Small Bowel Obstruction
by Julie Rackliffe Lucey, MS
Small bowel obstruction means the small intestine is partially or totally blocked. When this happens, the contents of the intestine cannot properly get out of the body. Stools, fluid, and gas build up inside the intestine. This is a potentially serious condition that requires urgent medical care.
Bowel obstruction may be caused by a mechanical problem. In this case, something inside the body blocks the movement of material through the intestine.
It can also be caused by ileus, a slowing down or stopping of bowel activity. Ileus is a nonmechanical type of obstruction, which may also be referred to as pseudo-obstruction.
Mechanical small bowel obstruction may be caused by:
Ileus may be caused by surgery on the intestine or certain medications such as opioids.
Factors that may increase your chances of small bowel obstruction include:
Symptoms of small bowel obstruction often occur in combination. Small bowel obstruction may cause:
Ileus pain is often less severe than mechanical small bowel obstruction.
You will be asked about your symptoms and medical history. A physical exam will be done. The exam will include listening for bowel sounds in your stomach. Very high pitched bowel sounds heard through a stethoscope suggest mechanical bowel obstruction. Conversely, ileus often produces no bowel sounds.
Imaging tests are used to evaluate abdominal structures. These may include:
Treatment depends on the cause and severity of the obstruction. You will usually require treatment by a specialist. Your doctor will also treat you for any underlying conditions that contribute to small bowel obstruction.
Before any surgical treatment or procedure can begin, you may need to be stabilized. This may include:
After the blockage is relieved, nutrition is given through an IV or feeding tube until you are able to eat solid foods. Other treatment for small bowel obstruction includes:
Medications may include:
Surgery may be needed if you do not respond to medical treatment, or in the following circumstances:
There are no current guidelines to prevent small bowel obstruction. Managing any underlying conditions such as Crohn disease, can reduce your chances.
National Cancer Institute
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Association of Gastroenterology
Crohn's and Colitis Canada
Abdominal adhesions. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/abdominal-adhesions. Updated September 2013. Accessed January 9, 2018.
Baron TH. Acute colonic obstruction. Gastrointest Endosc Clin N Am. 2007;(17)2:323-329.
Bonin EA, Baron TH. Update on the indications and use of colonic stents. Curr Gastroenterol Rep. 2010;12(5):374-382.
Gastrointestinal complications—for health professionals (PDQ). National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-hp-pdq. Updated May 10, 2017. Accessed January 9, 2018.
Intestinal pseudo-obstruction. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
...(Click grey area to select URL)
Updated February 2014. Accessed January 9, 2018.
Kulaylat MN, Doerr RJ. Small bowel obstruction. Available at: https://www.ncbi.nlm.nih.gov/books/NBK6873. Accessed January 9, 2018.
Small bowel obstruction. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated August 9, 2017. Accessed January 9, 2018.
4/7/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed... : Katz DS, Baker ME, Rosen MP, et al. Suspected small bowel obstruction. American College of Radiology (ACR) Appropriateness Criteria. Available at: https://acsearch.acr.org/docs/69476/Narrative. Updated 2013.
Last reviewed November 2018 by EBSCO Medical Review Board Daus Mahnke, MD
Last Updated: 12/20/2014
EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
To send comments or feedback to our Editorial Team regarding the content please email us at firstname.lastname@example.org. Our Health Library Support team will respond to your email request within 2 business days.