Small Bowel Obstruction

Small bowel obstruction is the term used for a partial or complete blockage of the small intestine. Surgery is often required to identify and treat the underlying cause and avoid further damage to your bowel.

What is a small bowel obstruction?

The small bowel is another name for your upper intestine, where your body digests and absorbs nutrients from food you eat before it continues its journey into the lower intestine to be eliminated as waste. When something stops the flow of food and waste through the small bowel (upper intestine) – either partially or completely – it is called a small bowel obstruction.

Signs that you may have an obstruction include a swollen abdomen, feeling full, painful spasms, not being able to poo or pass gas, diarrhoea, nausea, vomiting or bad breath. 

What causes a small bowel obstruction?

Some common causes of small bowel obstruction include:

• Scar tissue and adhesions – where the wall of the intestine becomes twisted or damaged usually because of scar tissue from previous abdominal surgery.

• Hernias – where a section of small intestine breaks through a weak area in the abdominal wall, keeping it trapped or pinched in place.

• Inflammatory bowel disorders – other diseases like Crohn’s disease or diverticulitis can cause narrowing, abnormal openings or other complications that may increase your risk.

• Tumours – cancer affecting the colon may block or narrow the intestine. 

Does a small bowel obstruction always require surgery?

Any obstruction in the small bowel needs to be resolved quickly because any blockage that stops the muscles moving can prevent the semi digested food, waste and gas from moving through your intestines normally. Over time, this can cut off the supply of blood and permanently damage the intestine. If left too long, a bowel obstruction can become life-threatening.

Treatment for a small bowel obstruction usually starts with conservative treatments. This includes intravenous fluids, bowel rest with nothing to eat and other non-surgical interventions. If your upper intestine is completely blocked or becomes strangulated (where there is no blood supply to the area), you will need to have surgery urgently to prevent further damage.  

Step by step: small bowel obstruction surgery

Surgery to relieve a blocked or damaged part of your small bowel may involve the following steps:  

• Surgery can be performed laparoscopically (via keyhole) or open surgery (laparotomy) in an emergency.

• Under general anaesthesia, Dr Hopkins will perform an adhesiolysis to remove abdominal adhesions and break down scar tissue from previous surgeries. In many cases, this completes the surgery. 

• If the bowel is too damaged or ischaemic (lacking blood supply to any tissues) Dr Hopkins may need to perform a small bowel resection.

• In this case, Dr Hopkins will remove any damaged sections before joining two healthy sections of bowel together. This is called a small bowel resection.  

• If it is not safe or possible to re-join your bowel together you may be given an ileostomy where the small bowel is routed through an opening cut into your abdomen (a stoma) where a stoma bag worn over the top collects waste.

• An ileostomy may only be needed for a short time to give part of your intestine time to rest and heal from a problem or disease. 

After surgery: what to expect

Recovery and management after surgery for small bowel obstruction will depend on the underlying cause of the obstruction and will be tailored to your specific needs in consultation with your medical team.  

Within 2-3 weeks you should be able to return to work and normal activities. It’s important to avoid heavy lifting or strenuous exercise while your body heals from surgery.

If you have any questions about this surgery or would like to make an initial appointment to see Dr Hopkins, please get in touch.