Also known as an intestinal obstruction, a bowel obstruction is a condition in which part of the bowel becomes blocked. Obstructions can be caused by hernias, impacted feces, diverticulitis, and volvulus (twisting of the colon). Crohn's disease and other types of inflammatory bowel diseases can also lead to bowel obstructions, and they may develop due to the presence of cancer in the colon. In adult patients, the most frequent causes of bowel obstructions are colon cancer and intestinal adhesions that may form after abdominal or pelvic operations. In pediatric patients, telescoping of the intestine (intussusception) is the most frequent cause of a bowel obstruction.
Doctors evaluate patients for possible bowel obstructions with a physical exam. During the exam, the physician will gently feel the abdomen for any lumps or tenderness, and they will use a stethoscope to listen for the presence of bowel sounds. X-rays, CT scans, ultrasounds, and air or barium enemas may be necessary to properly diagnose a bowel obstruction. Treatment normally requires hospitalization. Patients may have surgery to remove the blockage, and metal stents are sometimes needed.
Intermittent Abdominal Pain
Intermittent abdominal pain may occur during the early stages of a bowel obstruction. If the obstruction worsens, pain can become severe and persistent. Most patients describe the pain as a cramping sensation. To assess abdominal pain, doctors will ask the patient about when the pain began, how long it lasts, and if it occurs after eating or other activities. The doctor will also want to know whether the pain is sharp or dull and whether it occurs in a particular part of the abdomen or over a larger area. When going to an appointment for abdominal pain, patients might wish to bring a list of their current medications, and it can also help to keep a journal noting when painful episodes have occurred and any potential triggers for the pain.
The doctor will perform a full abdominal exam to find out more about the potential causes of the patient's pain. First, they will need to listen to the abdomen with a stethoscope to check bowel sounds are present and normal. The absence of bowel sounds is a potential indicator of a bowel obstruction. Next, the doctor will gently feel the patient's abdomen to check for lumps, hernias, or areas of pain that may provide clues as to the diagnosis. Depending on the results of the exam, imaging studies may be performed. Patients should always inform their healthcare team about any changes in their abdominal pain levels.