Intestinal Obstruction

Intestinal obstruction is a blockage that prevents the normal passage of food, fluid, and gas through the intestine. It is a surgical emergency, as prolonged obstruction can cut off blood supply to part of the bowel.

• Crampy abdominal pain that comes in waves
• Abdominal bloating and distension
• Vomiting, which may become faeces-like in prolonged obstruction
• Inability to pass stool or gas
• Loud or absent bowel sounds on examination, depending on the stage and cause

• Can result from a physical blockage, such as scar tissue (adhesions) from previous surgery, a hernia trapping a loop of bowel, a tumour, or twisting of the bowel (volvulus).
• Can also result from the bowel temporarily losing its normal muscular movement (a functional obstruction, or ileus), often after surgery, injury, or in the context of severe infection.
• Risk is increased by previous abdominal surgery, hernias, and certain bowel conditions.

• Diagnosed based on the characteristic pattern of colicky abdominal pain, distension, vomiting, and inability to pass stool or gas.
• Abdominal X-ray or ultrasound, where available, can show dilated loops of bowel and help confirm obstruction.
• Assessment for signs of bowel ischaemia (loss of blood supply) — such as severe, constant pain, fever, or signs of shock — is critical, as this changes the urgency of surgical intervention.

Intestinal obstruction requires urgent hospital admission for intravenous fluids, correction of electrolyte imbalances, and decompression of the bowel using a tube passed through the nose into the stomach to relieve pressure and vomiting.

Some cases, particularly those caused by adhesions without signs of bowel compromise, may initially be managed without surgery, with close monitoring for improvement.

Obstruction caused by a hernia, tumour, volvulus, or any case with signs of bowel ischaemia requires emergency surgery to relieve the blockage and remove any non-viable bowel tissue.

Close monitoring is essential throughout, as intestinal obstruction can deteriorate quickly if the blood supply to the bowel becomes compromised.

• Seek prompt medical care for persistent abdominal pain, especially with vomiting and inability to pass stool or gas.
• Report new abdominal symptoms promptly if you have had previous abdominal surgery, given the risk of adhesions.
• Seek timely treatment for hernias to reduce the risk of trapped bowel causing obstruction.
• Maintain regular bowel habits and seek care for persistent constipation.