What Is a Bowel Obstruction—and Should You Be Worried?
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Medically reviewed by Robert Burakoff, MD
Bowel obstruction occurs when the small or large intestine (colon) becomes partly or completely blocked. This prevents food, fluids, gas, and stool from passing through the digestive tract. Scar tissue (adhesions) from previous surgeries, hernias, tumors, and inflammatory bowel disease (IBD) are common causes of bowel obstruction. Symptoms include abdominal pain, bloating, constipation, and vomiting.
Bowel obstruction treatment depends on the severity and cause of the obstruction. Medications and intestinal decompression may treat a partial obstruction. Complete bowel obstruction is a medical emergency that requires surgery to remove the blockage. Bowel obstruction can affect people of all ages. It's one of the most common reasons for emergency surgeries in the United States.
Types
Bowel obstructions are often categorized based on:
The location of the blockage (small intestine or large intestine)
Whether the blockage is partial or complete
Healthcare providers determine the most effective treatment based on the type of bowel obstruction.
Small Intestine vs. Large Intestine Obstruction
Small intestine obstructions are the most common type of bowel obstruction. The small intestine breaks down food, absorbs nutrients, and moves food along the digestive tract to the large intestine. A blockage in the small intestine can lead to symptoms like crampy abdominal pain, bloating, and vomiting.
About 25% of bowel obstructions occur in the large intestine. The large intestine (colon) absorbs water and electrolytes from food waste and forms the remaining contents into stool that passes through the rectum and anus. Obstruction in the large intestine can cause abdominal discomfort, constipation, and inability to pass gas.
Partial vs. Complete Bowel Obstruction
Small and large bowel obstructions can be partial or complete. If you have a partial bowel obstruction, some liquids and gas can pass through the obstruction. If you have a complete bowel obstruction, nothing can pass through.
About 85% of complete small-bowel obstructions require surgery, while about 85% of partial small-bowel obstructions resolve with other treatments.
Bowel Obstruction Symptoms
Bowel obstruction symptoms may develop gradually or begin suddenly. Symptoms vary in severity based on the type of obstruction and whether the intestine is partially or entirely blocked.
Small Intestine Obstruction Symptoms
Symptoms of a blockage in your small intestine usually develop suddenly and may include:
Abdominal pain or cramping, especially in the upper to mid-abdominal area
Vomiting, which may include vomiting green bile
Bloating, or a feeling of fullness in your abdomen
Abdominal distension (enlargement)
Loss of appetite
Rapid heart rate
Large Intestine Obstruction Symptoms
Symptoms of a blockage in your large intestine may develop gradually and tend to be milder than small intestine obstructions. Common symptoms include:
Abdominal pain, especially in the lower abdomen
Pressure or feeling of heaviness in the lower abdomen
Constipation
Inability to pass gas
Bloating or abdominal distention (swelling)
Vomiting (usually hours after other symptoms develop)
Loud, high-pitched abdominal sounds
Partial vs. Complete Bowel Obstruction Symptoms
Symptoms of a partial bowel obstruction may come and go for days or weeks and usually worsen over time until they're treated. Partial bowel obstructions may cause:
Colicky abdominal pain (severe, intermittent cramping)
Diarrhea
Excessive flatulence (gas)
A complete bowel obstruction is a medical emergency that requires immediate treatment. You will likely experience a sudden onset of severe symptoms, such as:
Severe, sudden abdominal pain
Inability to pass gas or stool
Loss of appetite
Causes
A bowel obstruction may have a mechanical or functional cause. Healthcare providers can determine the most effective treatment based on the type and cause of obstruction.
Mechanical Bowel Obstruction Causes
A mechanical bowel obstruction occurs when a physical barrier restricts the normal flow of food, fluids, and waste through the intestines. Common causes of mechanical bowel obstructions include:
Hernia: This condition occurs when a portion of the intestine protrudes through a weakened abdominal wall.
Adhesions: Scar tissue on the intestine that forms after surgery or due to intestinal inflammation can cause an obstruction.
Tumors: Both benign (non-cancerous) and malignant (cancerous) tumors can cause a blockage when inside the intestines or on a nearby structure in the abdominal cavity.
Hard objects: Foreign objects (non-food items) and large, hard stools can get stuck in the intestines.
Intussusception: This condition occurs when one part of the intestine telescopes (folds) into another, shortening the bowels and causing a blockage.
Parasitic infection: Though rare, parasitic worms can collect in the intestines and cause a blockage.
Impacted stool: Stool hardens and remains in the rectum, often due to long-term constipation.
Structural changes to the intestines: For example, volvulus is a condition that occurs when a loop in the intestine twists around itself.
Related: How Long Can You Go Without Pooping?
Functional Bowel Obstruction Causes
A functional bowel obstruction—also known as ileus, paralytic ileus, or pseudo-obstruction—occurs when intestinal muscles do not function effectively even though there's no physical blockage. This impairs the flow of intestinal contents.
Common causes of functional bowel obstruction include:
Paralytic ileus: Muscles that move food through the intestines become paralyzed.
Intestinal or abdominal infections: For example, appendicitis is an abdominal infection that occurs when the appendix, a small finger-shaped pouch attached to the large intestine, becomes inflamed. Bacteria or viruses can cause intestinal infections like gastroenteritis (e.g., food poisoning or a stomach virus).
Certain medications: Drugs like narcotics (opioid pain relievers) and antipsychotics (used to treat psychosis, a condition that occurs when someone experiences a loss of contact with reality) can impair muscle function in the intestines.
Ischemia: Decreased blood flow to the bowels can restrict or stop movement of the intestinal muscles.
Nutritional deficiencies: Lack of essential minerals or electrolyte imbalances (e.g., potassium) can lead to bowel obstruction. Electrolytes are electrically charged minerals in blood, sweat, and urine that help regulate the nervous system, hydration, muscle function, and blood pH.
Underlying medical conditions: For example, many people with kidney disease have chronic constipation, which can lead to a bowel obstruction.
Risk Factors
People of all ages can be affected by bowel obstructions. However, certain factors may increase your risk. These include:
History of hernias
Previous abdominal surgery
Nutritional deficiencies
Inflammatory conditions, such as Crohn’s disease—a type of inflammatory bowel disease (IBD) that causes inflammation in the gastrointestinal (GI) tract
History of certain cancers, such as colon cancer, ovarian cancer, or stomach cancer
Consuming non-food items
Diagnosis
Diagnosing bowel obstruction involves assessing your medical history and doing a physical examination and diagnostic testing. Your healthcare provider might refer you to a gastroenterologist, a medical doctor who specializes in conditions related to the digestive system.
Your provider will check for signs of bloating and listen to your abdomen with a stethoscope. Your bowel will typically make gurgling sounds, but your provider may also hear high-pitched sounds or no sounds. They will also palpate (touch) your belly to check for tenderness or pain.
Possible diagnostic tests include:
Abdominal X-ray: This imaging test helps visualize any blockages or abnormalities in the digestive tract.
Computed tomography (CT) scan: This imaging test provides detailed images to identify the location and extent of the obstruction.
Barium enema: An enema is a process where fluids are injected into the rectum (lower part of the large intestine) to cleanse the colon, stimulate defecation, or administer medication. A contrast liquid (barium) given through an enema highlights the large intestine on X-rays, helping identify blockages.
Colonoscopy: A flexible tube with a camera is inserted into the rectum to examine the colon and detect tumors, polyps, or other obstruction causes.
Blood tests: Blood work can help check for electrolyte imbalances, infection, and other factors related to bowel obstruction.
Bowel Obstruction Treatment
Bowel obstruction requires prompt medical treatment to help restore proper intestinal function and prevent complications. Most bowel obstructions are treated in the hospital, and treatment approaches vary based on the cause and location of the blockage.
Medications
Intravenous (IV) fluids and medicines can restore the balance of electrolytes in your body and help you stay comfortable. If hard, large stool is causing an obstruction, enemas or stool softeners can help soften stool and relieve the blockage. If you have an infection or the blockage caused a perforation (hole) in your bowel, you will be treated with antibiotics.
Intestinal Decompression
A flexible tube, called a nasogastric tube, is inserted through your nose and into your digestive tract. The tube removes fluids and gas from your intestines to relieve pressure and pain. You will not be able to eat or drink during this treatment, as this can worsen the obstruction.
Colonic Stent
A stent is a tubular structure made of a flexible and expandable material. This is inserted into your colon to relieve the blockage. Once in place, the stent expands, allowing stool, gas, and fluids to move through the blocked area. Colonic stents are useful when surgery poses higher risks or when immediate intervention is necessary.
Surgery
Bowel obstruction surgery is typically done by a colorectal surgeon—a surgeon who specializes in conditions that affect the large intestine. Surgery is necessary in cases of complete obstruction or when non-surgical treatment methods are ineffective. Surgery for bowel obstruction includes:
Removal of the bowel obstruction
Bowel resection, which involves removing damaged intestinal tissues and stitching the remaining intestines together with stitches or staples
You may need a colostomy or ileostomy if your obstruction requires a bowel resection and the remaining intestines cannot be reconnected. Both procedures involve forming a small opening in the abdomen, called a stoma, and bringing the remaining part of the intestine to the surface of the stomach. Waste products are collected in a pouch attached to the stoma outside of your body.
Colostomies and ileostomies can be temporary or permanent, depending on how much of the intestine was removed during the bowel resection.
Prevention
Bowel obstruction is not always preventable, as many causes are outside your control. While there are no guaranteed ways to prevent bowel obstruction, certain habits may help lower your risk:
Drink 8-10 cups of fluids (e.g., water) daily. Daily water recommendations vary slightly based on various factors.
Eat smaller meals throughout the day, chew foods well, and eat at a relaxed pace.
Take a daily multivitamin with mineral supplements to help ensure you get the nutrients your body needs.
Manage digestive conditions. For example, follow your treatment plan if you have IBD.
Related: Best Foods for Crohn's Disease
Complications
Untreated bowel obstruction can lead to complications resulting from trapped fluids, gas, and stool buildup. Possible bowel obstruction complications include:
Bowel perforation: Pressure in the blocked intestine can cause it to rupture, leading to a dangerous leakage of its contents into the abdominal cavity.
Infection: Accumulated waste and fluids can create an environment conducive to bacterial growth, potentially causing infection within the abdomen. Possible infections include a life-threatening condition known as peritonitis.
Electrolyte imbalance: Obstruction can disrupt the balance of essential minerals in the body, leading to electrolyte imbalances that can affect your overall health.
Gangrene: Tissue death (gangrene/necrosis) can occur if a bowel obstruction disrupts or stops blood supply to the intestine.
Recognizing the symptoms of bowel obstruction and seeking prompt treatment is the best way to prevent complications.
A Quick Review
Bowel obstruction occurs when your small or large intestine becomes partly or completely blocked. This prevents food, fluids, gas, and stool from passing through the digestive tract. It can lead to symptoms like abdominal pain, bloating, constipation, nausea, vomiting, or diarrhea.
Most bowel obstructions are treated in a hospital. Treatment may include intestinal decompression or surgery, depending on the location and severity of the obstruction. Some bowel obstructions are medical emergencies requiring immediate surgery.
Contact a healthcare provider if you have symptoms of a bowel obstruction. Prompt diagnosis and treatment can reduce the risk of complications.
Frequently Asked Questions
Can you still poop with a bowel obstruction?
You may still be able to poop with a bowel obstruction, depending on whether the intestine is partially or completely blocked. You may pass small amounts of stool or experience diarrhea with a partial obstruction.
How can you tell the difference between a bowel obstruction and constipation?
Constipation and bowel obstruction both involve changes in bowel habits, but an obstruction typically causes more severe symptoms. With a bowel obstruction, you may experience intense abdominal pain, vomiting, and the inability to pass gas or poop.
What foods should you avoid if you have a bowel obstruction?
Your healthcare provider may recommend a low-fiber, low-fat diet if you have a bowel obstruction. High-fiber foods like beans, whole grains, raw vegetables, nuts and seeds, and fatty meats are harder to digest and may worsen the obstruction. In some cases, your healthcare provider may recommend liquid meals and dietary supplements. Talk to your healthcare provider for guidance on foods to eat and avoid with a bowel obstruction.
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