Bowel obstruction is a serious medical condition that happens when stool cannot properly move through the intestines. If you were assigned female at birth (AFAB), this condition can be especially difficult to diagnose since it shares so many symptoms with premenstrual syndrome (PMS).
Keep reading to find out more about bowel obstruction, including causes and how doctors treat it.
Bowel obstruction is usually related to one of two types of causes. The first is related to conditions that keep the bowels from moving stool forward. The second is compression or narrowing that physically blocks stool.
The bowel is made up of a small intestine and a large intestine. Both parts can become obstructed. According to 2019 research, the most common causes for all adults include:
Examples of other intestinal blockage causes include:
- bezoars (balls of hair)
- carcinomatosis
- endometriosis
- foreign bodies
- gallstones
- inflammatory bowel disease (IBD)
- ischemic stenosis
- intussusception
- post-anastomotic stenosis
- radiation-related stenosis
- stenosis
People of all genders experience bowel obstruction at similar rates. In an estimated 80 percent of bowel obstructions, the small intestine is involved.
If you have a history of abdominal surgery, you’re also more likely to have a bowel obstruction since scar tissue can increase your risk for it.
Can endometriosis cause bowel blockage?
Endometriosis is a condition that causes endometrial tissue to grow in places other than the uterus in people assigned female at birth. This is problematic because endometrial tissue can cause cramping, pain, and bleeding. The bowel is one of the most affected locations outside the genital area.
In rare cases, endometriosis can cause bowel blockage. When endometriosis-related bowel blockage does occur, it is typically in the large intestine, according to 2018 research.
Unfortunately, because endometriosis causing a bowel obstruction is so rare, doctors may not easily recognize it as the underlying cause. To diagnose someone with endometriosis, a surgeon has to remove a tissue sample and test it for the presence of endometrial tissue.
A bowel obstruction can be a very uncomfortable or painful occurrence that can develop suddenly or over time. Symptoms can include:
- abdominal bloating
- cramping
- nausea
- not having a bowel movement (constipation)
- not passing any gas
- stomach discomfort
- vomiting of dark green bile
All these symptoms are easy to mistake for PMS. However, the symptoms of a bowel obstruction will worsen over time and persist throughout the month.
Can you still have a bowel movement with an obstruction?
It’s a common misconception that you can’t have a bowel movement if you have a bowel obstruction.
Some people do pass stool even when they have a bowel obstruction. Their symptoms are typically pain, bloating, and nausea. You can even have loose stools but still have a bowel obstruction.
If you experience regular abdominal pain or any of the other symptoms of a bowel obstruction, it’s worth discussing them with your doctor. It can be helpful to keep a journal of your symptoms prior to the appointment to help them fully understand and rule out other conditions.
A doctor will usually recommend imaging studies, such as a computed tomography (CT) scan or ultrasound. The CT scan will especially help a doctor identify if there is an obstruction. The bowel before the obstruction will usually be very enlarged.
The discrimination against women and AFAB people when it comes to receiving a prompt and accurate diagnosis has been widely documented for years.
In cases like a bowel obstruction, where symptoms may be easy to dismiss as something non-concerning, like PMS, you may find that you need to advocate for yourself. Don’t be afraid to ask for a second opinion if you’re struggling to find a treatment plan that works for you.
When you have a bowel obstruction, the treatment goals are to avoid adding to the stool that isn’t leaving your body and decompress the bowel by removing extra air. You’ll need to seek care at a hospital until you start having bowel movements again.
To treat a bowel obstruction, healthcare professionals often use what’s known as a nasogastric tube. This small, flexible tube enters through your nose and goes down to your stomach. A small amount of suction is applied, which helps remove food and excess air to reduce bloating.
Other treatments may include:
- antibiotics
- intravenous fluids
- pain control
Ideally, the obstruction will resolve in a few days.
Surgery options for bowel obstruction treatment
An estimated 20 percent of all people with a bowel obstruction, either in the large or small intestine, require surgery. Sometimes, a surgeon may recommend surgery to remove scar tissue that is keeping stool from moving forwards.
Other times, you may need to have a portion of your bowel removed if the obstruction is affecting blood flow to your intestines.
A bowel obstruction can cause the bowel to twist and affects blood flow to the intestine. At first, this causes symptoms like swelling and inflammation. These increase the risk for bacteria in the bowel to leak out of the intestines and into the protective lining around the intestine, known as the peritoneum.
If the bowel keeps twisting, blood flow will be completely reduced to the intestine. This effect is known as strangulation and can lead to ischemia or bowel death, according to 2019 research.
When the tissue dies, it can have weak areas that perforate and leak contents into the peritoneum. This can result in severe infection and possibly death if not treated.
Bowel obstruction is a medical emergency. If you are able to seek care before your symptoms worsen, you’re less likely to require surgery. It’s important that a doctor identifies the underlying cause to help reduce the risk that you could experience a bowel obstruction in the future.
Sometimes, the cause may be something treatable, like endometriosis. Seeking emergency care can get you on the right track to finding out.