A bowel obstruction is a serious condition that requires immediate medical attention. If left untreated, the intestine can rupture and leak its contents, causing inflammation and infection of the abdominal cavity and its lining (peritoneum), a condition called peritonitis.

Treatment of a bowel obstruction usually begins immediately after a diagnosis has been confirmed, and hospitalization of the patient is always required. Treatment will depend on the underlying cause and type of obstruction. In the case of partial obstructions, nonsurgical treatments are usually the first line of treatment.

For a partial obstruction, a physician will typically perform a nasogastric aspiration. During this procedure, a long, thin nasoenteral tube is inserted through a patient’s nose and placed in the stomach or intestine. Suction is then applied to the tube to remove substances (e.g., food, gas, fluids) that have accumulated above the blockage. If the obstruction is in the colon, however, a physician will insert a colorectal tube through the rectum into the colon to relieve pressure. The nasoenteral or colorectal tube may decrease swelling and remove fluid and gas build-up.

Other types of treatment for a partial obstruction include the use of liquids (enemas), small mesh tubes (stents for malignancy) or medications (e.g., dexamethasone for inflammation) to open up the blockage. For example, fecal impaction is often treated by moistening and softening the stool with an enema. Sometimes, patients may need to have stool manually removed from the rectum after it is softened. Glycerin suppositories may also be administered to assist in the manual removal of feces. In some cases, a bowel obstruction resolves without further treatment. The patient is also administered fluids and electrolytes intravenously (into a vein) to restore water and salts lost through vomiting or diarrhea. It should be noted that the patient is not allowed to eat or drink anything until intestinal function normalizes or resumes. Patients are provided nutrition through a vein (parenteral nutrition) until the bowel function returns.

Surgery (laparotomy), however, is almost always necessary for a complete or strangulating obstruction (when blood flow is cut off to the intestine). Surgery is performed while the patient is under general anesthesia (agent that eliminates pain and sensation and induces unconsciousness). A physician will make an incision in the patient’s abdomen. Then the site of the bowel obstruction is located and the obstruction is relieved. Procedures to prevent recurrence of a bowel obstruction are also performed during laparotomy. These include the repair of hernias, removal of foreign bodies and complete removal of adhesions if present.

During a laparotomy, a physician will also examine the intestine for any signs of injury or ischemia (lack of blood flow). If necessary, the surgeon will remove injured or strangulated sections of the intestine and stitch the healthy ends of the intestine together, a procedure that is called resection. If resection is not possible, a physician will perform ostomy surgery, a procedure that involves bringing out the ends of the intestine through an opening created in the abdomen. Stool can then pass through this hole into an ostomy pouch.

In the case of patients with advanced cancer with chronic bowel obstruction, a physician may insert a gastrostomy tube through the wall of the abdomen directly into the stomach. A gastrostomy can relieve excess gas and fluid in the stomach.

Some patients who undergo surgery for bowel obstruction will experience complications including bowel leaks, formation of scar tissue (adhesions) and temporary paralysis of the bowels (pseudo-obstruction). In some cases, surgery to repair bowel obstruction can cause bowel obstruction. Surgery for bowel obstruction also carries the typical risks associated with any surgery, such as bleeding and infection. Patients also may have a reaction to anesthesia, including breathing problems.

Recovery time after surgery for bowel obstruction varies from patient to patient and will depend greatly on the type of procedure performed.

Prognosis is generally favorable for patients who receive proper – and timely – diagnosis and treatment of a bowel obstruction, especially if they are otherwise healthy.