Management of Bowel Obstruction

Initial Management Approach

The American College of Physicians recommends initial management of bowel obstruction should focus on intravenous fluid resuscitation (preferably with crystalloids), nasogastric tube decompression, bowel rest, and pain control 1
Surgical management is indicated for complete mechanical obstruction, while pharmacologic management may be used for symptom control in partial or functional obstructions 1
Enemas are contraindicated in patients with intestinal obstruction as they can increase the risk of perforation, exacerbate the obstruction, and worsen clinical status 1

The European Association for the Study of the Liver recommends albumin administration at 6-8 g/L of ascites removed to prevent post-paracentesis circulatory dysfunction in large-volume paracentesis (>5L) 2, 3
The Infectious Diseases Society of America recommends IV albumin (1.5 g/kg on day 1 and 1 g/kg on day 3) administered with antibiotics to significantly reduce the incidence of acute kidney injury and mortality in spontaneous bacterial peritonitis 2, 4