Some people with serious illness can experience bowel obstruction. This occurs when the small or large intestine is partly or completely blocked. It can be caused by the bowel not working properly or by something blocking the bowel, such as a tumour. This means food and fluid can’t get through the bowel and gets stuck. This can happen quite suddenly or develop gradually over days or weeks.
- feeling bloated and full up
- pain (usually crampy tummy pain)
- feeling sick with loss of appetite
- vomiting (including undigested food or bowel fluid)
- constipation (no solid motion or wind)
- cancer or fluid (ascites) in the abdomen pressing on the outside of the bowel, or blocking the tube on the inside. Colon, stomach or ovarian cancer are the commonest cancers to cause obstruction.
- neurological illnessess (eg multiple sclerosis) can affects the nerve supply of the bowel - this can stop the bowel from working (an ileus)
- People who have had surgery or radiotherapy to the abdomen can develop bowel obstruction from scar tissue (adhesions)
Bowel obstruction can be complicated to manage and it is important to seek advice urgently from your nurse or doctor. Sometimes it can be managed with medications (steroids and bowel stimulants) and sometimes an operation is needed. Surgery may be posible to bypass the blockage or remove the blockage.
If this is not possible then a stoma may be needed - opening the bowel onto the wall of the abdomen, and collecting stool into a stoma bag. This is a difficult concept, but many people adapt and manage a stoma really well.
But surgery or a stoma may not be possible, and may not help - in this case your palliative team will aim for comfort and symptom relief with medicines, often delivered by a syringe pump, as oral medications may not be absorbed because of the blockage.
A low residue diet is advised for people who are thought to be at high risk for bowel obstruction, or for those who have recently been treated for bowel obstruction by their medical team. The Royal Surrey NHS Foundation Trust have produced a detailed leaflet to explain this type of diet and how it can be adjusted according to symptoms.