What to Expect During Bowel Obstruction Surgery and Recovery

A bowel obstruction is a painful blockage that can occur either in your small intestine or large intestine. An obstruction may also be categorized as either a complete obstruction or a partial obstruction. In many cases, bowel obstructions can resolve on their own. However, when they don’t, surgery is the best way to treat the obstruction.

Read on to find out what to expect during bowel obstruction surgery and how to support the recovery process that follows.

How to Know If You Have a Bowel Obstruction

Though you won’t know for sure if you have a bowel obstruction unless you visit a doctor, there are some telltale signs.

• Bloating
• Abdominal pain
• Cramping
• Inability to pass a bowel movement or gas
• Diarrhea if you have a partial bowel obstruction instead of a complete obstruction
• Nausea
• Vomiting

Causes of a Bowel Obstruction

The causes of a bowel obstruction are variable. Here are many of the causes of a bowel obstruction.

• Inflammatory bowel disease: Crohn’s disease or other inflammatory bowel diseases can damage parts of the intestine and prevent them from working as well as they should. This can cause food particles to build up and form a blockage.
• Herniation: Having a hernia increases the risk of developing a bowel obstruction. Herniated intestine means that a portion of your intestine has managed to squeeze through a gap in the abdominal wall. This can pinch off part of the intestine and prevent food from passing normally through the digestive system.
• Scar tissue: Past trauma to the abdomen or having other abdominal surgeries in the past can increase your risk of developing a bowel obstruction. Scar tissue can develop as a result of healing, and prevent the smooth passage of food through the digestive system.
• Diverticulitis: Diverticulitis is a condition in which infected pouches form in the large intestine, which can inhibit the normal passage of stool through the body.
• Twisted colon or twisted intestine: Also called volvulus, a twisted colon or twisted intestine is exactly what it sounds like. The intestines fold around itself and cut off the normal passage of food through the digestive system.
• Intussusception: Intussusception occurs when a section of the intestine essentially folds into another section, creating what’s often called a “telescoping” effect. Intussusception is the primary cause of bowel obstruction for children.
• Ileus: Ileus or paralytic ileus occurs after abdominal surgery or a severe case of gastroenteritis. The muscles of the digestive system fail to contract and are essentially paralyzed, precluding the passage of food through the body. Ileus may resolve on its own, but it may also result in a bowel obstruction. Ileus symptoms include bloating and inability to pass bowel movements. If there is no pain involved, the issue will likely resolve on its own.
• Intestinal stenosis: This form of intestinal obstruction occurs in infants, most likely as a result of low blood flow to a portion of the intestines.
• Colon cancer: In very rare cases, cancerous growths may be the cause of a bowel obstruction. Surgery and radiation therapy are common treatments for colon cancer.

Visiting the Doctor

The only way to confirm the existence of a bowel obstruction is to go to the doctor. If symptoms are severe and come on suddenly, a bowel obstruction may be a medical emergency. In this case, it’s best to go to the nearest emergency room just to be safe. Doctors can then confirm whether your severe symptoms are the cause of a bowel obstruction or another condition affecting the abdominal area. To confirm the existence of a bowel obstruction, the physician will administer an abdominal x-ray as well as blood tests. In some cases, other imaging such as a CT scan or ultrasound may be useful in determining the presence of an intestinal blockage.

Bowel Obstructions Can Be Life-Threatening

If you are having symptoms of a bowel obstruction, it’s best to get medical attention as soon as possible. Sometimes the symptoms of constipation can be confused with a bowel obstruction. When is constipation an emergency? Constipation becomes an emergency if you are experiencing pain, bloating, or bleeding. In any case, if you are concerned, you should contact your doctor for advice. If left unresolved for too long, a bowel obstruction may cause the intestine to rupture. Intestinal matter will then enter the abdominal cavity and cause a serious infection called peritonitis.

Depending on the location and type of bowel obstruction, you may require emergency surgery. In other less urgent cases or in the case of a partial bowel obstruction, you may be booked for surgery at a later date.

Keep in mind that there are many causes of a bowel obstruction. The majority of bowel obstructions occur acutely in response to an inflammatory condition, ileus, or the buildup of scar tissue from a previous surgery. In rarer cases, a bowel obstruction occurs as a result of a cancerous growth or tumor. For this article, we cover bowel surgery that is required to relieve less serious, acute episodes of bowel obstructions.

Other Methods of Treatment

Unless it’s an emergency, the physician will usually save surgery as a last resort and try other methods of treatment to relieve the obstruction. Other modes of treatment include:

• Enemas: An enema may be necessary to improve imaging of the bowels, though the enema may also resolve the blockage.
• Nasogastric tube: A nasogastric tube is a tube that is threaded through the nose and into the stomach to remove gas that’s creating pressure around the obstruction.
• Bowel obstruction diet: To help ease your symptoms while the blockage resolves, your physician may encourage you to eat low-fiber foods that do not add much bulk to your stool. A low-fiber diet may help relieve some of your symptoms until the blockage passes.
• Stent: A stent may be placed in the bowels via the mouth or colon. The stent is made of metal mesh and expands once placed, holding the bowels open and allowing the blockage to clear.

Certain cases of bowel obstructions, like those resulting from ileus, tend to be responsive to non-surgical treatments of the obstruction. However, if the obstruction does not resolve in response to these treatment methods, you will likely be booked for surgery.

What to Expect During Bowel Obstruction Surgery

During a bowel obstruction surgery, you will be put under general anesthesia. As a result, you will be unconscious, unaware of what’s happening, and unable to feel any pain.

During the procedure, the surgeon will usually aim to remove the blockage while also addressing the underlying cause of the blockage. In some cases, a bowel obstruction surgery can be performed as a minimally invasive surgery. In other cases, a surgeon will need to perform open surgery to reach the blockage and damaged area of the intestines.

Your surgeon may create a stoma in your abdominal cavity, which is essentially a temporary opening to allow waste products to exit the body before they progress all the way through the digestive tract. A stoma can be created throughout an ileostomy or a colostomy. An ileostomy attaches the small intestine to the opening, while colostomy attaches the large intestine to the opening.

Having a temporary stoma in place is more common if the surgeon had to perform a bowel resection, which requires taking out damaged parts of the intestine and sewing the healthy parts back together. The stoma prevents bacteria-laden stool from infecting the surgical juncture and potentially leaking into the abdominal cavity.

Following the procedure, you will be taken to the recovery room and monitored while you wake up from anesthesia.

What to Expect During Recovery

A bowel obstruction surgery is major surgery and requires significant recovery time. The procedure is not an outpatient procedure, and you will need to remain in the hospital for up to a week post-surgery to be monitored. After your hospital stay, you will be discharged from the hospital to continue healing at home. Recovery from bowel obstruction surgery at home may take an additional 6 weeks or longer.

Both the exterior surgical site and your bowels will need to heal throughout the recovery process. If you had a stoma put in place during the procedure, you will have a bag attached to the stoma that is outside of your body and collects waste products.

Recovery from a Bowel Obstruction Surgery

There are several steps you can take to ensure that you recover fully from a bowel obstruction surgery and prevent the formation of bowel obstruction in the future.

1. Avoid Strenuous Activity

While you recover from bowel obstruction surgery, you should avoid strenuous activity. Engaging in vigorous activity can jeopardize the healing of your intestines and the surgical wound. You should only resume exercise when you are cleared by your physician.

On the other hand, gentle movements like walking will likely be encouraged. Gentle activity helps keep your blood flowing and decreases the chances of developing a blood clot. Undergoing surgery is a risk factor for developing blood clots because remaining stationary for a long period of time means that the blood has the chance to pool.

2. Take Care of Surgical Wounds

Regardless of whether you underwent a minimally invasive procedure or an open surgery, you will have incisions made in your abdomen. Looking after these wounds post-surgery can help prevent infection. Your nurse will give you specific instructions for taking care of surgical wounds after your procedure.

Preventing infection is a top priority since infection can cause complications and elongate your healing time.

3. Soft Diet

Following surgery, your digestive system will be fragile. Your surgeon will likely advise you to follow a soft diet that’s also low in fiber, to give your digestive system a break as it heals. While following a soft diet, it can be challenging to get all of the nutrients you need to support optimal healing. Here are a few good foods that you can eat as you recover.

• White pasta with tomato sauce: White pasta is low in fiber and easy to digest. Top with tomato sauce and for extra protein, add in lean ground meat. Make sure that the ground meat is free of gristle and is well-cooked.
• Eggs with toast: Eggs are an excellent protein source and are very soft. Though it may be tasty to eat the egg yolk runny, cook it through while you are healing from bowel obstruction surgery. It’s best to be cautious and avoid any potential cause of infection. Make sure that the toast it white toast, and not whole-grain toast which is packed with fiber.
• Soup: Soups and stews are a tasty way to get the nutrients you need while being gentle on the digestive system. To keep the fiber content low, aim for broth-based soups that contain small shreds of chicken breast, white pasta, and peeled and cooked vegetables like carrots.
• Protein shakes: Protein shakes are an excellent food option as you are recovering from surgery. The concern with following a soft diet that is also low in fiber is that you may be missing out on getting balanced ratios of essential amino acids from protein as well as antioxidants from fruits and veggies. Protein shakes afford you the opportunity to add protein supplements and to blend up fruits and veggies to make sure you’re getting the nutrients you need to support healing.
• Yogurt parfait: Create a spin on a yogurt parfait by topping nonfat Greek yogurt or vegan yogurt with soft, cooked fruits that are low in fiber. Stewed, skinless peaches or canned skinless pears are great options.
• Hot cereal: Hot cereal that’s low in fiber can be a staple food when you are recovering from bowel obstruction surgery. Always make sure that the cereal is low in fiber, like cream of wheat.
• Potato: Skinless boiled white potatoes are a great soft food option when you are recovering from bowel obstruction surgery. Always make sure that the skins are removed since the skins are high in fiber.

4. Eat Small Amounts

It’s important to take as much stress off of your digestive system as possible. Large meals can strain the digestive system and jeopardize the healing of the surgical site. Instead, stick to eating small amounts of food frequently throughout the day.

5. Stay Hydrated

Staying hydrated is an important part of recovery from any surgery. However, following a bowel obstruction surgery, it’s important to avoid chugging lots of water. Instead, gently sip water and clear fluids periodically throughout the day. Staying adequately hydrated can help food products travel more smoothly and efficiently through the digestive system.

6. Care for Stoma

If you have a stoma put in place, you will have a bag that hangs outside of the body and collects waste products. You will need to empty this bag periodically. You may also find it useful to plan out the timing of your meals, to make sure you can easily and conveniently empty the bag.  Keep in mind that the placement of a stoma is usually temporary, and when your bowels have adequately healed, you will likely need to go back to the surgeon for a procedure to remove the stoma.

7. Long-Term Maintenance

After you heal from bowel obstruction surgery, it will be important to monitor your eating habits to reduce the risk of developing another bowel obstruction. A large part of long-term maintenance nS includes protecting your digestive health by avoiding foods that cause bowel obstruction.  Here are a few quick tips:

• Avoid eating stringy foods: Foods like arugula, celery, and rhubarb are packed with fibrous strands that tend to get tangled in the digestive system. Even if we chew these foods thoroughly, the strands may not be destroyed. Avoid eating these foods altogether, or chop and cook stringy foods thoroughly to reduce their impact.
• Eat a low-fiber diet: Just as a low fiber diet is helpful for encouraging healing after a bowel obstruction surgery, a low fiber diet is also very effective for reducing the risk of developing another bowel obstruction in the future. Just as a low fiber diet is helpful for encouraging healing after a bowel obstruction surgery, a low fiber diet is also very effective for reducing the risk of developing another bowel obstruction in the future. When eating a low fiber diet, it’s best to avoid food like beans, whole grains, and raw fruits and vegetables containing seeds and skin. Too much fiber adds bulk to your stool, which increases the risk of developing a bowel obstruction.
• Stay hydrated: Staying hydrated is crucial for encouraging the passage of food through the digestive tract.
• Eat small meals: Just like you should avoid eating large meals during the recovery process, it’s also important to avoid eating large meals to help prevent a bowel obstruction from forming in the future. Aim to instead eat small meals frequently throughout the day, to avoid overwhelming your digestive system.
• Chew thoroughly: When food particles are thoroughly chewed, it is less likely that they will ball up and form a blockage in the digestive tract. Avoid eating quickly and swallowing large chunks of unchewed food.

8. Attend All Follow-Up Appointments

Make sure that you attend all follow-up appointments set by your surgeon. Attending follow-up appointments of bowel obstruction surgery will be the same. Always make sure that the foods you are eating and post-surgery strategies you’re using work for your specific surgery. Make sure to get all exercise, supplements, and foods cleared by your doctor. It’s also important to make sure that you follow all post-surgery care guidelines provided by your doctor.

9. Pain Management

Pain management is a critical part of the recovery process after any surgery. After a bowel obstruction surgery, your surgeon and nurses will likely only administer opioid painkillers if absolutely necessary. Because opioids are a direct cause of constipation, they are not ideal pain relievers for individuals who are prone to bowel obstructions. When you are discharged from the hospital, you will likely be recommended to use acetaminophen as a painkiller and to avoid ibuprofen, since nonsteroidal anti-inflammatory medications may increase the risk of experiencing gastrointestinal discomfort and bleeding.

Conclusion

A bowel obstruction is a painful blockage in the digestive tract that may cause either a small bowel obstruction or large bowel blockage. Having a bowel obstruction – a partial or complete obstruction –  is a painful condition that may resolve on its own. It may also be a medical emergency that requires surgical intervention. Bowel obstruction surgery is a major surgery that requires removing the blockage while addressing the root cause, such as inflammatory bowel disease or leftover scar tissue. Healing from a bowel obstruction surgery takes a couple of months. During the recovery period, it’s important to follow a soft diet that’s low in fiber, while also ensuring that you get all of the nutrients necessary for healing such as protein.