Small bowel obstruction means the small intestine is partially or totally blocked. When this happens, the contents of the intestine cannot properly get out of the body. Stools, fluid, and gas build up inside the intestine. This is a potentially serious condition that requires urgent medical care.
Bowel obstruction may be caused by a mechanical problem. In this case, something inside the body blocks the movement of material through the intestine.
It can also be caused by
ileus, a slowing down or stopping of bowel activity. Ileus is a nonmechanical type of obstruction, which may also be referred to as pseudo-obstruction.
Mechanical small bowel obstruction may be caused by:
Adhesions—scar tissue left behind, in most cases by previous abdominal surgery
Ileus pain is often less severe than mechanical small bowel obstruction.
You will be asked about your symptoms and medical history. A physical exam will be done. The exam will include listening for bowel sounds in your stomach. Very high pitched bowel sounds heard through a stethoscope suggest mechanical bowel obstruction. Conversely, ileus often produces no bowel sounds.
Imaging tests are used to evaluate abdominal structures. These may include:
Treatment depends on the cause and severity of the obstruction. You will usually require treatment by a specialist. Your doctor will also treat you for any underlying conditions that contribute to small bowel obstruction.
Before any surgical treatment or procedure can begin, you may need to be stabilized. This may include:
Monitoring and IV fluids—Observation at a hospital may be needed to see if the blockage will get better on its own. No food will be allowed and fluids will be given through an IV.
Nasogastric tube—A tube is inserted through the nose and into the stomach to remove fluids and gas, which can promptly relieve pain and pressure. It will be left in place until the intestines are working well.
Catheterization—A tube is placed in the bladder to drain and test urine.
After the blockage is relieved, nutrition is given through an IV or feeding tube until you are able to eat solid foods. Other treatment for small bowel obstruction includes:
Medications may include:
Oral triple therapy—to reduce gas, bloating, and improve symptoms
Muscle stimulants—to promote muscle contraction in the intestine
Antibiotics—to treat bacterial infections
Surgery may be needed if you do not respond to medical treatment, or in the following circumstances:
Intestinal strangulation, which may be caused by volvulus or intussusception
Abdominal adhesions. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/abdominal-adhesions. Updated September 2013. Accessed January 9, 2018.
Bonin EA, Baron TH. Update on the indications and use of colonic stents. Curr Gastroenterol Rep. 2010;12(5):374-382.
Gastrointestinal complications—for health professionals (PDQ). National Cancer Institute website. Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-hp-pdq. Updated May 10, 2017. Accessed January 9, 2018.
Intestinal pseudo-obstruction. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/intestinal-pseudo-obstruction/Pages/facts.aspx. Updated February 2014. Accessed January 9, 2018.
Kulaylat MN, Doerr RJ. Small bowel obstruction. Available at: https://www.ncbi.nlm.nih.gov/books/NBK6873. Accessed January 9, 2018.
Last reviewed November 2018 by
EBSCO Medical Review Board
Daus Mahnke, MD
Last Updated: 12/20/2014
EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
To send comments or feedback to our Editorial Team regarding the content please email us at email@example.com. Our Health Library Support team will respond to your email request within 2 business days.