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Thursday, February 2, 2012

Managing Small Bowel Obstructions

Some gynecological cancer survivors are at high risk for a small bowel obstruction.  This may be due to surgical adhesions or the tumor itself.  First, it is important to know what the signs and symptoms are of a partial small bowel obstruction.

Symptoms may be cramping, gas, bowel changes, nausea and vomiting.  Vomiting, increased abdominal girth and pain may indicate a total obstruction.  Keep in mind that symptoms may vary by individual and the severity of the obstruction.  It is important to notify your doctor immediately if you notice these symptoms.

Dietary Changes

With a partial small bowel obstruction, there may be dietary changes to minimize discomfort.  Here are some tips and strategies to help minimize discomfort:
  • Eat smaller meals, more frequently throughout the day.  Think appetizers, all day long.
  • High fiber foods may be more gas forming and be harder to pass through a narrow opening.
  • Follow a low fiber diet.  Avoid the skins on fruits and vegetables; avoid whole grains, nuts and seeds. 
  • Switch to white bread, white flour pasta and peeled potatoes which may be better tolerated.  
  • Eat lower fiber cereals (cereals with less than 3 gm of fiber per serving.) Some low fiber cereals include: puffed rice, Cheerios, cream of rice or cornflakes. 
  • Avoid fatty and greasy foods. These are much more difficult to digest and may stay in the stomach longer causing greater discomfort.
  • Drink plenty of fluids: water, broth, tea, gelatin and juice may help you stay well hydrated.  Some people find that “full” liquids: hot cereals, cream blended soups, puddings, milkshakes and nutritional drinks are tolerated.  If nausea is persistent, switching to nutritional concentrated liquids is worth trying.
  • Avoid lactose containing drinks if gas or milk intolerance is a problem.
  • Avoid gas-forming foods such as gassy vegetables (beans, brussels sprouts, cabbage, onions, and cauliflower), soft drinks and chewing gum.
If the above strategies do not work, reach out to a registered dietitian with a CSO credential (certified specialist in oncology) who is well versed in symptom management of partial small bowel obstructions.

For more individualized assistance, contact the registered dietitian for Pennsylvania Hospital’s Joan Karnell Cancer Center at 215-829-6560.

For the Abramson Cancer Center, the contact number is 215-615-0538.

If you are not within this system, you may ask your oncologist for a referral or visit Eatright.org to identify a nutrition professional in your area.


Debra DeMille, MS, RD, CSO is a nutritional counselor at the Joan Karnell Cancer Center. Debra has worked at Pennsylvania Hospital since 1988 with the last 12 years specializing in oncology. Debra guides individuals receiving chemotherapy and radiation as well as addressing survivorship issues including the use of integrative therapies.


She conducts cooking programs and group counseling sessions for cancer survivors.

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