A bowel obstruction is a blockage that prevents food, fluids and gas from passing through the intestines normally. The obstruction can be partial or complete. Symptoms include abdominal pain, bloating, nausea, vomiting, constipation and inability to have a bowel movement or pass gas. Eating with a bowel obstruction can make the condition worse and should be avoided in most cases.
What causes a bowel obstruction?
Some common causes of bowel obstructions include:
– Adhesions or scar tissue from previous abdominal surgery. This is the most common cause in adults.
– Hernias that protrude into the bowel and cause blockages.
– Twisting of the intestine known as volvulus.
– Tumors in the bowel, ovary or colon.
– Strictures or narrowing of the bowel due to inflammation.
– Impacted stool that accumulates and clogs the intestines.
– Intussusception, where one part of the intestine slides into an adjacent part like a collapsible telescope. This is more common in infants and children.
What are the symptoms of a bowel obstruction?
Symptoms of a bowel obstruction may include:
– Abdominal pain that comes and goes, intensifies, then relieves temporarily. This cycling pattern is characteristic of bowel obstructions.
– Bloating and abdominal swelling.
– Nausea and vomiting, sometimes feculent vomiting if blockage is far down the colon.
– Inability to pass stool or gas. Constipation is common.
– Reduction or stoppage of bowel movements.
– Cramping and spasms.
– Dehydration from vomiting and inability to eat or drink.
Should you eat with a bowel obstruction?
Eating is generally not recommended when you have a bowel obstruction. Here’s why:
– Any food you eat cannot pass through the blocked intestine. This can worsen the obstruction and cause rupture of the bowel.
– Vomiting is common with bowel obstructions. Eating may exacerbate nausea and vomiting.
– Fluids cannot pass the site of obstruction. Eating solids can worsen dehydration.
– The intestines and digestive processes are disrupted. Food cannot be properly digested or absorbed until the obstruction is relieved.
– Eating may increase pain and discomfort. Food stretches the bowel which is already inflamed.
– Partial obstructions may become complete obstructions if more contents are added.
Risks of eating with a bowel obstruction
Eating with a bowel obstruction poses the following risks:
– Worsening distention and swelling of intestines. This increases pain and vomiting.
– Further vomiting which can cause electrolyte imbalances and dehydration.
– Increased risk of bowel perforation. An obstructed, swollen bowel is more likely to rupture if stretched further.
– Stimulating bowel motility by eating when the intestines are obstructed can lead to complications.
– Increased contamination and infection if bowel contents spill from a perforation.
– Progression from partial to complete obstruction by adding more intestinal contents.
– Shock from dehydration, electrolyte imbalance or sepsis if obstruction causes bowel contents to spill into the abdominal cavity.
When can you resume eating with a bowel obstruction?
In most cases, eating should be avoided until the bowel obstruction has resolved or been surgically relieved. Your doctor will determine when it is safe to resume eating normal foods without exacerbating the obstruction. Some general guidelines include:
– Partial obstructions that improve with medical management – Eating may be resumed when bowel function returns to normal and symptoms like nausea and vomiting resolve. This is typically within 12-24 hours after starting treatment. Small, low fiber meals are recommended initially.
– Complete obstructions requiring surgery – Eating is restricted until bowel function returns following surgery. This may take 3-5 days. Clear liquids are given first, advancing slowly to solid foods as tolerated without vomiting or distention.
– Chronic, partial obstructions – Small, frequent meals that are low in fiber and fat may be tolerated. But any worsening of symptoms warrants stopping oral intake.
– Obstructions relieved by colonoscopy or stenting – Eating can usually be resumed within 24 hours of the procedure provided symptoms like nausea and vomiting have significantly improved.
What can you eat when you have a bowel obstruction?
It’s safest to avoid all solids initially with a bowel obstruction. Here are some eating guidelines if your doctor determines you can tolerate limited foods:
– Clear liquids – Water, apple juice, weak tea, clear broth, popsicles, and gelatin. Avoid milk and pulp-containing juices which can stimulate bowel motility.
– Low residue foods – White bread, pasta, crackers, low fiber cereals, peeled cooked potatoes without seeds, chicken breast without skin or well-cooked fish.
– Smooth yogurt, milk, pudding, ice cream and cottage cheese.
– Canned fruit without skins, seeds or membranes. Ripe banana and melon are also tolerated well when bowel function resumes.
– Well-cooked eggs.
– Clear soups and broths strained of all fibers and particles.
– Avoid raw fruits and vegetables, whole grains, tough meats, nuts, seeds, alcohol, caffeine, gas-producing foods and very hot or cold items until your obstruction has resolved.
Treatments for bowel obstructions
Some treatments options for bowel obstructions include:
– Fasting – Discontinuing all foods and solids by mouth along with bowel rest helps reduce intestinal contents and may relieve a partial obstruction. Intravenous fluids are given for hydration.
– Nasogastric tube – Inserting a tube through the nose to the stomach can help decompress the intestines by suctioning out stomach contents.
– Fluids and electrolyte management – Correcting dehydration and imbalance through IV therapy can stabilize you until the obstruction passes.
– Medications – Stool softeners, laxatives, anti-nausea and anti-cramping medicines may be prescribed. Antibiotics if infection is present.
– Endoscopy – Inserting a thin, flexible tube with a camera (endoscope) into the colon to examine and possibly manipulate the obstruction.
– Bowel irrigation – Enemas and other preparations may be attempted to encourage stool passage beyond the obstruction.
– Surgery – Required for complete obstructions that don’t improve or cases with dead bowel tissue. Portions of unhealthy intestine may be resected.
– Stenting – Place stents endoscopically across an obstructing lesion to reopen the clogged area without major surgery.
Home care for minor obstructions
If you have a mild, partial bowel obstruction, the following home care steps may help manage it:
– Clear liquid diet – Stick to only fluids until obstruction improves. Avoid milk and citrus juices.
– Avoid solid foods – Don’t eat any solids or fiber which can make obstruction worse.
– Small frequent meals – Eat 5-6 tiny meals rather than 3 large ones if doctor says you may eat.
– Monitor symptoms – Note if pain, nausea or vomiting worsen and report to your doctor.
– Rest bowel – Don’t take laxatives, enemas or other stimulant preparations without medical advice.
– Increase fluids – Drink plenty of water and clear fluids if not contraindicated.
– Avoid gas-producing foods – These include beans, broccoli, dairy, soda etc.
– Consider stool softeners – If constipation accompanies obstruction, ask your doctor if a softener is appropriate.
– Avoid NSAIDs – Don’t take ibuprofen, aspirin or other non-steroidal anti-inflammatories without medical supervision.
Preventing bowel obstructions
You can lower your risk of bowel obstructions by:
– Increasing fiber slowly – This helps prevent constipation and obstructing fecal impactions. Stay hydrated when taking more fiber.
– Exercising regularly – Physical activity stimulates bowel motility to prevent stagnation.
– Avoiding dehydration – Drink adequate fluids daily.
– Treating diarrhea promptly – Persistent diarrhea can lead to bowel strictures.
– Having abdominal surgery through laparoscopy when possible – This lowers the risk of adhesions compared to open procedures.
– Early ambulation after surgery – Walking soon after abdominal surgery can prevent pooling of bowel contents leading to blockage.
– Chewing foods well – Inadequately chewed food is more likely to clog or obstruct the intestines.
– Being alert to symptom recurrence – Those with previous obstructions should watch for early signs like pain or constipation indicating another one.
When to seek emergency care
Seek immediate medical help if you experience:
– Severe abdominal pain and swelling
– Incessant vomiting
– High fever, chills or shaking
– Signs of shock like rapid heart rate, palpitations, weakness, confusion
– Inability to pass stool or gas for over 24 hours
– Dark black stools from digested blood
– Greenish vomiting possibly indicating small bowel obstruction
These can indicate a dangerous, life-threatening obstruction requiring hospitalization. Don’t wait for complete blockage and complications to develop. Call 911 or get to an emergency room quickly at the first signs of significant, unrelenting bowel obstruction symptoms.
Conclusion
Bowel obstructions should not be taken lightly or managed solely with home treatments. While eating a low residue diet may help control mild symptoms, most obstructions require limiting oral intake until the blockage can be resolved. Consuming a regular diet with a bowel obstruction typically leads to worsened pain, nausea, distention, perforation risk and other dangerous complications. Work closely with your doctor for proper evaluation and management and avoid eating solids until they determine your obstruction has sufficiently resolved. Prompt surgical intervention is often required, especially for high-grade or complete bowel obstructions. With appropriate treatment guided by your physician, most cases of obstruction can be managed successfully without permanent bowel injury.