Small bowel obstruction means the small intestine is partially or totally blocked. When this happens, the contents of the intestine cannot properly get out of the body. Stools, fluid, and gas build up inside the intestine. This is a potentially serious condition that requires urgent medical care.
Bowel obstruction may be caused by a mechanical problem. In this case, something inside the body blocks the movement of material through the intestine.
It can also be caused by an ileus, which is when the intestine itself does not work right. This nonmechanical type of obstruction is called paralytic ileus, or pseudo-obstruction. It is often the cause of obstruction in infants and children.
Mechanical small bowel obstruction may be caused by:
Paralytic ileus may be caused by surgery on the intestine or certain medications, such as opioids.
Factors that may increase your chance of having a small bowel obstruction include:
Symptoms of small bowel obstruction often occur in combination. Small bowel obstruction may cause:
Paralytic ileus pain is often less severe than mechanical small bowel obstruction.
You will be asked about your symptoms and medical history. A physical exam will be done. The exam will include listening for bowel sounds in your stomach. Very high pitched bowel sounds heard through a stethoscope suggest mechanical bowel obstruction. Conversely, paralytic ileus often produces no bowel sounds.
Imaging tests are used to evaluate abdominal structures. These may include:
Treatment depends on the cause and severity of the obstruction. You will usually require treatment by a specialist. Your doctor will also treat you for any underlying conditions that contribute to small bowel obstruction.
Before any surgical treatment or procedure can begin, you may need to be stabilized. This may include:
After the blockage is relieved, nutrition is given through an IV or feeding tube until you are able to eat solid foods. Other treatment for small bowel obstruction includes:
Medications may include:
Surgery may be needed if you do not respond to medical treatment, or in the following circumstances:
National Cancer Institute
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Association of Gastroenterology
Crohn's and Colitis Foundation of Canada
Abdominal adhesions. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/abdominal-adhesions/Pages/facts.aspx. Updated September 11, 2013. Accessed December 18, 2014.
Baron TH. Acute colonic obstruction. Gastrointest Endosc Clin N Am. 2007;(17)2:323-329.
Bonin EA, Baron TH. Update on the indications and use of colonic stents. Curr Gastroenterol Rep. 2010;12(5):374-382.
Gastrointestinal complications—for health professionals (PDQ). National Cancer Institute website. Available at: http://www.cancer.gov/about-cancer/treatment/side-effects/constipation/gi-complications-hp-pdq. Updated August 28, 2014. Accessed December 18, 2014.
Intestinal pseudo-obstruction. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/intestinal-pseudo-obstruction/Pages/facts.aspx. Updated February 26, 2014. Accessed December 18, 2014.
Kulaylat MN, Doerr RJ. Small bowel obstruction. Available at: http://www.ncbi.nlm.nih.gov/books/NBK6873. Published 2001. Accessed December 18, 2014.
Small bowel obstruction. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116815/Small-bowel-obstruction. Updated April 2, 2014. Accessed December 18, 2014.
4/7/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116815/Small-bowel-obstruction: Katz DS, Baker ME, Rosen MP, et al. Suspected small bowel obstruction. American College of Radiology (ACR) Appropriateness Criteria. Available at: http://www.acr.org/~/media/832F100277004BC69A8C818C7C9BFF33.pdf. Updated 2013. Accessed December 18, 2014.
Last reviewed December 2015 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.