From the Guidelines
Bowel obstruction symptoms include abdominal pain, bloating, nausea, vomiting, constipation, and inability to pass gas, and if left untreated, can lead to serious complications like bowel tissue death or perforation, thus requiring immediate medical attention. The pain typically comes in waves and may be severe, as noted in a narrative review on bowel obstruction for all physicians 1. Early symptoms often include cramping around the belly button, while later symptoms can progress to constant pain, visible abdominal swelling, and vomiting that may contain fecal matter. Complete obstruction usually presents with no bowel movements or gas passage, while partial obstruction might allow some stool or gas to pass. Other symptoms include loud bowel sounds early on (which may later become quiet), bad breath, dehydration signs like dry mouth and decreased urination, and rapid heartbeat. These symptoms occur because the blockage prevents normal movement of intestinal contents, causing backup and distension of the bowel, as discussed in a review on bowel obstruction management 1.
Some key points to consider in bowel obstruction symptoms include:
- The etiology of bowel obstruction, which can be based on a mechanical intrinsic luminal obstruction or extrinsic compression 1
- The high morbidity and mortality associated with bowel obstruction, accounting for nearly 30,000 deaths and more than $3 billion per year in direct medical costs 1
- The importance of prompt treatment to prevent serious complications, as bowel obstruction is a medical emergency that can lead to bowel tissue death or perforation if not promptly treated. Given the potential severity of bowel obstruction, it is crucial to seek immediate medical attention if symptoms persist or worsen over time, as noted in the review on bowel obstruction for all physicians 1.
From the Research
Bowel Obstruction Symptoms
Bowel obstruction symptoms can vary, but the most reliable findings include:
- Prior abdominal surgery
- History of constipation
- Abdominal distension
- Abnormal bowel sounds 2 Signs of strangulation include:
- Fever
- Hypotension
- Diffuse abdominal pain
- Peritonitis 2
Diagnosis and Management
Diagnosis typically requires imaging, and computed tomography and ultrasound are reliable diagnostic methods 2 Management includes:
- Intravenous fluid resuscitation
- Analgesia
- Determining need for operative vs. nonoperative therapy 2
- Nasogastric tube is useful for patients with significant distension and vomiting by removing contents proximal to the site of obstruction 2
- Surgery is needed for strangulation and those that fail nonoperative therapy 2, 3
Malignant Bowel Obstruction
Malignant bowel obstruction is a highly symptomatic, often recurrent, and sometimes refractory condition in patients with intra-abdominal tumor burden 4 Medical therapy with octreotide, dexamethasone, and metoclopramide may improve symptoms and bowel function in patients with malignant bowel obstruction 4, 5, 6 However, the effectiveness of this "triple therapy" is still being studied, and more research is needed to determine its efficacy 6