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Ovarian Cancer: What to Know About Bowel Obstructions

Medically Reviewed by Laura J. Martin, MD on July 17, 2022

Your bowels are your large and small intestines. They form a long tube in your abdomen, and they have important jobs. They help break down food, absorb its nutrients, and turn it into waste.

A bowel obstruction is when something blocks digested food, liquid, or waste from passing through your intestines. It can be a complication of ovarian cancer. You’re more likely to get this complication if your cancer is advanced. It can affect your quality of life and how long you’re able to live with your cancer.

You might also hear your doctor call it an intestinal obstruction. It can cause symptoms like belly pain, nausea, and vomiting.

How Common Are Bowel Obstructions With Ovarian Cancer?

This is a common complication. Up to just over half (51%)  of those with advanced ovarian cancer have bowel obstructions.

How Can Ovarian Cancer Lead to a Bowel Obstruction?

Some of the causes of bowel obstruction aren’t directly related to the cancer. These include hernias, a buildup of excess fluid, and scar tissue caused by radiation therapy.  But the usual cause is tumors that grow in the abdominal cavity or on the surface of the intestines can press on the bowel or cause it to narrow. Sometimes scar tissue from past surgeries can also cause bowel obstructions. 

What Are the Symptoms of a Bowel Obstruction?

A bowel obstruction can cause symptoms like:

  • Severe bloating and belly pain
  • Nausea and vomiting
  • Not feeling hungry
  • Getting full quickly
  • Can’t tolerate eating or drinking
  • Constipation

If you have any of these symptoms with ovarian cancer, let your doctor know right away. 

How Do Doctors Diagnose a Bowel Obstruction?

Your doctor will give you a physical exam and ask you about your symptoms. They may test your blood and urine, too.

The doctor might also recommend tests like an X-ray or CT scan to see inside of your belly to learn exactly where a blockage is in your bowel.

What Are the Treatments for a Bowel Obstruction With Ovarian Cancer?

Some ways that doctors treat this problem are:

Fasting. If you have a mild or partial obstruction, your doctor might have you restrict your diet to small sips of fluids until the symptoms improve.  Most people need to go to the hospital for treatment so they can get fluids through a needle in the vein (IV) to stay hydrated while they’re not eating.

You should fast only if your doctor tells you to, and follow their directions exactly.

If your bowels open up again, your treatment team may tell you to eat easy-to-digest foods and avoid foods that are high in fiber.  That’s called a low-residue diet.

Nasogastric tube. This device might ease belly pain and pressure from an obstruction. Your treatment team places a tiny tube into your nose and sends it down to your stomach to remove fluids and gas.

Other procedures. Your doctor may recommend one of these procedures for you depending on your overall health and the type of obstruction you have:

  • The doctor may insert a tube through your skin and into your belly to let your stomach juices drain, so your digestive tract isn’t totally blocked.
  • Sometimes your doctor can put a stiff tube called a stent into your large intestine to ease a blockage. This procedure comes with a high chance for health problems afterward, so ask your doctor to explain the benefits and risks to you first. These include pain and rectal bleeding. It’s also possible that the stent could puncture your intestine or move to another part of it. 

Surgery. This can treat severe bowel obstructions. Doctors can do surgery to remove tumor or scar tissue, or to remove a portion of the obstructed bowel. They can also do surgery to create a colostomy (in your large intestine) or an ileostomy (in your small intestine) to bypass the obstruction. These procedures let waste leave your body through an opening made in your belly and into a pouch that you wear over the opening.

Surgery is usually only an option if you’re healthy enough to get other treatments, like chemotherapy, after the operation. A lot of the time, though, the ovarian cancer has grown too much in the abdomen for surgery to unblock the obstruction to work. Ask your doctor to help you weigh the pros and cons.

If they recommend that you get surgery, get plenty of protein to help improve your healing.  Your surgeon might opt to give you an infusion of nutrition through a vein (IV) -- called parenteral nutrition -- for a short time before the operation to help you recover afterward.  

Can You Prevent Bowel Obstructions From Ovarian Cancer?

The only thing you can do to lower your chances for a bowel obstruction is to get treatment for your ovarian cancer. If you have symptoms of an intestinal obstruction, tell your doctor ASAP. It may help you avoid the need for hospital treatment or surgery.

Show Sources

SOURCES:

Sarah Adams, MD, associate professor, department of obstetrics and gynecology, division of gynecologic oncology; associate director of translational research, The University of New Mexico, Albuquerque.

Shannon N. Westin, MD, associate professor, department of gynecologic oncology and reproductive medicine, division of surgery, MD Anderson Cancer Center, Houston.

American Cancer Society: “Treatment of Invasive Epithelial Ovarian Cancers, by Stage.”

National Cancer Institute: “Bowel.”

Stanford Health Care: “How is a bowel obstruction treated?”

Mayo Clinic: “Intestinal obstruction.”

Cancer Research UK: “A blocked bowel (bowel obstruction).”

Cleveland Clinic: “Small Intestine.”

Medline Plus: “Intestinal Obstruction.”

Clinical Endoscopy: “Colonic Stent-Related Complications and Their Management.”

AMA Journal of Ethics: “Surgery for Bowel Obstruction in Ovarian Cancer.”

UptoDate: “Etiologies, clinical manifestations, and diagnosis of mechanical small bowel obstruction in adults.”

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