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A bowel obstruction is a partial or complete blockage of the intestines. It is a serious medical emergency and requires immediate medical attention.

A bowel obstruction (also referred to as an intestinal obstruction or blockage) is a condition in which the small or large intestine (bowels) becomes blocked. This blockage prevents food, fluids, and waste (stool) from passing normally through the digestive tract. As a result, digestive materials and gas become trapped, which can cause pain, discomfort, and can damage the intestinal tissue.

Causes of a Bowel Obstruction

Bowel obstructions can be caused by a variety of conditions, including cancerous tumors. Common causes of blockages include hernias, ingestion of a non-digestible object, inflammatory bowel disease (IBD), and diverticulitis.

 

In cancer patients, blockages may also be caused by:

  • Abdominal or pelvic surgery: Surgical procedures can result in scar tissue, also known as adhesions. These bands of scar tissue can bind abdominal organs, including the bowels, and are the most common cause of bowel obstruction.

  • Radiation therapy: Radiation therapy that targets cancer in the abdomen can damage the intestines, leading to scar tissue formation and inflammation, both of which can obstruct the bowels.

  • Cancerous tumors or masses: Cancerous tumors and masses may press on the outside of the bowels, restricting the flow of digestive material. They can also grow within the bowel itself, directly blocking the passage of material.

Signs & Symptoms

A bowel obstruction may feel different depending on whether the blockage is in the small or large intestine. It commonly feels like significant or severe abdominal pain, which may be spread out across the abdomen (also referred to as diffuse pain) or concentrated in one area. Symptoms may start out mild and become more severe as the blockage worsens.

 

Signs and symptoms of a blockage may include:

  • abdominal pain or cramping

  • abdominal swelling or bloating

  • constipation

  • diarrhea

  • nausea or vomiting

  • problems passing gas

  • loss of appetite

Treating a Bowel Obstruction

If you suspect a bowel obstruction, contact your doctor immediately to determine the best course of action. A healthcare team will evaluate you for a possible obstruction using tests such as a physical examination, X-rays, and a CT scan.

 

Treatment for a bowel obstruction will be performed in a hospital setting and may include:

 

  • Bowel rest: You may be asked to avoid eating and drinking to prevent the obstruction from worsening. In some cases, bowel rest or a liquid diet that is easier on your intestines can help your body clear the blockage. Bowel obstruction increases the risk of becoming dehydrated and/or having a dangerous electrolyte imbalance due to loss of fluids through vomiting, fluid accumulation in the bowel, reduced absorption of fluids by the intestine, and decreased oral intake of food/drinks. You may receive intravenous (IV) fluids to restore your body’s fluid and electrolyte balance.

  • Nasogastric (NG) tube: An NG tube is inserted through the nose, down the esophagus, and into the stomach. It helps relieve pressure caused by a bowel obstruction by removing fluid and gas from the digestive system. This can reduce nausea, vomiting, and pain, and may help the obstruction resolve on its own.

  • Surgery: Surgery may be necessary if the obstruction does not improve with other treatments or if there is a complete blockage. In cases where cancer causes the obstruction, surgery may involve removing the tumor that is causing the blockage. Your doctor will talk with you about your overall health and potential risks and benefits of surgery to help you decide if surgery is right for you. 

  • Stent: A stent is a tube placed inside the intestine to open the blocked area. Stents relieve bowel obstruction symptoms by temporarily opening the bowels to let food, waste, and gas pass through the body. Stents are commonly used to treat bowel obstructions caused by cancer, but they may also be considered in other situations as well.

  • Gastrostomy tube (G-tube): This tube is inserted through the abdominal wall directly into the stomach to release trapped fluid and air. It can be connected to a drainage bag with a valve. When the valve is open, fluid and air can leave the stomach, relieving pressure and discomfort. G-tubes are most often used to treat bowel obstructions caused by cancer.

Managing the Risk of Recurring Bowel Obstructions

There is only so much that can be done to manage or prevent bowel obstructions, especially in patients who have undergone extensive abdominal surgeries such as CRS/HIPEC. However, some lifestyle and dietary strategies may help reduce risk and support overall digestive health:

  • Hydration: Staying well-hydrated helps maintain a healthy water balance in your bowels, allowing stool to remain soft and move more easily through the intestinal tract.

  • Smaller, more frequent meals: Eating smaller portions throughout the day reduces the workload on the digestive system and can help prevent blockages.

  • Chew food thoroughly: Proper chewing breaks down food into small pieces, making digestion easier.

  • Monitor intake of high-fiber foods: While fiber is generally healthy, it can bulk up stool and may increase the risk of blockage in patients with narrowed or sensitive bowel areas. Avoid foods with skins, seeds, husks, or fibrous textures.  

  • Consistent physical activity: Gentle, regular movement can help stimulate digestion and promote healthy bowel function.

 

For some patients who face recurrent bowel obstructions, a care provider may recommend an ostomy to relieve symptoms, reduce risk of bowel damage as a result of obstructions, and improve quality of life. 

 

Dietary Considerations

Foods to Avoid:

These foods are more difficult to digest and may increase the risk of bowel obstruction:

  • Raw vegetables, especially stringy ones like celery or cabbage

  • Corn, popcorn, nuts, and seeds

  • Dried fruits

  • Skins of fruits and vegetables (e.g., apple peel, grape skin)

  • Legumes (beans, lentils) due to their tough skins and high fiber

  • Tough or gristly meats

 

Foods to Eat:

These are generally easier to digest and less likely to cause blockages:

  • Well-cooked vegetables in limited quantities (peeled and pureed if needed)

  • Canned fruits or peeled, soft fresh fruits in limited quantities (e.g., bananas, melon)

  • White bread, refined cereals, and pasta

  • Tender meats, fish, poultry (without skin or bones)

  • Eggs, dairy products, smooth nut butters (if tolerated)

  • White rice, plain potatoes (without skin)

 

In Case of Partial Obstruction Symptoms

(Symptoms may include cramping, bloating, nausea, or changes in bowel habits)

If symptoms of a partial bowel obstruction occur, temporarily switch to a liquid or low-residue diet, limiting intake of high-fiber foods and dairy-based foods. This helps reduce the amount of material moving through the bowel, easing pressure on the intestines and giving the body a chance to recover. Recommended options include:

  • Clear broth

  • Heavily pureed foods

  • Juice without pulp

  • Gelatin

  • Tea

  • Electrolyte drinks

Avoid high-fiber and most dairy products during this time, as they can increase stool bulk and worsen symptoms.

References

National Cancer Institute. Bowel Obstruction and Cancer Treatment.
https://www.cancer.gov/about-cancer/treatment/side-effects/bowel-obstruction

 

Cleveland Clinic. Bowel Obstruction Management and Treatment.
https://my.clevelandclinic.org/health/diseases/bowel-obstruction#management-and-treatment

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