Crohn’s disease-related inflammation can sometimes lead to intestinal blockage. Untreated, an intestinal blockage may lead to serious complications.

Crohn’s disease is a chronic condition that causes irritation and inflammation of the gastrointestinal (GI) tract. The disease most often affects the small and large intestine. However, inflammation can occur anywhere in the GI tract, from the mouth to the anus.

Chronic inflammation of the intestines can cause them to become thicker, or edematous. The inside lining of your intestine can swell, giving your food or stool less room to move. This can put you at risk of blockages in your intestines.

Keep reading to learn the possible warning signs of intestinal obstruction from Crohn’s disease, the types of blockages that can occur, and how doctors treat them.

The symptoms of a chronic blockage may come on shortly after a meal and include:

Vomiting, diarrhea, or constipation may sometimes occur as well.

Partial or complete blockages typically require urgent medical attention.

The types of blockages that can occur include:

Strictures

The chronic intestinal inflammation that characterizes Crohn’s disease may also lead to the development of scar tissue in your intestines.

As the cycle of inflammation and scarring continues, part of the intestinal tract may become narrow. This narrowed area is known as a stricture, or stenosis. If a stricture becomes too narrow, it may eventually block your intestinal tract.

If you have an intestinal stricture and you eat something that’s difficult to digest, the food you’ve eaten may lead to a bowel obstruction. Foods that can cause a bowel obstruction include:

  • raw vegetables
  • popcorn
  • nuts

The stricture itself can also become inflamed and cause blockages as well.

Crohn’s disease affects the entire thickness of the bowel wall. It can affect the small intestine. Because the small intestine is more narrow, Crohn’s strictures can lead to obstruction. Bowel obstructions with strictures may be temporary or permanent.

Adhesions

People with Crohn’s disease who have had a previous abdominal surgery may be more prone to developing adhesions. Adhesions can also develop from an abscess or fistula.

Internal organs normally have slippery surfaces that keep them from sticking together while your body is moving. Adhesions are bands of tissue that form on the surface of your organs. They can make your organs stick together.

Adhesions are frequently caused by abdominal surgery. An estimated 90% of people who have surgery that involves opening the abdomen develop adhesions.

For most people, adhesions are painless and don’t cause any problems. However, for some people, the adhesion may cause the intestine to become fixed or stuck on another organ. Additionally, the adhesions may form between different parts of the small or large bowel. If a fixed intestine becomes twisted, it can lead to an obstruction.

Bowel obstructions caused by adhesions can get better without surgery but still require medical attention.

You may require the temporary placement of a nasogastric (NG) tube to relieve symptoms related to the obstruction. This involves placing a narrow plastic tube through your nose and into your stomach. The tube is then attached to a vacuum suction. It removes any excess gas or fluids in your stomach that are present because of the obstruction. In very severe and rare cases, surgery is required to cut the adhesions and untwist the bowel.

Tumors

Crohn’s disease can raise the risk of certain types of cancer, including colorectal cancer. Immunosuppressant medications can also increase the risk of some types of cancer, including lymphoma.

While uncommon, blockages can also potentially result from tumors developing in the digestive tract. Some tumors, including those from colon cancer, grow slowly and may cause gradual symptoms that worsen over time. However, other types of tumors may develop more quickly and result in symptoms that can appear suddenly.

These blockages typically require surgery.

A person with temporary small bowel obstruction usually gets better within 48 hours of an NG tube placement. Eventually, they can advance to a clear fluid diet or take anti-inflammatory medications to reduce the swelling and inflammation produced by . Depending on the level of pain, doctors also prescribe pain-relieving medications administered through an IV.

In more serious cases, high dose steroids and a sterilized liquid diet usually help reduce the swelling.

Other people may require surgical intervention.

Endoscopy

Medications are not usually effective when a blockage is predominantly due to strictures. If this happens, a doctor or healthcare professional may perform an endoscopy to diagnose strictures and treat possible blockages.

During an endoscopy, a doctor passes an inflatable balloon through an endoscope, a long, thin tube with a camera on the end. They pass it through your mouth and into your stomach and small intestine to dilate the area of scarring. Success rates are very high for this procedure. An endoscopy may relieve symptoms for weeks, months, or even years for some people.

Surgery

If the area isn’t accessible with an endoscope or if stenosis recurs, surgery may be necessary. Surgery is generally reserved for people who continue to experience bowel obstruction despite the conservative therapies mentioned above. Also, if you develop a severe complication of obstruction, such as bowel necrosis or perforation, you’ll likely need emergency surgery.

The two types of surgery performed on people with Crohn’s disease of the small bowel are:

  • resection, which involves removing the scarred or blocked area of the intestine
  • strictureplasty, which involves restructuring the area of the stricture to make it wide again and allowing the passage of stool and intestinal contents.

The best candidates for strictureplasty are those who have had a resection before or have severe Crohn’s disease symptoms. Many who receive strictureplasty are able to stop taking medications and stay in remission from Crohn’s disease.

Strictures that are opened with strictureplasty usually remain open. People who have the procedure will generally only require surgery again if new strictures form elsewhere. Most people who’ve had the surgery begin to eat normally and even gain weight after the operation.

An intestinal obstruction can be a medical emergency. If you think you may have one, it’s best to get prompt medical attention.

Indicators of an obstruction can include:

  • nausea
  • vomiting
  • bloating
  • diarrhea
  • constipation
  • abdominal pain, which may be crampy and become severe
  • a high fever
  • intractable vomiting
  • an inability to pass gas or stool

Your symptoms may vary based on the location of the obstruction.

An intestinal blockage is treatable. However, if you don’t receive prompt treatment, the blocked parts of the intestine can start to die. Not getting prompt treatment can lead to very serious complications, such as a life threatening infection called sepsis.

Here are some questions people often ask about intestinal blockages.

How do you fix Crohn’s blockage?

Treating a blockage from Crohn’s disease depends on the underlying cause.

If the blockage results from strictures, a doctor may recommend dilation or surgery. If the blockage results from an adhesion, you may need bowel rest or surgery.

During bowel rest, doctors may recommend a liquid diet and medication initially. If that doesn’t work, surgery may be needed. An intestinal blockage can be an emergency, so it’s important to get prompt medical attention.

How do you clear an intestinal obstruction?

A complete intestinal obstruction is a medical emergency that often requires surgery.

For a partial bowel obstruction, your doctor may recommend waiting to see if it will clear on its own without surgery. Be sure to follow your doctor’s orders, including taking medications exactly as prescribed and switching to a liquid diet.

How long can you live with an obstructed bowel?

A bowel obstruction can be fatal if not treated. People who have a complete bowel obstruction and aren’t receiving fluids may only survive a few days to a few weeks. If they are receiving fluids, they may survive for up to two months. Complete bowel obstruction can also lead to perforation, or a hole in the wall of the intestine, which can become fatal.

Even a partial bowel obstruction is a serious problem that requires immediate medical attention.

What are the symptoms of an obstruction of the bowel?

The most common symptoms of a bowel obstruction include:

  • stomach pain, cramping, and swelling
  • bloating
  • vomiting
  • trouble passing gas
  • constipation

What does a Crohn’s blockage feel like?

A Crohn’s blockage may leave you feeling full, bloated, or gassy. You may have trouble passing gas or feel constipated. You may also experience nausea or vomiting. You may feel pain that worsens and becomes severe.

An intestinal obstruction, whether partial or complete, usually requires medical intervention. If you suspect one, it’s best to talk with your doctor or get emergency medical attention.

Treatment can depend on the exact cause of the obstruction but may involve the placement of an NG tube to remove the contents from your digestive system until the obstruction resolves.

Some obstructions may require surgery.