Bowel Obstruction

A bowel obstruction occurs when the normal passage of food, fluid, and gas through the intestines is partially or completely blocked. Obstruction can affect the small bowel or the large bowel (colon) and may become an emergency if the bowel loses its blood supply or perforates.

Common symptoms include cramping abdominal pain, abdominal swelling, nausea or vomiting, inability to pass stool or gas, and dehydration.

Assessment is aimed at confirming the obstruction, identifying the cause, and determining urgency.

Clinical examination and assessment of hydration
Blood tests (infection markers, kidney function, electrolytes)
Imaging:
- Abdominal X-ray (sometimes)
- CT scan (commonly used to locate the blockage and determine the cause)
- Ultrasound in selected cases
In some cases, endoscopy may be required, particularly for large bowel obstruction.

Urgent assessment is required if pain is severe or worsening, there is fever, persistent vomiting, blood in stool, or signs of shock.

What to expect

Before Your Surgery

If an operation is planned or likely:
Authorization will be arranged by the rooms or hospital staff.
Fasting is required; in emergencies you may already be fasting due to vomiting.
Most chronic medications will be reviewed and adjusted.
Inform your doctor if you are taking blood-thinning medication.
You may require antibiotics and blood tests prior to theatre.

Day of Surgery

Bowel obstruction surgery is performed under general anaesthesia. You may have:

IV lines for fluids and medication
A nasogastric tube
A urinary catheter
Sometimes surgical drains, depending on findings

Post-operative monitoring focuses on pain control, bowel function, hydration, and infection prevention.

Procedure

Treatment depends on the location, cause, and severity of the obstruction.

Non-surgical management (selected cases)

Intravenous fluids and electrolyte correction
Bowel rest (nothing by mouth)
Nasogastric tube to decompress the stomach if vomiting or significant distension is present
Pain relief and anti-nausea medication
Close monitoring in hospital

Surgical or procedural treatment (when required)

Removal of the cause (e.g., adhesions, hernia repair, tumour resection)
Relief of the obstruction and assessment of bowel viability
In selected large bowel obstructions, endoscopic stenting may be used as a bridge to surgery or palliation
If the bowel is compromised, a segment may need to be removed and reconnected, or a stoma may be required

Procedure Length

If surgery is required, it typically takes 1–4 hours, depending on the cause and complexity.

Possible Complications

Bleeding
Infection
Injury to bowel or nearby organs
Bowel perforation or leak after repair/resection
Need for stoma formation (temporary or permanent)
Ongoing or recurrent obstruction
Blood clots (DVT/PE) or chest infection
Unintended damage to surrounding structures
Seek urgent medical care if symptoms worsen, pain becomes constant and severe, or there is fever, fainting, or inability to keep fluids down.

Duration of Hospital Stay

Hospital stay depends on severity and treatment:
Non-surgical management: often 2–5 days
Surgical management: typically 5–10 days or longer, depending on recovery and bowel function

Discharge Instructions

Follow dietary guidance (often gradual progression from liquids to soft foods).
Keep wounds clean and dry and follow dressing instructions.
Take prescribed medication as directed.
Walk daily and avoid prolonged bed rest.
Monitor for fever, worsening pain, vomiting, abdominal swelling, or inability to pass stool/gas.

Return to Activities

Gentle walking is encouraged soon after discharge.
Avoid heavy lifting and strenuous activity for 4–6 weeks after surgery.
Increase activity gradually as tolerated.

Bowel Obstruction

What to expect

Before Your Surgery

Day of Surgery

Procedure

Procedure Length

Possible Complications

Duration of Hospital Stay

Discharge Instructions

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