your intestine. It's a life-threatening emergency that will likely require emergency surgery.

Pseudo-obstruction

A pseudo-obstruction is when you have symptoms of a bowel obstruction but no actual blockage. This can happen because of problems with your gastrointestinal muscles or with the nerves that control them. Opioid drugs may cause it. 

Signs of an intestinal blockage will depend on how serious the obstruction is. But a blockage almost always comes with belly pain, usually around your belly button, and cramps. Other bowel obstruction symptoms include:

Constipation

Inability to pass gas

Loss of appetite

Nausea or vomiting

A hard, swollen belly

Diarrhea (with a partial blockage)

You may also have symptoms of dehydration, like:

Pee that looks dark

A fast heartbeat 

If you've been constipated and have any of these other  symptoms, contact your doctor right away. They'll let you know what to do, including whether to call 911. Many people with bowel obstructions are older and may have other serious illnesses, so a bowel obstruction may be life-threatening. You'll probably need to go to the hospital for treatment.

Bowel obstruction symptoms in kids

Children with bowel obstruction have the same symptoms as adults. You might notice them crying and puling their legs up toward their bellies. They'll probably be less active than usual and may also have:

Blood in their poop

A fever

Vomit that looks green or yellowish

What causes a bowel obstruction? It can happen in several ways:

Part of your bowel may get twisted, which can close it off and keep anything from passing through. This is called volvulus. Some children are born with it, and adults sometimes get it, too. 

Your bowel can get inflamed and swell up. Diverticulitis, in which tiny pockets form in your intestine, can cause this type of swelling.  

Part of your intestine can slide into another part like a telescope (intussusception). This is the most common cause of bowel obstruction in young children.

Abdominal adhesions, bands of scar tissue that form between the loops of your intestine, can cause an obstruction. Abdominal surgery is usually the cause of such adhesions. 

Other types of scarring or a hernia can also make your bowel too narrow for anything to pass through. Inflammatory bowel diseases like Crohn's disease can create scar tissue in the bowel, as can radiation treatments. 

A tumor or other type of growth inside your bowel could block it. Colon cancer is the main cause of large bowel obstruction.

Damaged blood vessels leading to the bowel can cause some bowel tissue to die, leading to a blockage.

When you swallow a foreign object, such as hair, a plastic toy, or something else your body can't digest, it could physically block your bowel. Gallstones can also obstruct your intestine.

Foods that cause bowel obstruction

It's rare for any food to cause a bowel obstruction. But it could happen if you have hypothyroidism (an underactive thyroid gland), an immune system disorder called Guillain-Barre syndrome, or a condition that causes your digestive system to work slowly. Foods that have been reported to lead to bowel instruction include:

Apricots

Bananas

Coconut

Dried fruits

Risk factors for bowel obstruction

You're at higher risk for bowel obstruction if you have or have previously had:

Your doctor will ask about your medical history, including whether you've been constipated, if you've had cancer, and what symptoms you've had. They also may do a physical exam to see whether your belly is swollen, if they can hear noises that point to an obstruction, or if they can feel a lump.

They may also order blood tests to look for signs of dehydration or infection. If they think you may have a bowel obstruction, they'll likely use an imaging test to make the diagnosis. 

Bowel obstruction imaging tests

Several types of imaging tests can be used in diagnosing a bowel obstruction:

Abdominal X-ray. An X-ray may reveal the location of the blockage and whether there are signs of a rupture or dead area in your intestine.  But not all bowel obstructions show up on a standard X-ray.

Barium enema or air enema. Your doctor may insert air or liquid containing a metallic substance called barium into your rectum to create images that are clearer than those of regular X-rays. For children with intussusception, either type of enema can actually unfold the inside-out section of bowel and correct the blockage. 

Computerized tomography (CT) scan. This test uses a series of X-ray images to create detailed cross-section pictures of your bowel.

Ultrasound. Doctors often use this type of imaging test on children with bowel obstruction. It uses high-frequency sound waves to create images of the intestine.

You'll probably need to go to the hospital for treatment. If you have a complete bowel obstruction, you'll likely have surgery right away. Most partial obstructions don't need surgery. Your doctor will help stabilize your condition and may put you on a liquid diet to help your intestines rest.

Depending on how serious your obstruction is and what caused it, bowel obstruction treatment might include:

IV fluids. If you have dehydration, you'll get fluids and electrolytes through an IV.

Medications. You might also get nausea and pain relief drugs by IV to ease symptoms.  If you have an infection, you'll also get antibiotics.

Nasogastric tube. A doctor may place a thin tube through your nose and into your stomach to suction out fluids and gases that have built up in your digestive tract. This can relieve symptoms and may also help clear the blockage.

Bowel rest: To allow your intestine to clear the obstruction and let swelling go down, you may need to stop eating or drinking temporarily. You'll get a liquid that provides the nutrition you need. 

Stent. A doctor may place a mesh tube called a stent into your bowel to open the blocked area. This may be enough to treat the bowel obstruction. Or you might need surgery once your condition is stable enough.

Bowel decompression. In this procedure, a doctor guides a thin tube into the blocked area to open it up and relieve pressure. It can be done with a colonoscopy, in which the tube is inserted through your anus, or with surgery.

Bowel obstruction surgery

Your doctor may do surgery to remove whatever is causing the obstruction. They may also need to remove damaged parts of your bowel. If a hernia caused the blockage, you'll get surgery to repair it.

You may need a colostomy or ileostomy as well. After your doctor takes out the damaged section of intestine, they sew the rest to an opening in your skin. Poop exits your body through this opening and goes into a disposable bag. In some cases, your intestine can be reattached after you get better.

Treatment for pseudo-obstruction

Pseudo-obstruction often gets better on its own. Your doctor may just keep an eye on your condition until your symptoms improve. You may need to be fed through an IV or nasogastric tube until that happens. 

They can also prescribe a drug that helps your bowel contract and move food through. If a medication or another condition is to blame, they can discontinue the drug or treat the illness. 

Signs bowel obstruction is clearing

Most people recover from a bowel obstruction without complications after treatment. The main signs that your bowel is no longer blocked are being able to pass gas and poop again. Pain and bloating will also clear up.

If you think you have a bowel obstruction, don't try to treat it at home. An intestinal blockage can be life-threatening, particularly for people who have other health problems. While a partial blockage may clear without surgery,  you need a doctor's guidance.

If you've had a bowel obstruction in the past, you can take steps to prevent another one. The most important one is to follow your doctor's instructions. Other bowel obstruction self-care tips include:

Drink enough liquids to keep yourself well-hydrated.

Eat several mini-meals throughout the day instead of fewer but larger meals.

Always chew your food thoroughly.

Avoid high-fiber foods, raw fruits and veggies, and fiber supplements.

Get regular exercise. Shoot for at least 30 minutes most days of the week.

Complications from bowel obstructions can quickly turn serious. That's why it's important to get prompt treatment.

Possible complications include:

Short bowel syndrome. With this condition, the damage to your intestine keeps you from absorbing enough nutrients from food.

Abdominal abscesses. These are pockets of pus and inflectedfluid that form inside your abdomen (your belly area).

Tissue death. Sometimes called strangulation, this happens after a blockage cuts off the blood supply to part of your bowel. That can kill tissue in your abdominal wall, which can lead to gangrene. This puts you at risk of infection and can be life-threatening.  

Perforation. This is a tear in your intestine. It can be caused by tissue death or by pressure from built-up fluids and digestive gases behind the blockage. When these contents leak out of your intestine, it could lead to infection. 

Infection. You can get a dangerous infection in your abdomen called peritonitis. That, in turn, can lead to a life-threatening blood infection called sepsis. 

A bowel obstruction is when one of your intestines becomes partly or completely blocked. It needs medical care right away, so see a doctor if you have constipation along with symptoms like belly pain, bloating, and nausea. Prompt treatment can help to prevent potentially serious complications. 

What does a bowel obstruction feel like? 

If you have a small bowel obstruction, you'll probably feel intense cramps in your belly area. The pain seems to come from one particular spot, and comes in waves every few minutes. A large intestine obstruction causes continual pain over your whole abdominal area.

Can a bowel obstruction go away by itself?

Most of the time, a partial obstruction will clear up without surgery. But you're still likely to need treatments like a nasogastric tube and bowel rest to relieve pressure on the blocked area. See a doctor if you think you may have a bowel obstruction.

Can laxatives clear a bowel obstruction?

If you have symptoms of intestinal obstruction, don't use a laxative without your doctor's OK. Laxatives can be dangerous when your constipation is due to something serious like an intestinal obstruction. Improper use of certain laxatives, like those that contain psyllium fiber, could even cause a bowel blockage. 

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Mum, 34, Given 6 Months To Live After Doctors Dismissed Her 'heartburn' Shares Her Devastating Biggest Fear

A MUM whose "debilitating" symptoms were dismissed as heartburn was given just six months to live - and she's terrified her three-year-old daughter won't remember her.

Sophie Louise Wright couldn't keep anything down other than bread and suffered intense pain under her ribs.

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Sophie Louise Wright with her fiancé, Lewis, and their daughterCredit: Jam Press

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Doctors first put Sophie's debilitating symptoms down to acid refluxCredit: Jam Press

But when tests came back negative and doctors told her she might have acid reflux, the mum-of-one thought it was all in her head.

As she gradually became sicker - rapidly losing weight, having to call off work and struggling to take care of her daughter - the oncology secretary, from Torquay, Devon insisted on having more tests.

The 34-year-old has since been given six months to live after being diagnosed with a rare form of cancer.

Even with treatment, doctors estimate she won't live past 18 months.

The mum is terrified her daughter will forget her and is hoping to raise money for treatment to give her more time with her little one.

"When my daughter is mentioned or I think about the time I have left with her, I cannot contain my emotions," Sophie told NeedToKnow.

"My biggest fear is not being around to watch her grow up.

"She's nearly four and I don't think she'll remember much of her life at this stage – so I'm worried she'll forget me.

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SAVE MY AMELIA

My daughter, 6, beat cancer but it's returned & NHS won't fund her treatment

"I don't want anybody to replace me. I just want to be her mum forever.

"I'd happily live with cancer destroying my life forever if it meant I got to be with her."

Sun Health Explainer: What is cancer?

My life was totally ruined and I questioned whether there was something mentally wrong with me, as all my results came back clear

Sophie Louise Wright

Sophie underwent surgery to remove polyps – tissue growth – from her bowel in May last year after experiencing bleeding from her bottom.

Up until her cancer diagnosis in October, she had also struggled with going to the toilet, which left her feeling bloated.

While the biopsies from the polyp removal came back negative, she had a gut feeling that something much worse was going on.

She said: "I thought perhaps the polyps had spread across my body – but I didn't think it was cancer.

"I gradually became sicker, more tired, losing weight and finding life hard.

"I had to cancel all plans with friends and family as I couldn't eat food and I was left housebound.

"It made my relationship with my daughter and fiancé harder, too, as I gave up.

"My life was totally ruined and I questioned whether there was something mentally wrong with me, as all my results came back clear."

The mum claims she was given anti-sickness tablets and told it was likely due to acid reflux or a stomach ulcer.

But after she underwent a series of blood tests, CT and MRI scans, as well as a liver biopsy, Sophie was diagnosed with metastatic lower GI adenocarcinoma cancer in her bowel.

Bowel cancer symptoms

IT'S the fourth most common cancer in the UK, the second deadliest - yet bowel cancer can be cured, if you catch it early enough.

While screening is one way of ensuring early diagnosis, there are things everyone can do to reduce their risk of the deadly disease.

Being aware of the signs and symptoms of bowel cancer, spotting any changes and checking with your GP can prove a life-saver.

If you notice any of the signs, don't be embarrassed and don't ignore them. Doctors are used to seeing lots of patients with bowel problems.

The five red-flag symptoms of bowel cancer include:

Bleeding from the back passage, or blood in your poo

A change in your normal toilet habits - going more frequently for example

Pain or a lump in your tummy

Extreme tiredness

Losing weight

Tumours in the bowel typically bleed, which can cause a shortage of red blood cells, known as anaemia. It can cause tiredness and sometimes breathlessness.

In some cases bowel cancer can block the bowel, this is known as a bowel obstruction.

Other signs include:

Gripping pains in the abdomen

Feeling bloated

Constipation and being unable to pass wind

Being sick

Feeling like you need to strain - like doing a number two - but after you've been to the loo

While these are all signs to watch out for, experts warn the most serious is noticing blood in your stools.

But, they warn it can prove tricky for doctors to diagnose the disease, because in most cases these symptoms will be a sign of a less serious disease.

What is adenocarcinoma?

Your type of cancer depends on what type of cell it starts in.

Adenocarcinomas start in the gland cells in the lining of the bowel wall, which normally produce mucus, a slimy substance that makes it easier for the poo to pass through the bowel.

Adenocarcinoma is the most common type of bowel cancer. 

The cancer has since spread to her liver and spine.

Sophie is receiving chemotherapy, immunotherapy and radiotherapy, which has worsened her symptoms, including ulcers and numbness in the feet.

While these aim to extend her life expectancy, the mum has discovered a form of treatment in Germany which claims to shrink the tumours until they disappear completely, through delivering chemotherapy directly into the liver rather than the entire body.

But it comes at an eye-watering £3,300 per pop, with an estimated 10 sessions needed to achieve these results.

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Sophie Louise Wright has been diagnosed with metastatic lower GI adenocarcinoma cancer in her bowelCredit: Jam Press

Now, she and her fiancé, Lewis, 35, along with her daughter, are fundraising for this - raising £23,000 out of the £30,000 total so far.

Even if I can't get rid of it, I hope I can live

Sophie Louise Wright

Currently, she's making the most of the time she has left and hopes to warn others with her story.

The mum added: "My little girl has been amazing.

"She helps me get dressed, takes me to the toilet, puts my shoes on.

"Lewis, who is also struggling, has kept the house afloat.

"He still puts me first each day and I honestly believe without him, I wouldn't be here.

"I hope that my future is positive and I can fight this.

"Even if I can't get rid of it, I hope I can live."

The mum had this piece of advice for others: "Don't take anything for granted and live your life how you want, as you never know what might happen.

"No one my age should be fighting cancer and worrying about when our time will be up.

"Just keep fighting, especially for those who love you."

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Sophie pictured in hospitalCredit: Jam Press

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The mum at first thought her symptoms were all in her head after tests came back negativeCredit: Jam Press

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With gruelling treatment she's been given 18 months to liveCredit: Jam Press

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The couple are fundraising for treatment in Germany to buy Sophie precious time with her almost four-year-old daughterCredit: Jam Press

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