Bowel Obstruction

Dr. D. Scott Crouch, emergency and general surgeon, discusses bowel obstruction.

What is a bowel obstruction?

The GI tract is one long continuous tube. The small bowel in the normal setting is very free to flop about in the abdomen and isn't really fixed except for a couple places. You can get a small areas of the small intestine that are trapped or kinked either due to adhesions from previous surgery or being stuck in a hernia. When that happens, obviously things don't pass through normally. Depending on where you're obstructed, you may get very bloated and have crampy abdominal pains usually along with a lot of nausea and vomiting.

How do you describe a bowel obstruction?

When I explain the anatomy of the small bowel, it's not unlike a garden hose. Just as if you're pulling a hose off of a reel or around the corner, you can have unusual little kinkings and twistings in the hose, and the small bowel is very similar to that. A lot of times when you get those kinks if you take the pressure off, things will kind of untwist and open back up. The bowel is no different. Many times those kinks are tethered in a way that it's not until we get in there and surgically lyse those adhesions or scar tissue that the bowel can then be relieved and open up.

How do you treat a bowel obstruction?

Most of the time it can be managed without surgery. We will decompress things with a tube that people don't like very much, but it does a nice job, and it's better than surgery. Then we'll give it a few days to try to relax and untwist or unkink as long as the patient remains stable. There are times where we know it's not going to relieve. For instance, if they have an incarcerated hernia, that's got to be fixed immediately, and we'll take that to surgery day or night whenever it's needed and they present.