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Small Bowel Obstruction

Authors:
  • Cynthia M. Johnson, MA
Publication Type:

Condition

Small Bowel Obstruction

Definition

A small bowel obstruction is when the small intestine is partly or fully 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. Emergency care is needed.

Causes

A small bowel obstruction can be caused by something inside the body blocking the movement of contents of the intestine. Examples are:

  • Scar tissue, such as from a prior surgery
  • Intussusception —one part of the intestine slides up into another part of the intestine
  • Volvulus—the intestine twists on itself
  • Impacted foreign bodies—items that were swallowed and got stuck

It can also be caused by ileus. This is a slowing down or stopping of bowel activity. It is also called as pseudo-obstruction. It may be caused by surgery on the intestine or certain medicines, such as opioids.

Small Bowel Obstruction.

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Risk Factors

Things that may raise the risk of a small bowel obstruction include:

  • Hernias
  • Crohn disease —an inflammatory bowel condition
  • Abdominal, joint, or spine surgery
  • Swallowing a foreign body
  • A decrease in blood supply to the small bowel
  • Abnormal growth of tissue in or next to the small intestine
  • Tumors in the small intestine
  • Cancer
  • Infection in the lining of the small intestine
  • Kidney disease
  • Long-standing diabetes
  • Gallstones (rare)

Symptoms

A person may have one or more of the following symptoms:

  • Abdominal fullness and gas
  • A swollen abdomen
  • Pain and cramps in stomach area
  • Vomiting
  • Constipation
  • Diarrhea
  • Bad breath

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. The exam will include listening for bowel sounds in the stomach.

Pictures will be taken of the abdomen. This can be done with:

Treatment

The goal of treatment will be to allow the contents of the intestine to move out of the body. How this is done depends on the cause and how severe it is.

Prevention

There are no current guidelines to prevent small bowel obstruction.

Initial Care

Initial care and monitoring may used to see if the obstruction resolves on its own. This may include:

  • Not eating anything by mouth
  • IV fluids to promote hydration
  • Nasogastric tube—A tube is inserted through the nose and into the stomach to remove fluids and gas
  • Catheterization—A tube is placed in the bladder to drain and test urine

If the blockage is resolved, nutrition is given through an IV or feeding tube until the person can eat solid foods.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • 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.
  • 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.
  • Intestinal pseudo-obstruction. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/intestinal-pseudo-obstruction.
  • Katz DS, Baker ME, et al. Suspected small bowel obstruction. American College of Radiology (ACR) Appropriateness Criteria. Available at: https://acsearch.acr.org/docs/69476/Narrative.
  • Long B, Robertson J, et al. Emergency Medicine Evaluation and Management of Small Bowel Obstruction: Evidence-Based Recommendations. J Emerg Med. 2019 Feb;56(2):166-176.
  • Small bowel obstruction. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/small-bowel-obstruction.
  • Ten Broek RPG, Krielen P, et al. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the World Society of Emergency Surgery ASBO working group. World J Emerg Surg. 2018;13:24.

Contributors

  • Nicole S. Meregian, PA
Last Updated:
2023-07-10

(C) Copyright 2023 EBSCO Information Services

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.