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Bowel obstruction

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This page has information about blockage of the bowel (obstruction) and cancer. You can find information on

 

About bowel obstruction

A bowel obstruction is a blockage in the bowel. The diagram below shows the bowel and the rest of the digestive system.

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Your bowel may become completely or partly blocked. This means that the waste from food you have digested can't get past the blockage. 

Sometimes a tumour in the abdominal area, such as an ovarian cancer, bowel cancer or stomach cancer, can grow so that it completely blocks the bowel. Other cancers such as lung cancer, breast cancer and melanoma can spread to the abdomen and cause a bowel obstruction. 

Sometimes a tumour might grow into the nerve supply of the bowel and damage it. This can stop the muscles working and cause bowel obstruction.

Bowel obstruction is much more common with advanced cancer. People who have had surgery or radiotherapy to the abdomen are more at risk of developing a bowel obstruction. 

 

Symptoms of bowel obstruction

The symptoms of a bowel obstruction are

  • Feeling bloated and full
  • Pain (usually colicky tummy pain)
  • Feeling sick
  • Vomiting large amounts (including undigested food or bowel fluid)
  • Constipation (shown by not passing wind and no bowel sounds)

Having a bowel obstruction is a serious complication of your cancer. If the blockage is caused by an advanced cancer, your treatment will be aimed at relieving your symptoms. It may also slow the progress of your cancer for a while, but won’t be aimed at curing it. 

 

Diagnosing a bowel obstruction

Your doctor will need to examine you and ask you several questions before deciding whether or not you have a bowel obstruction. Your doctor or nurse will then arrange some tests and investigations such as blood and urine tests. You may also have an abdominal X-ray or barium enema to find out exactly where the obstruction is in your bowel.

 

Treating a bowel obstruction

Treatments for a blocked bowel may include 

It’s important to understand what your doctors are trying to achieve with any treatments they recommend. So do talk it through with them or with your specialist nurse.

Drips and drains

If you have a blocked bowel you will need to stop eating and drinking until it is working normally again. This means you may need to have fluids through a drip to make sure that you don’t get dehydrated. This is called an intravenous infusion. In some cases, doctors can arrange an infusion of fluids for you at home. You have this through a fine needle put just under the skin, instead of into a vein.

You may also need to have a tube down your nose (nasogastric tube) to drain fluids from your stomach and stop you feeling sick. This treatment gives your bowel time to rest and may fix the blockage. But if it isn’t successful, your doctor will suggest another approach.

Surgery

Your doctor may suggest more long term relief from your symptoms by operating to unblock your bowel. This usually involves removing enough of the cancer to free the bowel, and possibly removing a part of the bowel as well. After the operation your surgeon is most likely to repair the bowel by stitching the ends back together. But sometimes it isn’t possible to do this and you may need to have a colostomy or ileostomy (stoma).

A stoma is an opening onto the abdomen. Your poo (stool or faeces) comes out of this opening into a plastic bag that sticks over it. There is detailed information about bowel surgery and having a stoma in the surgery for bowel cancer section.

Unfortunately no one can tell beforehand how much you will benefit from an operation to unblock your bowel. So understandably you might have doubts about having the operation at all. The operation may be successful and the cancer may not grow back to block the bowel again. But it is quite a big operation to have when you are likely to be feeling very low.

Deciding whether to have the operation can be difficult because it will not cure your cancer. It will only relieve the symptoms that you have. You may want to talk through having this operation with your close family and friends as well as your doctor and nurse.

A stent

A stent is a tube that is put into the bowel and it expands to keep the bowel open. If you are not able to have a big operation your surgeon may be able to put in a stent to relieve the symptoms caused by the obstruction. 

Medicines

Instead of an operation it is sometimes possible to use medicines to help control symptoms of a blocked bowel.

Doctors may use a drug called hyoscine butylbromide (Buscopan) to stop muscle spasms and reduces pain. They will also give painkillers and anti sickness drugs. They may also give a drug called octreotide or steroids

Octreotide works by reducing the amount of fluid that builds up in your stomach and digestive system. It can help to control sickness. Steroids can help to reduce the inflammation of your bowel, and can also help to control sickness. 

Unfortunately these types of treatment will usually only control your symptoms for a while.

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Updated: 21 May 2014