Dear L.L.

In general, each part of your intestinal tract has a certain diameter (think of the size of a pipe). Intestinal contents are moved through the intestine by several methods (most by muscular contraction). If the contents are liquid or soft, like paste, they can be pushed through even narrowed areas. The bowel lumen (diameter) can be reduced by strictures (from Crohn’s or surgery), adhesions or kinks. The most common cause of a blockage is eating the wrong stuff, such as a big bag of chips, popcorn, broccoli, or fresh fruit. This collection of fibrous food may result in a food plug or blockage.

With a blockage or obstruction, the intestinal contents tend to back up and stretch the bowel proximal to the area of narrowing or blockage. Stretching the bowel wall results in crampy pain and distention. Patients may also experience nausea or vomiting (more common if the blockage is proximal or prolonged). As intestinal contents are not passing through the bowel, the ostomy output tends to be reduced, changed in character, or stopped completely.

If an obstruction occurs, we usually recommend that the patient go on liquids until their symptoms resolve. If pain or blockage symptoms persist for more than four hours, you should contact your physician or go to an emergency room. An exam or x-rays help to confirm the significance and site of the blockage. Risks associated with an intestinal blockage are restricted bloodflow to or rupture of the bowel (a perforation). If the physician doesn’t think that the bowel is ischemic (reduced blood supply) or perforated, the patient is given IV fluid, may receive a nasogastric tube (removes proximal air and fluid) and is placed on bowel rest (nothing by mouth). Selecte patients with an ostomy may benefit from stomal irrigation. Most of the time, these efforts will resolve the blockage. If the blockage is not resolved or the surgeon is concerned about ischemia or perforation, surgery may be needed.