How to Know If You Have a Bowel Obstruction
What Is a Bowel Obstruction?
A bowel obstruction, or blockage, occurs when something prevents stool from passing through the intestine in the normal way.
To help explain what's going on in your body, we can use a garden hose as an analogy. If you stand on a garden hose, the water is unable to pass through it. The tap keeps pumping, but the water cannot pass beyond your foot, which is blocking the hose. As the pressure from the tap builds, the portion of the hose before the blockage swells with backed-up water. If you don't step away, the pent-up pressure will eventually cause the hose to break open and start leaking. This is approximately what happens with a bowel obstruction in your body.
What Are the Causes?
A bowel obstruction can be caused in a couple of different ways:
- Physical obstruction - In the garden hose analogy, this is your foot on the hose. This type of obstruction is usually called a dynamic or mechanical obstruction. This can be caused by scar tissue, a tumor, or by twisting of the intestines.
- Adynamic obstruction - This occurs when the intestinal, or peristaltic, muscles aren't working properly. Peristalsis is the process that helps move material through the digestive tract. This type of obstruction is also called paralytic ileus, or simply an ileus. This can be caused by a severe electrolyte imbalance, an infection in the bowel, or the manipulation of the intestine during surgery.
When to See a Doctor
If you experience any worrying symptoms, do not ignore them! See a doctor immediately. If it is indeed an obstruction, it can very quickly turn into an emergency situation.
Signs and Symptoms
- Swollen stomach
- Cramping and abdominal pain
- Nausea and vomiting
- Distention of the abdomen
- Inability to pass gas
- Dryness of the mouth with a decrease in urine output
- Muscle cramps
- Stoma patients: minimal or no stoma output
In the case of a mechanical (dynamic) blockage, the intestinal muscles still work normally—and in fact those muscles work even harder to try to push the material past the blockage. These strong muscle contractions, or peristaltic waves, cause increasing cramps and pain as the pressure builds up. As a result, the intestine before the blockage can and will collapse on top of itself. When this happens, the peristaltic waves reverse direction as the bowel tries to empty its contents and relieve some of the pressure. This material then moves up through your system and comes out via vomiting.
Blockages in the large intestine usually occur gradually. By contrast, a blockage in the small intestine can occur quickly and without a lot of warning. However, in both cases, it is important to note that the body's natural balance of minerals, such as sodium and potassium, can quickly become upset, causing rapid dehydration.
The symptoms of an ileus are the same as the mechanical bowel obstruction; however, the abdomen and intestines will sound very quiet because the muscles aren't contracting normally.
There are many causes of bowel obstruction. If you experience any worrying symptoms, do not ignore them! If it is indeed an obstruction, it can very quickly turn into an emergency situation. If your pain becomes severe, you are suffering from vomiting, dehydration, and muscle cramps, and if the symptoms have lasted for more than eight hours, you should seek medical help immediately.
Partial vs. Complete Obstruction
A bowel obstruction can be one of two types:
- Partial - A partial obstruction is when a small amount of fluid, or some other intestinal contents, can work its way around the the blockage. Symptoms include abdominal pain, cramping, and watery output that also has an unpleasant odor. There will also be abdominal distention. Nausea and vomiting will likely be present. Stoma patients may see swelling of the stoma.
- Complete - A complete obstruction is when nothing can get past the blockage. Symptoms include cramping, abdominal pain, nausea, and vomiting. Stoma patients will see swelling of the stoma.
What If I Have an Ileostomy or a Colostomy?
It is interesting to note that a bowel obstruction can occur in either the large or the small intestine, which means that people with ileostomies and/or colostomies can also experience a bowel obstruction.
If there is a partial obstruction, in which a small amount of fluid or intestinal contents can work its way around the the blockage, you might see some discharge, or mucus-type output, come out of your stoma.
In the case of a complete obstruction, there would be an absence of anything coming out of your stoma.
What You Should Do If You Suspect a Bowel Obstruction
- Stop eating solid foods.
- Increase fluid intake.
- Soak in a warm bath to relax the abdominal muscles.
- Massage your abdomen or try putting your knees up against your chest.
- Call your doctor if the pain becomes very severe, or if you have symptoms of dehydration, regardless of whether or not the symptoms have not been present for eight hours.
- Have someone drive you to your doctor or to the hospital.
- Stoma patients: If your stoma has become swollen, you should remove your pouch and replace it with one that has a large opening for your stoma.
- Don't eat solid food.
- Don't take any laxatives or other medication without consulting with your doctor first.
- If you are vomiting, or if you haven't passed anything through your bowel, don't eat or drink anything at all.
- Don't wait too long before your seek medical intervention.
- Stoma patients: Don't insert anything at all inside the stoma (unless otherwise instructed by a doctor or healthcare professional.
Diagnosis and Treatment
Diagnosis often involves an X-ray, CT scan, or ultrasound of the abdomen to determine the location and source of the obstruction.
Once the condition has been diagnosed, treatment typically includes the following:
- Intravenous therapy in order to replace the fluids and electrolytes you have lost through vomiting.
- Pain relief.
- Sometimes, a nasal tube is inserted in order to relieve built-up pressure in the intestines. This tube may also be used to relieve the source of the blockage.
- In severe cases, surgery may be required.
My Personal Experience
One afternoon I felt quite sick with abdominal cramping. I realized that my ileostomy pouch (bag) had less content in it than it had the last couple of times I'd checked. I also noticed that my stomach looked bigger than usual. I could hear and feel my stomach churning. Occasionally, the churning felt overwhelming, and I experienced some cramps that made me feel very sweaty and nauseous.
As the day progressed, the pain worsened. That night the cramps became even more severe, and I began to vomit. I also realized that by this point, nothing was coming into my pouch at all. I felt quite dreadful, and I wondered what on earth could be wrong with me.
I can honestly say, from my own personal experience with several bowel obstructions, that the sooner you identify the symptoms and seek treatment, the better. When you start to feel that first pain and the distention of your abdomen that usually accompanies it, you should act on it. Any delay in seeking medical treatment could cost you dearly.
I hope that by sharing my story I can encourage others to see a doctor as soon as they recognize the symptoms of a possible bowel obstruction. Save yourself from experiencing any more pain than necessary!