Bowel obstruction history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

## Overview

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The hallmark of bowel obstruction is abdominal distension with waxing and waning pain and obstipation. A positive history of previous abdominal surgery and abdominal adhesion is suggestive of bowel obstruction. The most common symptoms of bowel symptoms include abdominal pain with nausea and vomiting, abdominal distension, and obstipation. Common symptoms of bowel obstruction include episodic pain, abdominal distension, and constipation. Less common symptoms of bowel obstruction include constant severe pain, sudden severe pain, and postprandial abdominal discomfort.

## History and Symptoms

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### History

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Patients with bowel obstruction may have a positive history of:[1][2]

* Previous abdominal surgery
* Crohn's disease
* Hernia
* Foreign body ingestion
* Colorectal cancer

### Common Symptoms

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Common symptoms of bowel obstruction include:[3][4]

* Paroxysmal abdominal pain
* Abdominal distension
* Nausea
* Vomiting
* Obstipation
* Constipation

### Less Common Symptoms

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Less common symptoms of bowel obstruction include:[5]

* Constant severe pain - indicates peritoneal irritation
* Sudden severe pain - indicates bowel perforation
* Postprandial abdominal discomfort - may suggest chronic bowel obstruction

### Nature of pain in bowel obstruction

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#### Small bowel obstruction

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* In small bowel obstruction the pain tends to be colicky (cramping and intermittent) in nature, with spasms lasting a few minutes.
* The pain tends to be central and mid-abdominal.

#### Large bowel obstruction

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* In large bowel obstruction the pain is felt lower in the abdomen and the spasms last longer.

## References

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1. ↑ Mucha P (1987). "Small intestinal obstruction". Surg. Clin. North Am. 67 (3): 597–620. PMID 3296252.
2. ↑ Miller G, Boman J, Shrier I, Gordon PH (2000). "Etiology of small bowel obstruction". Am. J. Surg. 180 (1): 33–6. PMID 11036136.
3. ↑ Taylor MR, Lalani N (2013). "Adult small bowel obstruction". Acad Emerg Med. 20 (6): 528–44. doi:10.1111/acem.12150. PMID 23758299.
4. ↑ Cheadle WG, Garr EE, Richardson JD (1988). "The importance of early diagnosis of small bowel obstruction". Am Surg. 54 (9): 565–9. PMID 3415100.
5. ↑ Tamijmarane A, Chandra S, Smile SR (2000). "Clinical aspects of adhesive intestinal obstruction". Trop Gastroenterol. 21 (3): 141–3. PMID 11084840.

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