1. Bowel obstruction occurs when the bowel becomes blocked, preventing food and liquids from passing through the intestines. This can affect either the small or large intestine. 2. There are different types of bowel obstruction including small or large intestine obstruction, partial or complete obstruction, and mechanical or functional obstruction. 3. Symptoms of bowel obstruction include abdominal pain, bloating, vomiting, constipation, and loss of appetite. Diagnosis involves imaging tests and physical examination to locate the blockage. 4. Treatment depends on the severity and includes managing symptoms, surgery to remove or bypass the blockage, and nursing care during recovery. Complications can include infection, sepsis, and short bowel syndrome.

1. 1
BOWEL OBSTRUCTION
Mrs. D. Melba Sahaya Sweety RN,RM
PhD Nursing , MSc (Pediatric Nursing),
B.Sc Nursing
Associate Professor
Enam Nursing College,
Savar, Bangladesh.

2. INTRODUCTION
Intestinal obstruction, also known as bowel
obstruction is the disorder which causes the
blockage of the bowel. It can be either partial
or full. These blockages prevent the liquid or
food from passing through the intestine. The
blockage can be either in the small or large
intestine. Intestinal obstruction leads to
stoppage of the blood flow to the intestine,
which in turn causes the death of part of the
intestine.
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3. DEFINITIO
N
Bowel obstruction (or intestinal obstruction) is a
mechanical or functional obstruction of the
intestines, preventing the normal transit of the
products of digestion.
– LEWIS.
Partial or Complete impairment of the forward
flow of intestinal contents is known as an
Intestinal Obstruction.
– JOYCE M.BLACK
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4. TYPES OF BOWEL
OBSTRUCTION
Types of Intestinal
Obstruction
Based on the
Location
Small bowel Obstruction
Large bowel Obstruction
Based on the
degree of
Obstruction
Partial Obstruction
Complete Obstruction
Pseudo Obstruction
Based on the
Process of
Obstruction
Mechanical Obstruction
Functional or Paralytic
Obstruction
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5. TYPES OF BOWEL
OBSTRUCTION
Small bowel
Obstruction
Small bowel obstruction is
a partial or complete
blockage of the small
intestine, This causes waste
matter and gases to build up
in the portion above the
blockage. It could also
interfere with the
absorption of nutrients and
fluids.
Large bowel
Obstruction
Large bowel obstruction is
an interruption in the
normal flow of intestinal
contents through
the colon and rectum. A
large bowel obstruction is a
medical emergency. Gas and
stool build up, and the
intestine may rupture.
Partial
Obstruction
Complete
Obstruction of the
intestine cause no
food is passed
through the intestine.
an occlusion of
arterial blood supply
to the bowel
effectively stops
bowel function.
Complete
Obstruction
In this type, some
kind of food and
fluids are still able
to pass through the
intestine
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6. TYPES OF BOWEL
OBSTRUCTION
Pseudo Obstruction
Intestinal pseudo-
obstruction (paralytic ileus)
can cause signs and
symptoms of intestinal
obstruction, but it doesn't
involve a physical blockage.
In paralytic ileus, muscle or
nerve problems disrupt the
normal coordinated muscle
contractions of the
intestines, slowing or
stopping the movement of
food and fluid through the
digestive system.
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Mechanical Obstruction
An intraluminal obstruction
or a mural obstruction from
pressure on the intestinal
wall occurs. Example
Intussusception, neoplasm,
stenosis, strictures, adhesion
etc..
Functional or Paralytic
Obstruction
The intestinal musculature cannot
propel the content along the bowel.
Examples are amyloidosis, muscular
dystrophy, endocrine disorders such
as diabetes, or neurologic disorders
such as Parkinson disease. The
obstruction also can be temporary
and the result of the manipulation of
the bowel during surgery.

7. Intestinal
adhesions: bands
of fibrous tissue in
the abdominal cavity
that can form after
abdominal or pelvic
surgery that may
force the intestines
out of place.
Hernias:
portions of intestine
that protrude into
another part of your
body
Crohn's disease:
which can cause the
intestine's walls to thicken,
narrowing the passageway
ETIOLOGY - SMALL BOWEL OBSTRUCTION
Cancer: It
obstruct the
intestinal Flow
Volvulus :
Twisting of the
colon
Intussusception. This
condition means that a
segment of your intestine
slides into another segment
Ischemic
strictures
Intestinal
Atresia:
disruption in the
normal small
intestine continuity,
Foreign Body
Obstruction 7

8. Colon cancer.
A cancerous tumor
causes the blockage
ETIOLOGY - LARGE BOWEL OBSTRUCTION
Diverticulitis.
Tiny pouches
(diverticulae) can
grow off the large
intestine lining.
These may become
inflamed.
Volvulus :
Twisting of
the colon
Inflammatory
Bowel disease :
That cause
adhesion and
obstruction
Constipation
and Fecal
Impaction or
Fecaloma
Colon Atresia
Adhesion
Endometriosis
infiltrating the muscularis
propria may lead to localized
fibrosis in the bowel wall,
strictures, and small or large
bowel obstruction
Hernia
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9. Intraluminal Factors : Obstructed Hernia,
Postoperative adhesion, volvulus, Intussusception, Tumor/
foreign body
PATHOPHYSIOLOG
Y Extraluminal Factors : Paralytic ileus due
to abdominal surgery, hypokalemia, vascular
insufficiency, Neuromuscular diseases
Strangulation and injury to bowel
Obstruction to the flow of Fluid
Gas and Fluid Collection
Increased Intraluminal pressure
Necrosis of bowel mucosa and perforation
of the intestine
Anaerobic bacterial growth and seepage of
intestinal content
PERITONITIS
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10. Severe
Abdominal
Bloating
CLINICAL
MANIFESTATION
Abdominal Pain: In
small bowel obstruction the
pain tends to be colicky
(cramping and intermittent) in
nature, with spasms lasting a
few minutes. In large bowel
obstruction the pain is felt
lower in the abdomen and the
spasms last longer
01 02 03
Abdominal
Distension
04
Vomiting and
Constipation: In
small bowel obstruction
Vomiting occurs before
constipation. In large
bowel obstruction
Constipation occurs
earlier and vomiting
may be less prominent.
Dehydration and
Electrolyte
abnormalities :
are seen in SBO
05 06 07 08
Loss of
appetite
Rectal
Bleeding:
may present
in LOB
Visible
Peristaltic
wave with
high pitched
tinkling
sound: due to
abdominal
distension
Diarrhea:
Due to
partial bowel
obstruction
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11. History Collection : About any recent surgeries or medical treatments as well as
ongoing health conditions and signs and symptoms.
CT scan or MRI : This imaging procedure provides more detailed
photos than x-rays.
Abdominal X-rays can show a bowel blockage’s location.
These images can also show air around the intestine or diaphragm
Air in these places can indicate a dead bowel or rupture.
Physical Examination: To identify the location of the Pain, any mass
or lump.
DIAGNOSTIC
EVALUATION
Barium Enema: This procedure is performed to rule out the exact location of
Obstruction .
Laboratory studies: Electrolyte and Complete blood count
reveals the picture od dehydration, possible infection and plasma
volume.
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12. PERITONITIS
COMPLICATIONS
SEPSIS
SHORT
BOWEL
SYNDROME
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13. MEDICAL MANAGEMENT
MANAGEMENT
NG aspiration and Decompression:
by Putting a tube through your
nose and into your stomach
(nasogastric tube)to suck out air
and fluid and relieve abdominal
swelling
Administer IV Fluid: to correct
electrolyte imbalance
DRUG THERAPY
Opioids : To relieve pain
Antiemetics : to relieve
vomiting
Antibiotics : For infection
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14. MANAGEMENT
SURGICAL MANAGEMENT
Cecostomy : by in which surgical
opening of the cecum may be
performed who are poor surgical
risk and urgently need relief.
Stent Placement: A mesh tube
called a stent is placed inside the
intestine to open forcefully is a
safe option for people who are too
sick for surgery
colostomy or ileostomy: It is a
surgical procedure that brings one
end of the large intestine out 14

15. MANAGEMENT
NURSING MANAGEMENT
Who Does not require surgery:
 Assessing and measuring the NG output
 Assessing for fluid electrolyte imbalance
 Monitoring nutritional status.
 Monitor the patient symptoms indicating that the
intestinal obstruction is worsening
 Provide emotional support and comfort.
Surgery is required:
• Prepare the patient for surgery include preoperative
education regarding post operative nursing care,
wound care, Colostomy care etc..
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