A bowel obstruction means there is a blockage in the bowel. It is a serious complication, which is much more common with advanced cancer.
About bowel obstruction
Your bowel may become completely or partly blocked. This means that the waste from digested food can't get past the blockage.
Bowel obstruction can happen when:
- cancer in the abdominal area (such as ovarian, bowel or stomach cancer) grows so it completely blocks the bowel
- other cancers (such as lung or breast cancer) spread to the abdomen and block the bowel
- cancer grows into the nerve supply of the bowel and damages it - this can stop the muscles working and cause bowel obstruction
- a solid mass of indigestible material accumulates in the GI tract sometimes causing a blockage. These are called bezoars.
Bowel obstruction is much more common with advanced cancer. And people who have had surgery or radiotherapy to the abdomen are more at risk of developing a bowel obstruction.
Symptoms of bowel obstruction
Having a bowel obstruction is a serious complication. The symptoms include:
- 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)
Diagnosing a bowel obstruction
Your doctor will examine you and ask you questions. They will then arrange some tests and investigations. These may include blood and urine tests.
You may also have an abdominal X-ray. Or you might have a barium enema to find out exactly where the obstruction is in your bowel.
Treating a bowel obstruction
It’s important to understand what your doctors are trying to achieve with any treatments they recommend. So talk it through with them or with your specialist nurse.
Treatments for a blocked bowel may include:
Drips and drains
Your doctor may suggest treatment to give your bowel time to rest. This may fix the blockage. But if it isn’t successful, your doctor will suggest another approach.
You need to stop eating and drinking until your bowel is working normally again. You may need fluids through a drip so you don’t get dehydrated. This is called an intravenous infusion.
Sometimes you can have an infusion of fluids 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). This drains fluid from your stomach and stops you feeling sick.
Your doctor might suggest a venting gastrostomy to help relieve nausea and vomitting caused by a bowel obstruction. This is when they put a special tube called a percutaneous endoscopic gastrostomy tube (PEG tube) into your stomach through an opening made on the outside of your abdomen. This is usually done under sedation.
Your doctor might suggest surgery to offer you longer term relief from your symptoms. The surgeon removes enough of the cancer to unblock the bowel. They may remove 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.
Deciding whether to have the operation can be difficult.
The surgery will not cure your cancer. It will only relieve the symptoms that you have. Unfortunately no one can tell beforehand how much you will benefit from an operation to unblock your bowel.
The operation could be successful and the cancer might 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.
You might want to talk through having this operation with your close family and friends as well as your doctor and nurse.
A stent is a tube that the surgeon puts into the bowel. It expands to keep the bowel open. This can relieve the symptoms caused by the obstruction.
Your surgeon may be able to put in a stent if you are not able to have a big operation.
Instead of an operation, medicines can sometimes help control symptoms of a blocked bowel. Unfortunately these types of treatment will usually only control your symptoms for a while.
A drug called hyoscine butylbromide (Buscopan) stops muscle spasms and reduces pain. You can also have painkillers and anti sickness drugs.
You may also have a drug called octreotide. Octreotide reduces the amount of fluid that builds up in your stomach and digestive system. It can help to control sickness.
Or you might have steroids. Steroids can help to reduce the inflammation of your bowel. They can also help to control sickness.