A small bowel obstruction may resolve without invasive intervention, but abstaining from solid food is usually a first step.
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"You definitely have to change your diet," says Rajiv Chhabra, MD, a gastroenterologist with Saint Luke's Health System in Overland Park, Kansas, and Kansas City, Missouri. "Since things are moving slowly in your gastrointestinal tract and food is not moving freely, you want to consume things that will move more easily and not get stuck."
Causes, Symptoms and Diagnosis
A small bowel obstruction — whether partial or full — results from such conditions as adhesions, inflammatory bowel disorders, hernia and others that slow or block the flow of digested matter to your large intestine, resulting in a buildup of gases and waste in the portion of your intestine above the blockage, explains the Cleveland Clinic.
"The most common cause is a history of abdominal surgery that resulted in adhesions or scarring," Dr. Chhabra says. "Sometimes bowel gets twisted into a hernia."
"Diet does not usually initiate the obstruction, per se, but can aggravate the condition once you develop it," he says. "You usually have to have one of the above-mentioned baseline conditions first."
Symptoms, according to the Cleveland Clinic, may include abdominal bloating, stomach cramping and pain, nausea and vomiting, dehydration, appetite loss, malaise and, in the case of a complete obstruction, severe constipation.
To diagnose, your doctor will ask you about your medical history, survey your abdomen for pain, swelling, bulges and other signs and order blood tests, the Cleveland Clinic says. If you have more severe symptoms, like fever, an elevated heart rate or low blood pressure, your doctor may order imaging tests, such as X-rays or a CT scan.
All About Diet
While a complete small bowel obstruction may require surgery, a partial obstruction can often be managed conservatively, starting with restricting your diet to clear fluids and, if you take it, medication, Dr. Chhabra says.
"We recommend you start with pale fluids, such as water and broth — liquids you can see through, at least partially," he says. "As things get better, you can consume full liquids, which are more opaque. These include milk and high-calorie meal replacements like Ensure, which can help you meet nutritional needs."
The Provincial Health Services Authority (PHSA) in British Columbia, Canada, suggests making your own juices for variety and consuming hard candies, Jell-O and Popsicles to make the diet more tolerable. And, since most clear liquids have little to no protein, PHSA recommends asking your dietitian about supplementation if your clear-liquid diet is for five or more days.
Dr. Chhabra advises staying on the liquid diet until you have a bowel movement and start to pass gas, which indicates that your blockage is beginning to resolve. Symptoms like nausea and abdominal distress should also begin to abate.
"At that point, it is probably safe to start adding low-fiber foods, but you want to go slow," he adds. "Stay away from raw fruits and vegetables, seeds — anything with a husk — and dry meat, like barbecue." The PHSA recommends avoiding foods that have 2 or more grams of fiber per serving.
To Prevent a Recurrence
If you have another health condition that could cause an obstruction or have had an obstruction and want to keep it from happening again, Dr. Chhabra advises a number of dietary modifications:
- Avoid high-fiber foods and dry meats.
- Consume five or six small meals a day, rather than two or three large ones.
- Chew food thoroughly, at least 20 times or until it is liquid in your mouth.
plenty of fluids.
"Other things that can help are increasing physical activity, which stimulates bowel function and helps keep things moving," Dr. Chhabra says. Along that line, try to avoid becoming constipated. "Constipation slows down everything upstream in the small bowel as well," he says, "so if you feel like that is going to be a problem, consider a mild laxative or stool softener."
Is This an Emergency?
- Rajiv Chhabra, MD, gastroenterologist, Saint Luke’s Health System, Overland Park, Kansas, and Kansas City, Missouri
- Cleveland Clinic: “Small Bowel Obstruction: Overview”
- Cleveland Clinic: “Small Bowel Obstruction: Diagnosis and Tests”
- Provincial Health Services Authority, British Columbia, Canada: “Oncology Nutrition: Diet Advice to Manage a Partial Bowel Obstruction”
- U.S. National Library of Medicine: "Clear Liquid Diet"