Medicines for Bowel obstruction

What it is

Bowel (intestinal) obstruction is a blockage that partly or completely stops the normal passage of food, fluid, gas and waste through the intestines. It is a serious condition, because behind the blockage, the bowel fills up and stretches, and, if not treated, the bowel wall can be damaged (its blood supply can be affected) and, in severe cases, can burst (perforate), which is life-threatening. Obstruction can occur in the small or large bowel and has many causes: common ones include scar tissue (adhesions) inside the tummy from previous surgery, hernias (where a loop of bowel gets trapped), tumours (particularly in the large bowel), a twisting of the bowel (volvulus), inflammatory conditions, and, in children, other specific causes. The typical symptoms are: crampy tummy pain (often coming in waves), vomiting (which can become frequent, and in a low blockage may be feculent-smelling), a swollen, bloated tummy, and being unable to pass stool or wind (absolute constipation), depending on the level and completeness of the blockage. Because bowel obstruction can progress to serious complications, and needs prompt treatment, these symptoms — particularly the combination of tummy pain, vomiting, bloating, and not passing stool or wind — should prompt urgent medical assessment.

How it is treated

Bowel obstruction is a medical and often surgical emergency requiring urgent hospital assessment and treatment. In hospital, the diagnosis is confirmed and the cause and severity assessed with examination and imaging (such as X-rays or, commonly, a CT scan), and blood tests. Initial treatment usually involves: resting the bowel (stopping eating and drinking), giving fluids into a vein to correct dehydration and salt imbalances, and often passing a tube through the nose into the stomach to drain the built-up fluid and gas and relieve the pressure and vomiting ("drip and suck"). Pain relief and monitoring are provided. What happens next depends on the cause and severity: some obstructions (for example those due to adhesions, or a partial blockage) settle with this conservative treatment and careful monitoring; others need surgery — for example to release trapped bowel, repair a hernia, remove a tumour or twisted segment, or deal with bowel that has been damaged. Urgent surgery is needed if there are signs that the bowel's blood supply is compromised or it has perforated, as these are life-threatening. Treating the underlying cause and preventing recurrence are part of care. The reassuring message is that bowel obstruction, though serious, is treated effectively with prompt hospital care — resting and decompressing the bowel, correcting fluids, and surgery where needed — so the combination of tummy pain, vomiting, bloating and not passing stool or wind should prompt urgent assessment.