Small Bowel Obstruction and How You Can Manage It
Small bowel obstruction (SBO) can present as an acute condition requiring prompt attention, where something blocks the normal flow of food and liquid through the small intestine [1], [3]. This can be as simple as a clump of scar tissue preventing things from moving forward, or it can be caused by conditions like hernias or inflammation.
Table of Contents
Acute small bowel obstruction is more common than many people think; it has been reported to cause about 2% of all visits to the emergency department for abdominal pain. It also makes up a substantial chunk—around 12% to 16%—of emergency surgical admissions, and it leads to roughly 20% of emergency surgical procedures [1], [4].
Because of these high numbers, early detection and proper treatment matter a lot. If left untreated, an obstruction can lead to perforation (a hole in the bowel) or strangulation (tissue death), both of which can be very serious.
The most frequent cause of SBO is the presence of intra-abdominal adhesions (scar tissue) that form after an abdominal surgery. These adhesions are responsible for about 65% of all cases [4]. Other causes may include:
Crohn disease and other inflammatory bowel diseases are significant etiological factors for SBO, particularly in patients with a history of these conditions. This make it also slightly different than others like Small Intestinal Bacterial Overgrowth (SIBO).
Scar tissue often shows up after surgery as the body heals. Over time, these bands of tissue can tighten or create knots. When they snag or twist a part of the intestines, it leads to a blockage that must be addressed before it causes more harm.
When a blockage occurs in the small intestine:
This chain reaction can progress quickly. The more the intestine stays obstructed, the more fluid and nutrients get trapped, leading to more swelling, more pain, and possibly worse outcomes if not treated in time.
SBO typically shows up with:
Often, people with SBO will mention that they had past abdominal surgeries. This is a key predictor, since previous operations increase the likelihood of adhesions forming over the years [1].
Doctors generally take note of certain signs to suspect SBO:
Once the patient's symptoms and exam point to a probable SBO, imaging tests such as CT scans or MR enterography help confirm the diagnosis. These tests can reveal where the obstruction is, what might be causing it (e.g., adhesions or hernias), and whether there are hints of strangulation or blood supply issues [2], [7]. Imaging can also reveal bowel wall thickening and edema, which are indicative of complications. Additionally, imaging can identify signs of vascular compromise, which necessitate prompt surgical intervention. Such detailed information from the images allows doctors to decide if surgery is necessary right away or if less invasive options could work first.
In the past, surgery was the first plan of action for SBO. Nowadays, doctors often try a combination of methods that do not always require an operation. These changes are thanks to better understanding of how SBO develops, the use of laparoscopic techniques, and improved imaging technology that gives a clearer picture of what's going on inside [8].
Small bowel obstruction, often caused by scar tissue, hernias, or tumors, requires immediate care to prevent serious complications. Quick diagnosis is essential, as untreated obstruction can lead to bowel perforation or tissue death. While modern diagnostic methods and nonoperative treatments can be effective, surgery remains crucial in certain cases. Awareness of risk factors and prompt intervention are key to a successful recovery.
[1] Taylor, M. R., & Lalani, N. (2013). Adult small bowel obstruction. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 20(6), 528–544. https://doi.org/10.1111/acem.12150
[2] Silva, A. C., Pimenta, M., & Guimarães, L. S. (2009). Small bowel obstruction: what to look for. Radiographics : a review publication of the Radiological Society of North America, Inc, 29(2), 423–439. https://doi.org/10.1148/rg.292085514
[3] Bower, K. L., Lollar, D. I., Williams, S. L., Adkins, F. C., Luyimbazi, D. T., & Bower, C. E. (2018). Small Bowel Obstruction. The Surgical clinics of North America, 98(5), 945–971. https://doi.org/10.1016/j.suc.2018.05.007
[4] Tong, J. W. V., Lingam, P., & Shelat, V. G. (2020). Adhesive small bowel obstruction - an update. Acute medicine & surgery, 7(1), e587. https://doi.org/10.1002/ams2.587
[5] Rami Reddy, S. R., & Cappell, M. S. (2017). A Systematic Review of the Clinical Presentation, Diagnosis, and Treatment of Small Bowel Obstruction. Current gastroenterology reports, 19(6), 28. https://doi.org/10.1007/s11894-017-0566-9
[6] Azagury, D., Liu, R. C., Morgan, A., & Spain, D. A. (2015). Small bowel obstruction: A practical step-by-step evidence-based approach to evaluation, decision making, and management. The journal of trauma and acute care surgery, 79(4), 661–668. https://doi.org/10.1097/TA.0000000000000824
[7] Tai, F. W. D., & Sidhu, R. (2023). Small bowel obstruction: what a gastroenterologist needs to know. Current opinion in gastroenterology, 39(3), 234–241. https://doi.org/10.1097/MOG.0000000000000924
[8] Aka, A. A., Wright, J. P., & DeBeche-Adams, T. (2021). Small Bowel Obstruction. Clinics in colon and rectal surgery, 34(4), 219–226. https://doi.org/10.1055/s-0041-1725204
[9] Cappell, M. S., & Batke, M. (2008). Mechanical obstruction of the small bowel and colon. The Medical clinics of North America, 92(3), 575–viii. https://doi.org/10.1016/j.mcna.2008.01.003
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Newsweek
04-06-2025
- Newsweek
SNAP Cuts Could Cost Michigan $900 Million: 'Unacceptable'
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Budget officials in Michigan have reported that federal food assistance spending cuts included in the One Big Beautiful Bill Act would cost Michigan approximately $900 million. The budget bill, passed by the House of Representatives in May and being considered by the Senate currently, exceeds 1,000 pages and contains some of the most significant changes to food stamp eligibility and benefits in recent years. Some $290 billion is earmarked to be cut from the nation's largest anti-poverty program via tightening eligibility, shifting program costs to states and limiting future benefit increases. Why It Matters Around 15 percent of Michigan's population—nearly 1.5 million residents—relies on SNAP benefits to help them purchase essential groceries. According to the Center for Budget and Policy Priorities, a left-leaning think tank, more than 59 percent of SNAP participants in the Great Lakes State are in families with children, and 39 percent are in families with older adults or are disabled. What To Know The State Budget Office (SBO) memo, prepared in consultation with the Michigan Department of Health and Human Services (MDHHS), concluded that the state likely would not be able to cover the food assistance cuts without severely harming funding for education, public safety and Medicaid. Stock image/file photo: Customer entering a grocery store. Stock image/file photo: Customer entering a grocery store. GETTY The SBO also said there would be a knock-on effect on businesses in Michigan. In the 2024 fiscal year, it reported $3.2 billion in SNAP benefits "supported almost 10,000 retailers across the state, paying grocery stores, farmers markets, and other businesses in Michigan and contributing to local economies," saying that federal cuts would be "devastating." Michigan is not the first state to outline the significant financial impact Republican plans could have on state finances. In late May, the Wisconsin Department of Health Services said the state would lose some $314 million in food assistance if President Trump's bill comes to pass. What People Are Saying Democratic Governor Gretchen Whitmer said in a statement on Wednesday: "In Michigan, we will fight to make sure our kids and families are fed, but we need Republicans in our congressional delegation to step up for their own constituents who need SNAP and Medicaid to survive. If these cuts are signed into law, more Michiganders will go to bed with a pit in their stomach. That's unacceptable." The Center on Budget and Policy Priorities, a left-leaning think tank, reported in March: "Mandating that states pay even a small share of SNAP food benefit costs would hit state budgets hard at a time when many states are facing revenue downturns. States are not in a position to absorb these substantial additional costs. In fiscal year 2024, tax revenue fell in 40 states after adjusting for inflation, and many states are projecting budget shortfalls in the short and long term." President Donald Trump, in a post on Truth Social, said the One Big Beautiful Bill Act will "make sure SNAP is focused on Americans ONLY!" What Happens Next The legislation moves to the GOP-controlled Senate this week, where potential changes to the bill will be considered.
New York Post
01-06-2025
- New York Post
How many days a month the average person is tired, has headaches or deals with tummy issues
Feeling off more often than on? You're not alone. Most of us are running on empty, clutching our stomachs or popping pain relievers more often than we'd care to admit — and a fresh study has the data to prove it. 3 A new survey shows Americans feel tired an average of 12.9 days per month. Antonioguillem – A new survey — conducted by Talker Research on behalf of Doctor's Best — has revealed that only 28% of us feel completely healthy, with the remaining 72% living in chronic discomfort. Respondents said they feel tired 12.9 days, experience mood changes 10.1 days, suffer from tummy issues 9.8 days and deal with headaches 7.5 days — per month. The research also found that the average American only feels truly healthy for 19 days out of the month — meaning nearly two weeks are spent in a fog of fatigue, headaches or digestive distress. And those aches and pains may be taking more than a physical toll. 3 Around 32% of men admit to having trouble performing sexually as a result of their health issues. fizkes – Roughly 65% of Americans say their health issues make it more difficult to function optimally at their job — and 40% report they make it harder to exercise, potentially creating a negative cycle of wellbeing. Another 15% complain they take away from their ability to enjoy quality time with family and 32% of men admit to having trouble performing sexually as a result. Of the maladies, gut issues appear to have the biggest impact on our personal lives — as one in three Americans regularly deal with stomach problems, with almost half (48%) confessing these tummy troubles make them more reluctant to have sex. 'When your gut is unbalanced, everything else begins to suffer: work, sleep, intimacy and even the simple joy of being with family,' Katie Lucas, CMO of Doctor's Best, said in a press release. 3 'When your gut is unbalanced, everything else begins to suffer: work, sleep, intimacy and even the simple joy of being with family,' Katie Lucas said. leszekglasner – 'We often try to convince ourselves that health is a private issue, but the statistics show otherwise. When we don't feel well, it affects every aspect of our lives. Healing the gut isn't just about improving digestion; it's about reclaiming the parts of life we're gradually losing.' Perhaps surprisingly, the data indicates that — of all of the generations — Gen Z is the one most likely to suffer from upset stomach. This is troubling, as bloating, gas and discomfort are often dismissed as harmless digestive issues, but they can sometimes signal more serious health problems — such as colon cancer, which has been on the rise among younger adults. 'Normalizing chronic symptoms like bloating, discomfort or irregular bowel habits can delay diagnosis of underlying conditions such as SIBO, IBS, celiac disease or even inflammatory bowel disease and colon cancer,' gastroenterologist Dr. Ali Rezaie previously told The Post.
Los Angeles Times
02-05-2025
- Los Angeles Times
Small Intestinal Bacterial Overgrowth (SIBO): What You Need to Know
When everything's working right, your small intestine is like a clean, well-organized hallway; nutrients pass through, digestion goes smoothly, and there's not much clutter. But sometimes, bacteria that usually hang out in the colon sneak in and start multiplying where they don't belong: the small intestine. That's where small intestinal bacterial overgrowth, or SIBO, comes into play. It's more than just bloating or discomfort; it's a condition that's increasingly being recognized as a driver behind chronic digestive issues and interconnected digestive diseases, but it remains tricky to pin down and even harder to diagnose definitively. One of the challenges in diagnosing SIBO is the range of gastrointestinal symptoms, such as diarrhea and bloating, that it can cause. At its core, SIBO happens when there's either: Traditionally, the diagnosis hinges on a test called the jejunal aspirate, which involves extracting fluid from the small intestine and checking for bacteria. A count of over 100,000 colony-forming units (CFU) per milliliter has been the benchmark. But more recent studies suggest that even 1,000 to 10,000 CFU/mL might indicate a problem [3], [10]. This variation reveals a big issue: there's no one-size-fits-all definition. The bacterial population in the small intestine plays a crucial role in diagnosing SIBO, as an abnormal increase can lead to symptoms like diarrhea and malnutrition. This is very different from Meckel's Diverticulum as well. People with SIBO often show up in primary care complaining of everyday symptoms like: These symptoms are easy to misattribute to other common issues like food intolerances or irritable bowel syndrome (IBS) [4]. In fact, SIBO may actually cause or worsen IBS and other functional gastrointestinal disorders. That's because the excessive bacteria can disrupt digestion, produce gas, and interfere with nutrient absorption [5]. Weight loss can also occur due to the malabsorption of nutrients. Here's what's happening behind the scenes: Despite its potential impact, SIBO often flies under the radar due to its overlapping symptoms and the challenges involved in making a clear diagnosis. While the jejunal aspirate remains the most direct method, it's invasive and not widely available [7]. More commonly, doctors use breath testing to measure hydrogen or methane gases produced by bacteria. But these tests have limitations—they can be inaccurate or yield inconsistent results. Because different clinics use different criteria to define and test for SIBO, it's hard to say how many people actually have it [3]. This lack of standardization makes it tough to collect reliable prevalence data. Understanding the risk factors associated with SIBO is crucial for identifying specific populations at risk and improving diagnostic accuracy. Exciting developments are on the horizon. Future tests may rely on metagenomics (studying bacterial DNA) and metabolomics (analyzing the chemical products of metabolism) to detect imbalances more precisely [9]. These techniques could provide a clearer picture of what's going on in the gut—and help reduce misdiagnoses. [8] Additionally, understanding the role of intestinal immunity in maintaining gut health could lead to more accurate diagnostic methods in the future. SIBO and intestinal methanogen overgrowth (IMO) are often lumped together, but they're not the same thing. IMO involves an overgrowth of methane-producing microorganisms—mainly Methanobrevibacter smithii—which can cause different symptoms, especially constipation [10]. Though the symptoms overlap with SIBO, the organisms and gases involved are different. That's why IMO requires distinct tests and treatments [6]. SIBO is still a bit of a puzzle. There's growing awareness, but many people remain undiagnosed or misdiagnosed. As science sharpens its tools, we're likely to see: Researchers are starting to think beyond just the number of bacteria in the small intestine and instead looking at the types of bacteria, how they interact with the body, and what chemicals they produce. All of this may eventually help tailor care to each person's gut microbiome. Nutritional support will also be a crucial element in future SIBO management, addressing deficiencies in vitamins and minerals to improve patient outcomes. SIBO is more than a minor gut nuisance—it's a real condition that can significantly affect daily life. But because it mimics other gastrointestinal issues, and because diagnostic methods aren't always consistent or reliable, it often remains overlooked. Recognizing and addressing the underlying cause of SIBO is crucial for effective management and prevention of recurrence. Fortunately, we're entering a new phase of understanding thanks to better research, advanced testing, and a deeper appreciation for how our gut bacteria influence health. As clinicians gain more clarity on what SIBO is—and isn't—patients with chronic GI symptoms may finally get the answers and relief they've been searching for. In severe cases, individuals may experience significant health issues such as night blindness due to vitamin A deficiency, osteomalacia linked to vitamin D deficiency, and various neurological impairments resulting from vitamin B12 deficiency. [1] Pimentel, M., Saad, R. J., Long, M. D., & Rao, S. S. C. (2020). ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth. The American journal of gastroenterology, 115(2), 165–178. [2] Zafar, H., Jimenez, B., & Schneider, A. (2023). Small intestinal bacterial overgrowth: current update. Current opinion in gastroenterology, 39(6), 522–528. [3] Rao, S. S. C., & Bhagatwala, J. (2019). Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management. Clinical and translational gastroenterology, 10(10), e00078. [4] Krajicek, E. J., & Hansel, S. L. (2016). Small Intestinal Bacterial Overgrowth: A Primary Care Review. Mayo Clinic proceedings, 91(12), 1828–1833. [5] Skrzydło-Radomańska, B., & Cukrowska, B. (2022). How to Recognize and Treat Small Intestinal Bacterial Overgrowth?. Journal of clinical medicine, 11(20), 6017. [6] Rezaie, A., Pimentel, M., & Rao, S. S. (2016). How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach. Current gastroenterology reports, 18(2), 8. [7] Quigley E. M. (2014). Small intestinal bacterial overgrowth: what it is and what it is not. Current opinion in gastroenterology, 30(2), 141–146. [8] Bushyhead, D., & Quigley, E. M. (2021). Small Intestinal Bacterial Overgrowth. Gastroenterology clinics of North America, 50(2), 463–474. [9] Ponziani, F. R., Gerardi, V., & Gasbarrini, A. (2016). Diagnosis and treatment of small intestinal bacterial overgrowth. Expert review of gastroenterology & hepatology, 10(2), 215–227. [10] Takakura, W., & Pimentel, M. (2020). Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome - An Update. Frontiers in psychiatry, 11, 664.
