Bowel Obstruction

A bowel obstruction often occurs due to adhesions (internal scars) that form in the small intestines (small bowel) and sometimes in the large intestines (colon). Adhesions form as the first step in healing from a surgery, infection, inflammation or trauma. Adhesions are a primary cause of obstruction, or blockage, in the bowel. Regardless of where they form, adhesions join structures with strong glue-like bonds that prevent them from functioning properly.

Adhesions may form as curtains or ropes within or between the loops of the bowel, completely blocking the passage designed to transport food. When these adhesions prevent the body from processing food, a bowel obstruction can quickly become a life-threatening condition.

The first indication of a bowel obstruction is often pain, nausea or vomiting accompanied by difficulty or inability to pass gas or stool. Blocked from its normal clear passage, food becomes backed up. The intestines stop functioning, preventing the patient from eating or eliminating waste.

The first symptoms of a bowel obstruction are often pain, nausea or vomiting accompanied by difficulty or inability to pass gas or stool.

A more comprehensive list of bowel obstruction symptoms include:

• Pain or tenderness around or just below the belly button
• Stomach cramps that come and go
• Swelling or bloating of the stomach (distention)
• Constipation and the inability to pass gas (sign of complete blockage)
• Diarrhea (if bowel is partially blocked)
• Nausea and vomiting

If you are experiencing severe abdominal pain or other bowel obstruction symptoms, you should seek immediate medical care.

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We know bowel adhesions well. We faced a similar situation 20 years ago when our Director of Services, Belinda Wurn, PT, developed severe adhesions after pelvic surgery and radiation therapy to her abdomen. Unable to work due to the pain, and having seen the devastating effects of bowel adhesions in her own patients, Belinda was determined to find a non-surgical way to address bowel obstructions.

With her husband, massage therapist Larry Wurn, Belinda began investigating the etiology and biomechanics of adhesion formation. They discovered that adhesions are made of tiny but powerful strands of collagen, similar to the strands of a nylon rope. These strands form after a surgery or other tissue trauma to help the body heal. Once healing has occurred, these bonds remain in the body and can grow to create powerful bonds, like straitjackets in the body. The Wurns found that the bonds appear to dissipate when placed under certain types of manual pressure and shearing.

The Wurn Technique^® focuses on reducing or eliminating bowel adhesions, crosslink by crosslink.

Using this knowledge, the Wurns began intensive study of the anatomy of internal structures, aiming to free the bonds without damaging the underlying structures. The Wurn Technique^® is a very site-specific physical therapy, the result of more than two decades of study and investigation by the Wurns and their staff. It has been credited with saving lives and returning normal lifestyles to many people, including those suffering from bowel obstructions.

Like peeling apart the run in a three-dimensional sweater, the Wurn Technique focuses on reducing or eliminating adhesions, crosslink by crosslink. It has been shown in peer-reviewed medical journals to reduce adhesions, decrease pain and improve soft tissue mobility without the risks of surgery or drugs. In fact, published studies and citations have shown its ability to open adhered structures as tiny as fallopian tubes,⁵ organs that are much smaller and generally less accessible than the small bowel. Clear Passage therapists have had many successes decreasing or eliminating the adhesions that block the intestines. They have broken the repetitive “adhesion-obstruction-surgery” cycle that many of their patients describe as their life before Clear Passage.

A 2013 study in the Journal of Clinical Medicine demonstrated the effectiveness of the Wurn Technique in treating bowel obstructions. Study participants with complex surgical histories and adhesions reported no symptoms after receiving the hands-on therapy. Each reported lasting pain relief and avoidance of further SBOs after therapy. X-rays for one participant showed that the obstruction cleared after therapy, while the other participant was canceled a scheduled bowel surgery after attending therapy.⁶
A study published in the Journal of Palliative Care in 2013 showed total reversal of bowel obstruction in a terminally-ill patient.

Before therapy, the patient lived with recurring SBOs, repeat surgeries, pain and dysfunction. She received nutrition intravenously, via PICC lines. After receiving the non-surgical therapy, she was able to have the PICC line removed because she could eat a normal diet, greatly increasing her quality of life.⁷

In addition to cancelling planned surgeries, therapy has allowed our bowel obstruction patients to manage their own symptoms, without fear of any additional bowel obstructions.

Once hospitalized with a bowel obstruction, the patient will generally receive a nasogastric (NG) tube through the nose and into the stomach to relieve pressure. Physicians then place a PICC line into a vein to draw blood, or to give the patient nutrition, pain medications, etc. Then, the medical team will wait to see if the obstruction clears on its own.

If the obstruction does not clear, doctors generally recommended open surgery as the primary method to clear small bowel obstructions. While this surgery can be effective and save the lives of those in immediate danger, obstructions tend to recur for many patients as post-surgical adhesions form in the months or years after surgery. Thus, many patients find themselves in a continuous cycle of “adhesions-obstruction-surgery-adhesions,” with no end in sight.

Surgical repair of the bowel generally involves cutting deeply into the body under general anesthesia to access the intestines. The physician often cuts through the bowel to remove the obstructed area. Finally, he reattaches the (now shortened) bowel ends.

While surgical lysis of bowel adhesions can be effective and save lives, it has some major drawbacks:

• It carries the risks associated with general anesthesia.
• It carries the risk of infection deep within the body (peritonitis) from spillage of bowel contents into the abdomen. Bacteria escaping into the body cavity can cause an infection in the body that requires another surgery, and/or significant quantities of antibiotics to clear. Sometimes, the second surgical wound is left open, to allow the body to heal from the inside. This can cause a considerable amount of internal scarring (adhesions).
• Despite the best skills of the finest surgeon, the body often creates more adhesions as it heals from the very surgery designed to remove them.

A study in Digestive Surgery found that more than 90% of patients develop adhesions after open abdominal surgery and 55% to 100% of women develop adhesions following pelvic surgery.³ Another study reported that 35% of all open abdominal or pelvic surgery patients were readmitted to the hospital more than twice to treat post-surgical adhesions during the 10 years after their original surgery.⁴ Thus, abdominal surgery has been identified as a major cause of adhesion formation, leaving many patients trapped in the “surgery-adhesions-surgery” cycle described earlier. Click here to watch patient testimonials.