Small Bowel Obstruction

What is Small Bowel Obstruction?

From the moment you swallow food until you release the remains of your meal in a bowel movement, the entire digestive tract performs an amazing feat of moving the food through the organs by way of a special set of muscles that contract and expand. In fact, the sound you hear when your stomach growls is a result of the contractions that are going on as you digest food.

Small bowel obstruction is a potentially dangerous condition. There are a number of conditions in which the contractions of the bowel muscles make the process of moving the food very slow. These can be annoying and impact the quality of life.

There are two types of small bowel obstruction:

  • functional — there is no physical blockage, however, the bowels are not moving food through the digestive tract
  • mechanical — there is a blockage preventing the movement of food.

Funtional causes may include:

  • Muscle or nerve damage that may be the result of abdominal surgery, or disorders such as Parkinson's disease
  • Infections
  • Certain medications that paralyze the contractions. Strong narcotics have this effect.

There are also serious conditions which may require immediate intervention:

  • Hernias — probably the most common condition in children and adults, in which a small part of the intestine protrudes through another part of the body. Adhesions may also be a cause. Scar tissue can form that blocks the intestinal canal.
  • Inflammatory Bowel Disease — a condition in which the walls of the intestine become inflamed
  • Tumors in the intestine that impede the flow
  • A volvulus, or a twisting of the intestine
  • Intussusception, a condition in which a segment of the intestine collapses into itself

Symptoms of Small Bowel Obstruction

  • intermittent pain due to perstalsis
  • distension of the stomach depending on where the obstruction is located
  • vomiting
  • constipation
  • fever and a racing heart

Why you need to see a physician if you suspect you have a small bowel obstruction?

If a part of the intestine becomes twisted, blood flow to that portion may be reduced, and the blocked part may die. This is a very serious condition. Another serious condition can occur in which the intestine ruptures, leaking contents into the bowel cavity. This causes an infection known as peritonitis.

Your doctor may ask you these questions about your condition:

  • How long have you been experiencing this problem
  • Have you had this condition before? Did it clear up?
  • Did the pain arise quickly?
  • Is the pain constant?
  • Have you ever had surgery in the abdominal area?

Diagnosis of Small Bowel Obstruction

Usually all that is required to diagnos an obstruction of the small bowel is an x-ray of the abdomen.

  • Luminal contrast studies
  • computed tomography (CT scan)
  • ultrasonography (US)

Once the diagnosis of bowel obstruction is entertained, location, severity and etiology are to be determined. Most importantly is the differentiation between simple and complicated obstruction.

Treatment of Small Bowel Obstruction

  • Antiemetics are medications that keep you from throwing up
  • Analgesics are mild pain relievers
  • Antibiotics will attack any infection you may have
  • Bowel decompression is a procedure in which a tube is guided into the impacted area in an attempt to reduce the pressure and address adhesions.
  • Surgery

Complications of Small Bowel Obstruction

  • Abdominal abscesses are pockets of infected pus in the abdominal cavity
  • Sepsis, a condition in which the blood becomes infected
  • Short Bowel Syndrome is a condition that results in malabsorption of nutrients

Quick intervention is the best medicine for small bowel obstructions. Complications arise quickly, and require complex surgery. Early intervention results in favorable outcomes with few complications. See your doctor if you think you may be having a problem.