What are the symptoms of a bowel obstruction (intestinal obstruction)?

From the Guidelines

Bowel obstruction symptoms include abdominal pain, severe bloating, vomiting, constipation, and inability to pass gas, and require immediate medical attention to prevent severe morbidity and mortality. The symptoms of bowel obstruction can vary depending on the location and completeness of the blockage, but typically include abdominal pain that comes in waves, severe bloating, vomiting, constipation, and inability to pass gas 1. The pain typically worsens after eating and may be accompanied by a visibly distended abdomen. Early signs might include cramping and intermittent pain, while complete obstruction causes constant, severe pain 1. Vomiting often contains bile or fecal matter in later stages. Patients may notice decreased or absent bowel movements and may develop fever, rapid heart rate, and dehydration as the condition progresses.

These symptoms occur because the intestinal blockage prevents normal passage of digestive contents, causing backup and distension of the bowel. The severity depends on the location and completeness of the blockage. Bowel obstruction is a medical emergency requiring immediate attention, as it can lead to tissue death, perforation, and life-threatening infection if untreated 1. Anyone experiencing these symptoms should seek emergency medical care immediately rather than attempting home remedies. Key signs that indicate a patient may be in critical conditions include abnormal vital signs, such as tachycardia, tachypnea, cool extremities, mottled or cyanotic skin, slow capillary refill, and oliguria 1.

Some important laboratory tests to diagnose bowel obstruction include a complete blood count, renal function and electrolytes, and liver function tests 1. Low serum bicarbonate levels, low arterial blood pH, high lactic acid level, marked leukocytosis, and hyperamylasemia may be useful in the diagnosis of intestinal ischemia. A coagulation profile should also be tested because of the potential need for emergency surgery 1. It is crucial to seek medical attention immediately if symptoms persist or worsen over time, as prompt treatment can significantly improve outcomes and reduce the risk of complications.

From the Research

Symptoms of Bowel Obstruction

• The symptoms of bowel obstruction can vary, but common findings include:
  • Prior abdominal surgery
  • History of constipation
  • Abdominal distension
  • Abnormal bowel sounds 2
• Signs of strangulation, a serious complication of bowel obstruction, include:
  • Fever
  • Hypotension
  • Diffuse abdominal pain
  • Peritonitis 2, 3
• Other symptoms that may be present in patients with bowel obstruction include:
  • Nausea
  • Vomiting
  • Colicky abdominal pain
  • Cessation of passage of flatus and stool 4
• Laboratory evaluation and imaging studies, such as abdominal radiography or computed tomography, can help confirm the diagnosis and guide treatment decisions 2, 3, 4

Diagnostic Criteria

• The diagnosis of bowel obstruction is typically made based on a combination of clinical, radiologic, and sonographic findings 5
• Imaging studies, such as computed tomography, can help identify the location and cause of the obstruction, as well as any signs of complications such as ischemia or perforation 3, 4
• A contrast agent swallow, such as Gastrografin, can be used to help diagnose and manage small-bowel obstruction 5

Treatment Options

• Treatment for bowel obstruction typically involves:
  • Intravenous fluid resuscitation
  • Analgesia
  • Nasogastric decompression
  • Bowel rest 2, 4
• Surgery may be necessary in cases where there is evidence of vascular compromise, perforation, or failure to resolve with nonoperative management 2, 4
• In some cases, a Gastrografin challenge may be used to help determine the need for surgical intervention 5