Abdominal pain, bloating, nausea. Sometimes these complaints hide intestinal obstruction: a partial or complete blockage of the small or large intestine. Below — how it manifests in adults, how the signs differ at different levels, and what exactly the doctor assesses.
Intestinal Obstruction: What It Is
Intestinal obstruction is a partial or complete disruption of the passage of food and its remnants through the intestine. A blockage slows movement or stops digestion. Food remnants, gases, and digestive juices accumulate above the obstruction and damage the intestinal tissue.
By level of involvement, a distinction is made between small bowel obstruction — which accounts for approximately 80% of cases — and large bowel obstruction, about 20%. By degree — complete and partial. There is also pseudo-obstruction: symptoms are present, but there is no mechanical obstruction.
The most common causes are adhesions after abdominal surgery, hernias, and intestinal tumors. Colon cancer is the leading cause of large bowel blockage. Less often, inflammatory bowel diseases, diverticulitis, and certain medications are responsible. Mechanical obstruction accounts for approximately 5–15% of cases of sudden severe abdominal pain that brings a person to the hospital.
Main Symptoms of Intestinal Obstruction
The classic set: severe pain or cramping spasms in the abdomen, vomiting, bloating, loud rumbling, an enlarged abdomen, inability to pass gas, constipation.
In small bowel blockage, pain initially comes in waves — short attacks every few minutes. Gradually it may become constant. Nausea and vomiting are added to the pain, appetite is lost, and general malaise appears. In partial blockage, diarrhea may occur.
A separate group is signs of dehydration: rapid pulse, dark urine, dry skin. This is a signal that every hour counts.
Partial Obstruction: How It Manifests
In partial blockage, the intestinal lumen is narrowed but not completely blocked. Stool and gas may pass — sometimes with difficulty, sometimes as liquid stool.
The difference is simple: in complete obstruction, it is impossible to pass gas or have a bowel movement at all. Pain increases, bloating and abdominal enlargement appear, and vomiting recurs. This condition requires immediate help, often surgery.
How the Signs Differ at Different Levels of the Intestine
In small bowel blockage, pain is more often concentrated in one place and comes in short waves every few minutes.
In large bowel blockage, spasms are felt diffusely, throughout the abdomen, and are continuous. In people with colon cancer, approximately 40% of diagnoses are made after symptoms of tumor blockage bring the person to the emergency department.
How the Doctor Confirms the Diagnosis
First — history and examination: when the pain started, whether it changes in waves, whether there have been abdominal surgeries, what medications you take. The doctor assesses symptoms and a history of abdominal surgeries to suspect obstruction.
Next — imaging. Computed tomography is used, including CT enterography, and X-ray studies of the gastrointestinal tract. They show the level of the obstruction, its cause, and the condition of the tissues.
Prepare answers to several questions for your conversation with the surgeon.
- How the pain changes — in attacks or has become constant.
- When you last passed gas and had a bowel movement.
- What abdominal surgeries you have had previously.
- What medications you take regularly.
- Whether you have a hernia and whether it has changed.
Why Obstruction Is Dangerous and When to Call an Ambulance
Above the obstruction, fluid, gases, and digestive juices accumulate. In a day, fluid losses reach 4 liters or more, and protein losses — up to 300 g. Dehydration develops, blood pressure drops, and heart function is impaired. The intestinal wall without blood supply breaks down, and peritonitis and sepsis ensue.
Call 103 or 112 if abdominal pain is severe and cramping or has become constant, the abdomen is bloated, there is repeated vomiting, and gas and stool do not pass at all. A separate reason — rapid pulse, dark urine, and increasing weakness against a background of abdominal pain.
This material is for reference: it helps you recognize your symptoms but does not replace a doctor's examination.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer