Do you have bowel sounds with a bowel obstruction?

Índice Show

What are the symptoms of bowel obstruction?
Small bowel obstruction
Large bowel obstruction
What causes bowel obstruction?
What is a pseudo-obstruction?
How will my bowel obstruction be diagnosed?
What treatment will I need?
How can I prevent bowel obstruction?
Preventing causes
Resources and support
Considerations
When to Contact a Medical Professional
What to Expect at Your Office Visit

A bowel obstruction (blockage) is when food and liquids can't move through your intestines (gut).
It can be caused by many things, most commonly tumours such as bowel cancer, or other health conditions, such as hernias and adhesions.
Bowel obstructions usually cause cramping, abdominal pain, vomiting and inability to pass bowel motions (faeces or poo) or gas.
A bowel obstruction is an emergency and needs treatment in hospital to prevent serious complications.
You may need surgery or another procedure to remove the blockage.

Bowel obstruction (also called intestinal obstruction) is when something blocks the normal movement of food and liquids through your bowel (intestines). It can happen for a variety of reasons.

There are different types of bowel obstruction. A blockage in your digestive system can be:

in the small intestine or the large intestine
partial (meaning your bowel is partly blocked and some faeces (poo) can still get through) or complete (meaning it is fully blocked and not even gas can get through)
simple (just a blockage) or complicated (meaning the blockage has cut off your bowel's blood supply and caused damage to your bowel)

What are the symptoms of bowel obstruction?

The symptoms of a bowel obstruction depend on where the blockage is and the cause.

Small bowel obstruction

Symptoms of a small bowel obstruction come on quickly. You may notice:

If your pain is severe and constant, this may mean the blockage is affecting the blood supply to your bowel.

Large bowel obstruction

Symptoms of a large bowel obstruction come on gradually and are usually less severe. You may notice:

constipation that gets worse until you can't pass any bowel motions or gas
bloating
cramps in your lower abdomen
vomiting — this is uncommon and may start after the other symptoms

However, in some cases a large bowel obstruction can cause sudden constant pain. It depends on what is causing the obstruction.

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What causes bowel obstruction?

There are many reasons for bowel obstruction. Depending on your age and medical history, you might be more susceptible to certain types of bowel obstruction.

In adults, the most common causes of bowel obstruction are:

adhesions — these are scar-like bands of tissue that can form between organs that shouldn't be connected, usually after abdominal or pelvic surgery
tumours
hernias

Other causes include:

What is a pseudo-obstruction?

This is different type of bowel obstruction, also known as a functional bowel obstruction. This occurs when your bowel muscles are not contracting properly and can't push faeces along, even though there is no physical blockage.

It causes the same symptoms as a mechanical (physical) bowel obstruction.

Possible causes include:

abdominal surgery
injuries
a muscle or nerve disorder
abdominal infection
some medicines, such as opioids
low potassium

How will my bowel obstruction be diagnosed?

To diagnose bowel obstruction, your doctor will likely:

ask you questions about your health and symptoms
examine your abdomen
refer you for blood tests
refer you for x-rays or a CT scan of your abdomen

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What treatment will I need?

Treatment for bowel obstruction depends on the cause. You will usually need to go to hospital for treatment and monitoring.

While in hospital, you might have the following treatment:

Your urine output may be monitored.
You may get fluids through an intravenous (IV) drip.
You may receive pain relief and anti-nausea medicines.
A nasogastric tube may be inserted through your nose and down into your stomach (but usually only if you have severe bloating or vomiting).
Other procedures, such as colonoscopy or sigmoidoscopy, may be done.
You may need to have surgery.

Some people need to have surgery immediately. Some people are treated with IV fluids and medicines for 2 or 3 days before having surgery if they are not getting better. However, some people don't need surgery at all.

If your obstruction is caused by bowel cancer, you might need surgery to remove the affected part of your bowel.

How can I prevent bowel obstruction?

There are some types of bowel obstruction you can't prevent, but there are ways to help lower your chance of your bowel becoming blocked.

Diet

If your bowels are normal, fibre is good for you. However, if you know that parts of your bowel are narrowed, you should follow a diet low in insoluble fibre. Insoluble fibre is the hard and rough part of plants that we eat, such as fruit and vegetable skin, whole grains and some nuts and seeds. This type of fibre can get stuck in narrow parts of the bowel.

You can avoid insoluble fibre by:

peeling, cooking or finely cutting up fruit and vegetables and removing their seeds
eating white bread, pasta and rice rather than wholegrain
avoiding nuts and seeds

This type of diet can increase your risk of constipation. To prevent this, make sure to drink lots of water and get some exercise. Talk to your doctor about whether you might need a laxative medicine.

Also, it is important to cook your food well, avoid tough and stringy food, and chew well before swallowing.

It may be helpful to discuss your diet and nutrition with a dietitian.

Preventing causes

There are also ways to prevent some of the causes of bowel obstruction.

It's important to avoid smoking, to lower your risk of developing bowel cancer or a hernia.

You can also lower your risk of bowel cancer by:

including dairy products, whole grains and fibre in your diet and limiting red meat and processed meats
maintaining a healthy weight
getting 30 minutes of exercise most days
limiting alcohol to less than 2 drinks a day
having screening tests for bowel cancer

If you have a bowel condition such as Crohn's disease, it is important to follow your doctor's instructions to try and keep the condition under control.

Resources and support

For more about bowel obstruction or get advice on what to do next, call healthdirect on 1800 022 2221800 022 222 to speak to a nurse 24 hours, 7 days a week.

If you are concerned about bowel cancer, find out here about how to get a bowel screening test kit. You can also visit Bowel Cancer Australia for more information.

For more resources in languages other than English, you can find more information here:

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Last reviewed: September 2022

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Bowel sounds

Abdominal sounds are the noises made by the intestines.

Considerations

Abdominal sounds (bowel sounds) are made by the movement of the intestines as they push food through. The intestines are hollow, so bowel sounds echo through the abdomen much like the sounds heard from water pipes.

Most bowel sounds are harmless. They simply mean that the gastrointestinal tract is working. A health care provider can check abdominal sounds by listening to the abdomen with a stethoscope ( auscultation ).

Most bowel sounds are normal. However, there are some cases in which abnormal sounds can indicate a problem.

Ileus is a condition in which there is a lack of intestinal activity. Many medical conditions may lead to ileus. This problem can cause gas, fluids, and the contents of the intestines to build up and break open (rupture) the bowel wall. The provider may be unable to hear any bowel sounds when listening to the abdomen.

Reduced (hypoactive) bowel sounds include a reduction in the loudness, tone, or regularity of the sounds. They are a sign that intestinal activity has slowed.

Hypoactive bowel sounds are normal during sleep. They also occur normally for a short time after the use of certain medicines and after abdominal surgery. Decreased or absent bowel sounds often indicate constipation.

Increased ( hyperactive ) bowel sounds can sometimes be heard even without a stethoscope. Hyperactive bowel sounds mean there is an increase in intestinal activity. This may happen with diarrhea or after eating.

Abdominal sounds are always evaluated together with symptoms such as:

Gas
Nausea
Presence or absence of bowel movements
Vomiting

If bowel sounds are hypoactive or hyperactive and there are other abnormal symptoms, you should continue to follow up with your provider.

For example, no bowel sounds after a period of hyperactive bowel sounds can mean there is a rupture of the intestines, or strangulation of the bowel and death ( necrosis ) of the bowel tissue.

Very high-pitched bowel sounds may be a sign of early bowel obstruction.

Causes

Most of the sounds you hear in your stomach and intestines are due to normal digestion. They are not a cause for concern. Many conditions can cause hyperactive or hypoactive bowel sounds. Most are harmless and do not need to be treated.

The following is a list of more serious conditions that can cause abnormal bowel sounds.

Hyperactive, hypoactive, or missing bowel sounds may be caused by:

Other causes of hypoactive bowel sounds include:

Drugs that slow down movement in the intestines such as opiates (including codeine), anticholinergics, and phenothiazines
General anesthesia
Radiation to the abdomen
Spinal anesthesia
Surgery in the abdomen

Other causes of hyperactive bowel sounds include:

When to Contact a Medical Professional

Call your health care provider if you have any symptoms such as:

Bleeding from your rectum
Nausea
Diarrhea or constipation that continues
Vomiting

What to Expect at Your Office Visit

The health care provider will examine you and ask you questions about your medical history and symptoms. You may be asked:

You may need the following tests:

Abdominal CT scan
Abdominal x-ray
Blood tests
Endoscopy

If there are signs of an emergency, you will be sent to the hospital. A tube will be placed through your nose or mouth into the stomach or intestines. This empties your intestines. In most cases, you will not be allowed to eat or drink anything so your intestines can rest. You will be given fluids through a vein (intravenously).

You may be given medicine to reduce symptoms and to treat the cause of the problem. The type of medicine will depend on the cause of the problem. Some people may need surgery right away.

Mcquaid K. Approach to the patient with gastrointestinal disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 134.

Squires RA, Postier RG. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 47.