Small Bowel Obstruction Bariatric Surgery: Essential Tips for Success

Key Takeaways

• A small bowel obstruction is when your intestines become blocked, making it difficult or impossible for food, liquids, and air to move through. This can be a particular concern after bariatric surgery and may impact nutrient intake, underscoring the importance of bariatric vitamins and other supplements to maintain health.
• Symptoms may include nausea, vomiting, abdominal pain, and changes in stool patterns.
• Without treatment, a small bowel obstruction can cause severe complications, making it crucial for those who have undergone bariatric surgery to monitor their symptoms and follow prescribed aftercare, such as consuming bariatric protein shakes and bariatric multivitamins for nutritional support.

Small bowel obstruction (SBO) is a serious complication that can occur after bariatric surgery. The seriousness of the condition can range from being a nuisance to a life-threatening emergency if not promptly identified and treated.

They can occur due to scar tissue from bariatric surgery or an internal hernia. Treatment may involve having surgery to fix the obstruction, including options such as laparoscopic bariatric surgery for certain cases.

Post-surgery, certain supplements like bariatric vitamins chewable or liquid bariatric vitamin are recommended for patients to ensure they meet their daily nutritional needs, potentially aiding in faster recovery and reducing SBO risks.

In this article, we discuss what a small bowel obstruction is, its symptoms, treatment options, and follow-up care.

What is Small Bowel Obstruction?

SBOs happen when the small intestines become partially or completely blocked, preventing the normal flow of food, fluids, and gas. Because nothing can pass through, your stomach may start becoming distended, you may not have an appetite or even vomit, and it may be difficult to pass gas or have a bowel movement.

Healthcare professionals classify SBO as either partially or completely blocked. In a partial blockage, some food, fluids, and air can pass through, whereas in a complete blockage, nothing can pass through.

Also, an SBO can be simple or strangulated. Simple means there’s no damage to the blood supply to the intestines, and strangulation means the blood is no longer flowing to that area. A lack of blood supply can lead to the intestinal tissues dying.

Without treatment, an SBO can lead to severe complications such as intestinal perforation, infection, or sepsis (a severe infection and medical emergency).

How Do Doctor’s Diagnose a Small Bowel Obstruction?

If your surgeon suspects that you have an SBO, they’ll perform a physical exam, listen to your stomach sounds with their stethoscope, gently press on different areas of your abdomen, and ask you about your symptoms.

They may also use imaging techniques to look at your intestines.

• Abdominal X-ray: An abdominal X-ray may show the location of the blockage by showing the healthcare provider where free air is present in your abdomen.
• CT-Scan: A CT-scan is able to show a more detailed picture of where the blockage may be and what is causing it.
• Ultrasound: This procedure uses a small probe pressed along the outside of your abdomen to find where the bowel obstruction is.

Symptoms & Causes of Small Bowel Obstruction in Bariatric Surgery

Small bowel obstructions after bariatric surgery can occur soon after surgery or several years later.

The most common symptoms of small bowel obstruction include:

• Nausea
• Vomiting
• Loose stool
• Constipation
• Abdominal pain
• Abdominal distension
• Complete inability to pass any stool or gas

Small bowel obstruction after bariatric surgery can happen for several reasons. Sometimes, the intestines can twist, and nothing can flow through, like a garden hose that gets twisted and kinked. 

Other times, scar tissue that forms while the body recovers from bariatric surgery may grow around the intestine and strangle it. In other cases, the intestines may push through a weak area of the abdominal wall, forming a hernia that creates a blockage.

Treatment Options & Preventative Strategies Post-Bariatric Surgery

Treatment for SBO after bariatric surgery can include surgical and non-surgical methods. 

In severe cases, your surgeon will typically need to perform surgery to correct the blockage. This may include laparoscopic procedures to remove the blockage, repair a hernia, or release scar tissue that’s constricting the intestines.

For partial obstructions or in less severe cases, your surgeon may try to manage the SBO with a non-surgical approach. This may include inserting a small tube into your stomach connected to suction to relieve pressure and remove excess fluids and gas. They’ll also start you on intravenous (IV) fluids to keep you hydrated and your electrolytes balanced.

Your surgeon will also give you medications to help control your pain and nausea.

Along with these treatments, your surgeon may ask you to rest your digestive system and avoid eating or drinking until the bowel obstruction is resolved.

Unfortunately, SBOs can happen even when you follow all your surgeon’s after-surgery instructions. However, to decrease the risk of developing an SBO, it’s important to stick to all the guidelines they give you about what and how much to eat. 

It’s also crucial to walk frequently after surgery.

If you develop any symptoms of a possible bowel instruction, let your surgeon know right away.

Outlook and Prognosis

With prompt treatment, most people recover after receiving treatment for their bowel obstruction. Being able to pass gas or have a bowel movement is a sign that your digestive system is working properly again.

On the other hand, if diagnosis and treatment is delayed, serious complications can arise such as your bowels rupturing or a severe infection.

When to Call the Doctor

Notify your surgeon immediately if you have the following signs or symptoms:

• Nausea
• Vomiting
• Complete loss of appetite
• Severe abdominal pain or cramping
• Inability to pass gas or have a bowel movement
• Fever

Importance of Monitoring and Follow-Up Care

After bariatric surgery, it’s important to follow your surgeon’s guidelines for follow-up care. This helps ensure the long-term success of your surgery and may help reduce the potential risk of complications from an SBO.

It’s also important to educate yourself on the signs and symptoms of SBO and seek immediate medical help if you develop any.

Conclusion

SBO is a serious potential complication after bariatric surgery. It requires immediate medical attention.

SBO severity can range from minor to life-threatening. An SBO can develop immediately after surgery or years later and is commonly caused by scar tissue, twisted intestines, or hernias.

Treatment ranges from non-surgical methods, like relieving pressure in the stomach through suction, to surgery for more severe cases.

Following your surgeon’s post-surgery guidelines and being aware of symptoms are essential for early detection and effective treatment.

If you want to learn more, why not check out these articles below: 

• Types of Bariatric Surgery
• Best Bariatric Surgery
• Duodenal Switch Bariatric Surgery
• Roux en y Bariatric Surgery

References

Clapp, B., (2015). Small bowel obstruction after laparoscopic gastric bypass with nonclosure of mesenteric defects. JSLS.

Schick, M., et al. (2023). Small Bowel Obstruction. Stat Pearls.