A large bowel (large intestine) obstruction is a blockage that keeps gas or stool from passing through the body. An intestinal blockage can occur anywhere in the large intestine.
The large bowel obstruction may block the bowel completely or partially. A blocked intestine may rupture, causing a life-threatening infection.
What are the symptoms of large bowel obstruction?
You may have sharp stomach pains that come in waves. Eventually, the pain becomes constant. You may also have one or more of these symptoms:
Infants and children experience the same symptoms as adults. Infants can’t tell you where it hurts, but they may pull their legs up toward their bellies and cry. Other symptoms of bowel obstructions in children include:
What are the complications of large bowel obstruction?
A bowel blockage can stop blood flow, causing part of the intestine to die. As pressure builds up from the blockage, intestinal bacteria can leak into the bloodstream.
You may develop peritonitis, an abdominal infection. You are also at risk for a life-threatening system-wide infection called sepsis.
Your healthcare provider may surgically remove a segment of dead intestine (colectomy). In that case, you may need a colostomy. With a colostomy, poop empties into a sealed bag outside your body.
How is a large bowel obstruction managed or treated?
A large bowel obstruction is a medical emergency. It requires hospitalization. Partial bowel obstructions, especially those due to scarring or adhesions, may clear up without much medical help.
Treatments for large bowel obstructions include:
IV fluid replacement: IV fluids and electrolytes (sodium, chloride and potassium) treat dehydration.
Medications: Anti-nausea medicine and pain relievers can keep you more comfortable.
Nasogastric tube: Your healthcare provider inserts a long, thin tube through your nose. The tube reaches into the stomach or intestine. It suctions out fluids backed up from the blockage.
Barium enema: The same endoscopic procedure to detect a blockage can also treat some problems, such as a twisted intestine.
Surgery: Your healthcare provider may remove adhesions or tumors that are causing a blockage. Or surgery can fix a hernia. Your provider may place a stent (a mesh tube) to keep the intestine open. Rarely, a provider must remove a segment of the damaged or dead intestine.
How is a large bowel obstruction diagnosed?
Your healthcare provider will perform a physical exam to check for a swollen abdomen or masses. Usually, the stomach isn’t tender to touch.
Your healthcare provider will use a stethoscope to listen to the intestines. Loud or high-pitched bowel sounds or a quiet bowel may indicate a problem.
Your provider may order these tests:
Blood tests: A blood test checks for signs of infection and dehydration.
X-rays: Abdominal X-rays can show a bowel blockage’s location. These images can also show air around the intestine or diaphragm (the muscle that separates the stomach and chest). Air in these places can indicate a dead bowel or rupture.
CT scan: If x-rays reveal a problem, your provider may perform a CT scan. This imaging procedure provides more detailed photos than x-rays.
Barium enema x-ray: A barium enema x-ray is a lower gastrointestinal (GI) exam. While you are sedated with anesthesia, a provider inserts a catheter (thin tube) into the anus. The catheter fills the intestine with a safe, white barium liquid. This liquid travels through the intestine while a machine takes x-rays.
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