What are the signs of bowel obstruction?

From the Guidelines

Bowel obstruction typically presents with abdominal pain, often crampy and intermittent, which may become constant as the condition worsens, along with nausea and vomiting, especially vomiting undigested food or bile, and the inability to pass gas or have bowel movements. Other key signs include abdominal distension (swelling), tenderness upon touch, loud gurgling sounds or high-pitched tinkling bowel sounds, while others may have silent bowels upon examination 1. Fever, rapid heart rate, and dehydration can develop as complications arise. The severity and combination of symptoms depend on the location and completeness of the obstruction. Small bowel obstructions typically cause more severe vomiting and central abdominal pain, while large bowel obstructions may present with more significant distension and constipation. According to the most recent evidence, bowel obstruction is a serious medical emergency requiring prompt medical attention, as delayed treatment can lead to bowel tissue death, perforation, or systemic infection 1.

Key Signs and Symptoms

• Abdominal pain, often crampy and intermittent
• Nausea and vomiting, especially vomiting undigested food or bile
• Inability to pass gas or have bowel movements
• Abdominal distension (swelling)
• Tenderness upon touch
• Loud gurgling sounds or high-pitched tinkling bowel sounds
• Silent bowels upon examination
• Fever, rapid heart rate, and dehydration as complications arise

Importance of Prompt Medical Attention

Bowel obstruction can lead to severe complications if not treated promptly, including bowel tissue death, perforation, or systemic infection 1. Therefore, it is crucial to seek medical attention immediately if symptoms persist or worsen over time. The management of bowel obstruction may involve conservative treatment, such as nasogastric suction and fluid replacement therapy, or surgical intervention, depending on the severity and cause of the obstruction 1.

Location and Completeness of the Obstruction

The location and completeness of the obstruction can affect the severity and combination of symptoms. Small bowel obstructions typically cause more severe vomiting and central abdominal pain, while large bowel obstructions may present with more significant distension and constipation 1. Understanding the location and completeness of the obstruction is essential for guiding treatment and management.

From the Research

Signs of Bowel Obstruction

The signs of bowel obstruction can vary, but common symptoms include:

• Nausea and vomiting 2, 3, 4
• Abdominal pain 2, 3, 5, 6
• Constipation 3, 5
• Abdominal distension 5
• Abnormal bowel sounds 5
• Fever, hypotension, diffuse abdominal pain, and peritonitis may indicate strangulation 5, 6

Diagnostic Signs

Diagnostic signs that may indicate the need for urgent surgery include:

• Signs of ischemia 6
• Closed loop obstruction 6
• Single transition point 6
• Complications such as strangulation and ischemia of the obstructed bowel loop 6

Specific Signs of Malignant Bowel Obstruction

Malignant bowel obstruction may present with additional signs, including:

• Poor performance status 4
• Intra-abdominal carcinomatosis 4
• Massive ascites 4
• High obstruction 4

Imaging and Diagnosis

Imaging studies, such as computed tomography (CT) and ultrasound, are reliable diagnostic methods for bowel obstruction 5, 6, 4. Multidetector computed tomography (MDCT) can help identify the cause of the obstruction, determine the presence of a single transition point or closed loop, and seek signs of complications 6.