Small bowel obstruction occurs when the normal passage of intestinal contents is interrupted, leading to a mechanical or functional blockade in the small intestine. Mechanically, the obstruction can result from physical barriers that impede the flow of food, fluids, and gas. These barriers create a bottleneck effect, increasing intraluminal pressure upstream of the blockage. As the pressure rises, it compresses blood vessels in the bowel wall, reducing blood flow and potentially leading to ischaemia or necrosis of the affected tissue.

Mechanical Obstruction

The obstruction also disrupts the peristaltic movements — rhythmic contractions of the intestinal muscles responsible for propelling contents through the digestive tract. When the intestine tries to push against the blockage, it causes vigorous contractions that can lead to cramping pain and further strain on the bowel wall. This back-and-forth cycle exacerbates the buildup of fluids and gas, which cannot pass through the obstructed segment, resulting in abdominal distension and vomiting as the body attempts to expel the contents. The main causes of mechanical obstruction are:

• Adhesions — bands of scar tissue that form from a prior surgery or injury.
• Hernias — protrusion of the intestine through a weakened abdominal wall. 
• Tumours — growths that form and obstruct the intestine.
• Intussusception — a rare disorder where a part of the intestine telescopes into an adjacent part.
• Foreign bodies or impacted stool — common examples of foreign bodies include mistakenly swallowed objects, improperly chewed food and dental materials. 

Functional Obstruction

In cases of functional obstruction, such as paralytic ileus, the mechanism differs. The bowel loses its ability to contract and propel its contents due to a failure in the neuromuscular coordination of the intestine. This loss of motility prevents the progression of material, even in the absence of a physical barrier, mimicking the effects of a mechanical obstruction.

Both forms of obstruction disrupt the digestive process, prevent nutrient absorption, and risk severe complications if the condition is not addressed promptly.

At CRCS , we utilise various diagnostic techniques to accurately identify and assess small bowel obstruction, which help us ensure timely and effective treatment. Our approach combines a thorough evaluation of symptoms with diagnostic methods to determine the nature and severity of the obstruction. These include:

• Detailed medical history and physical examination — our specialists begin by understanding your symptoms, past surgeries, or conditions that could contribute to the obstruction. A careful physical examination often reveals telltale signs like abdominal distension or abnormal bowel sounds.
• Abdominal X-rays — a quick and non-invasive imaging technique to detect blockages, air-fluid levels, or bowel distension.
• CT (Computed Tomography) scans — at CRCS, we rely on high-resolution CT imaging to provide a detailed view of the obstruction, including its location, likely cause, and severity.
• MRI tests — may be particularly useful in children or pregnant women, as this method offers a safe and effective way to visualise the obstruction without radiation.
• Blood tests — these help identify complications such as infection, dehydration, or electrolyte imbalances caused by the obstruction.
• Gastrograffin studies — in select cases, we may use water-soluble contrast imaging to evaluate the structure and function of the small intestine.

Our comprehensive diagnostic process ensures that every patient receives personalised care according to their health condition.

At CRCS, we prioritise tailored and effective treatments for small bowel obstruction, focusing on alleviating discomfort, restoring normal bowel function, and preventing complications. Depending on the severity and cause of the obstruction, we offer a range of treatment options, including:

• Non-surgical management: for partial/subacute obstructions, we often begin with conservative approaches, such as bowel rest (nothing to eat or drink), intravenous fluids to address dehydration, nasogastric tube insertion to relieve pressure, and careful observation to monitor progress.
• Medications: in cases of paralytic ileus, we may administer medications to stimulate bowel motility and promote recovery.
• Endoscopic procedures: for certain blockages caused by foreign objects or localised narrowing, minimally invasive endoscopic techniques may be employed to attempt to relieve the obstruction.
• Surgical intervention: for complete obstructions or when non-surgical methods are ineffective, our skilled surgeons perform precise procedures to remove the blockage, repair hernias, or address complications such as bowel ischaemia or perforation.
• Post-treatment care and monitoring: at CRCS, we emphasise a holistic approach, offering follow-up care and dietary guidance to prevent recurrence and promote overall digestive health.

Our team at CRCS ensures that every patient receives comprehensive and compassionate care, using the most appropriate treatments for their condition. If you are experiencing bowel symptoms or are worried about small bowel obstruction, schedule a consultation with CRCS to receive expert care and personalised treatment. If you are unwell, then you need to go to the Emergency Department of the nearest Hospital.