Anyone who has had abdominal surgery can develop scar tissue that binds loops of bowel to each other or to the abdominal wall during healing. These are called adhesions. The more operations a person has had — and the more inflammation or infection was involved — the more likely adhesions are to form and the more extensive they tend to be. Adhesions often cause no symptoms at all, but when they narrow or kink a segment of intestine, food and gas can no longer pass through, leading to a bowel obstruction.
An obstruction usually announces itself with fairly recognizable signs. The abdomen swells and feels increasingly tight, and crampy, wave-like pain comes and goes. Vomiting is common, and over time the passage of gas and stool may stop completely. Because this can resemble simple indigestion or constipation, it is easy to dismiss as something that was eaten. But the two are very different: an untreated obstruction can compromise blood flow to the blocked segment, damage the bowel wall, and allow bacteria and inflammation to spread through the body — a dangerous condition called sepsis.
Older adults, in particular, are used to enduring discomfort and may fear that going to the hospital means bad news, so they often arrive late after tolerating symptoms for days. Yet many obstructions resolve with nothing more than bowel rest (no food), decompression through a nasogastric tube, and intravenous fluids when caught early — while a delayed case may require emergency surgery and a much harder recovery. It is safer to seek emergency care when the abdomen keeps swelling with persistent severe pain, when vomiting follows every attempt to eat, when there is no gas or stool for more than a day, or when fever or sudden weakness appears.
During recovery, gentle movement and walking — as directed by the care team — help restart the bowel. Lying in bed continuously because of pain can let the intestine become more sluggish, so with appropriate pain control it is generally better to get up and walk often within a comfortable range. Meals are usually restarted slowly with clear liquids, and eating smaller amounts more frequently while chewing well can ease the strain. What to eat and when, and how much activity is appropriate, vary from person to person, so these decisions are best made together with the medical team.
This article is for general information only and does not replace diagnosis or treatment for any individual. If you suspect these symptoms or are unsure, please consult a healthcare professional.