“They Kept Saying Constipation”: When a Bowel Obstruction Is Missed
Summary
A bowel obstruction is a blockage of the small or large bowel. It is a medical emergency, but early symptoms such as cramping, bloating and constipation can be mistaken for something minor, especially in people with long-term pain. This guide is for people whose obstruction was missed or whose years of pain were dismissed. It explains the warning signs, causes, what should happen, and the legal questions.
Quick answer · updated November 2026
Cramping pain, swelling, vomiting and not passing wind or stool together suggest bowel obstruction, which needs urgent assessment and often a CT scan. Adhesions from previous surgery and hernias are common causes in the small bowel; bowel cancer is a leading cause in the large bowel. If your symptoms were repeatedly put down to constipation, it is worth having your care looked at.
Bowel obstruction at a glance
- 1SymptomsCramping, bloating, vomiting, no wind.
- 2Risk factorsPrevious surgery, hernia, bowel cancer.
- 3AssessmentExamination, bloods and CT scan.
- 4TreatmentBowel rest or surgery.
- 5If delayedStrangulation, perforation, sepsis.
At any stage: vomiting with a swollen tummy and no wind passing is an emergency.
I’d had tummy pain on and off for years after a hysterectomy. My GP called it IBS. In emergency they called it constipation and gave me laxatives.
That night the pain came in waves, worse each time. My tummy swelled up like I was pregnant.
I went back to emergency. Different doctor, same answer: constipation, go home.
The next day I was vomiting green and hadn’t passed wind since the morning before.
A composite story, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. It does not describe any individual client.
If you were told it was constipation or IBS and it turned out to be a blockage, I want you to know that your questions are reasonable. Years of dismissed pain can make you doubt yourself. Asking whether something was missed is not making a fuss.
This guide covers the signs, causes, what should happen, records, and how the law looks at a missed bowel obstruction.
Why I can write this
I have been a medical negligence lawyer since 2014 and have worked on many hundreds of claims, including many involving abdominal pain that was dismissed. My doctorate looked at patterns of failure in medical negligence. I am not medically qualified. The clinical facts in this article are checked against named sources, listed in the references, and I explain how I work in our editorial standards.
Start with your question
- What are the symptoms of a bowel obstruction?
- What causes a bowel obstruction?
- How is a bowel obstruction diagnosed?
- How is it different from constipation?
- What happens if it’s missed?
- When is it an emergency?
- Could a missed obstruction be negligence?
Symptoms
Cleveland Clinic describes bowel obstruction as a medical emergency. Symptoms include cramping pain that comes in waves, nausea, vomiting, bloating and, with a complete blockage, being unable to pass stool or wind.1
Causes
Adhesions (scar tissue) from previous abdominal or pelvic surgery are the leading cause of small bowel obstruction, followed by hernias. Bowel cancer is the leading cause of large bowel obstruction.1 A history of surgery should raise suspicion.
Definition
Adhesions are bands of scar tissue that form after surgery and can kink or trap the bowel.
In plain terms: internal scar tissue that can block the bowel.
Diagnosis
Diagnosis relies on history, especially previous surgery, examination, blood tests and imaging, with a CT scan giving the most detail.1
Not just constipation
Constipation doesn’t usually cause repeated vomiting, a rapidly swelling tummy and an inability to pass wind. Laxatives can make an obstruction worse.
Questions to ask
- Could this be a bowel obstruction?
- Does my previous surgery change things?
- Should I have a CT scan?
- What should make me come back?
If it’s missed
A delayed diagnosis risks strangulation, where blood supply is cut off and bowel dies, and perforation, which can cause peritonitis and sepsis.1 Our guides to ongoing pain after abdominal surgery and bowel cancer diagnosed late cover related situations.
When it’s an emergency
See a doctor today
- Cramping pain coming in waves
- Bloating that’s getting worse
- No bowel movement despite laxatives
In plain terms: mention any previous surgery.
Emergency
- Vomiting, especially green
- Unable to pass wind
- Tummy hard and swollen
- Fever or fast heart
In plain terms: go to emergency and say you think it’s a blockage.
If your pain was repeatedly dismissed, see when being dismissed becomes a legal issue.
On the third visit, a surgical registrar examined me and ordered a CT straight away. Adhesions from my hysterectomy had trapped a loop of small bowel. By the time I got to theatre, part of it had died and was removed.
My records from the first two visits said “constipation, likely”, with no mention of my previous surgery and no scan.
I spent two weeks in hospital.
My husband read the notes and said, “They never asked about your operation.” I want doctors to ask.
A composite story, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. It does not describe any individual client.
What to look for in the records
Your records are often where the story becomes clear. You have a right to access your own health information. In NSW the Health Records and Information Privacy Act 2002 covers both public and private providers, and the Information and Privacy Commission explains how to ask.2 Our step-by-step guide to getting your medical records in Australia walks you through it.
| Record | Why it matters |
|---|---|
| Emergency notes | What symptoms and history were recorded. |
| Observations | Heart rate, temperature and blood pressure. |
| Blood tests | Signs of dehydration or infection. |
| Imaging | When a CT was done. |
| Operation note | What was found, including dead bowel. |
| GP notes | Years of symptoms and diagnoses. |
| Your own diary, photos and messages | Notes made at the time are evidence too. Keep them. |
How the law looks at it
A bowel obstruction can be hard to diagnose early, and a delay is not automatically negligence. But repeated presentations deserve a fresh look, and every case is worth reviewing. The questions are whether your symptoms and history were properly assessed, and whether a delay caused harm.
A claim usually turns on three questions: whether the care fell below what peers would widely accept as competent practice (section 5O of the Civil Liability Act 2002 (NSW))3, whether that shortfall probably caused harm you wouldn't otherwise have had (Tabet v Gett)4, and, where it matters, whether you were told the material risks first (Rogers v Whitaker)56. Our guide to how a medical negligence claim works explains each one in plain terms.
In a missed obstruction case, the questions might be: was your history of surgery or hernia considered? Were vomiting, swelling and no wind recognised? Was imaging arranged? Were you discharged without review despite returning?
In plain terms, the question is whether earlier diagnosis would probably have avoided bowel loss, perforation or a bigger operation.
For a missed diagnosis, the focus is usually on assessment rather than consent.
Who can claim, and when
The person harmed can claim. If they have died, their family may have a claim. In NSW, time usually runs from when you knew, or ought to have known, enough to claim, not from the treatment itself, and courts can sometimes extend it, so an old injury may still count. See time limits in NSW or other states, and ask early.
More: complaint or claim? · how a claim is paid for · what a claim can cover
In my practice
In missed obstruction files, the same diagnosis of constipation often repeats across visits, each made by a different doctor reading the last note. A history of surgery is frequently absent. The first doctor to examine afresh usually finds it quickly.
Both things can be true
The surgeons who operated may have saved your life, and the earlier assessments may still have fallen short. Both can be true.
The bigger picture
Bowel obstruction is a common surgical emergency. You can check a practitioner on the Ahpra public register,7 and complaints about care in NSW can go to the Health Care Complaints Commission.8 Our guide to getting your medical records explains how to ask for your file.
Support
You don't have to work through this alone. These services can help:
- Lifeline, 24-hour crisis support: 13 11 14 (listed on healthdirect's helplines page)9
- Beyond Blue, anxiety and depression support: 1300 22 4636
- Medicare Mental Health, help finding mental health support: 1800 595 212
- healthdirect, 24-hour nurse advice: 1800 022 222
- Health Care Complaints Commission (NSW): 1800 043 159
A woman told three times it was constipation now knows nobody asked about her operation. You deserve to be asked.
With care,
Rosemary
Frequently asked questions
What are the symptoms of bowel obstruction?
Cramping pain, bloating, vomiting and being unable to pass stool or wind.
What causes bowel obstruction?
Adhesions from surgery, hernias and, in the large bowel, cancer.
How is it diagnosed?
Usually with a CT scan, alongside history and examination.
Can laxatives make it worse?
They can if there is a blockage.
What happens if it’s missed?
The bowel can lose its blood supply or perforate.
Can I claim for a missed bowel obstruction?
You may well have a claim if assessment fell below the standard and the delay caused harm.
Questions about a missed diagnosis?
When you're ready, and not before, I can look at what happened and help you understand your options.
Missed and delayed diagnosis guides
- Neurological symptoms dismissed as psychological
- “They kept saying constipation”: When a bowel obstruction is missed (you are here)
- A cancer recurrence that wasn’t monitored
- A second heart attack or stroke
- Bowel cancer diagnosed late
Part of our guide to missed and delayed diagnosis. Not sure where you stand? Try the free claim checker.
References
- Cleveland Clinic. Bowel obstruction.
- Information and Privacy Commission NSW. Fact sheet: Accessing your health information in NSW.
- Civil Liability Act 2002 (NSW) s 5O, Standard of care for professionals.
- Tabet v Gett [2010] HCA 12.
- Rogers v Whitaker [1992] HCA 58; (1992) 175 CLR 479.
- Australian Commission on Safety and Quality in Health Care. Informed consent.
- Australian Health Practitioner Regulation Agency. Register of practitioners.
- Health Care Complaints Commission NSW. Home page.
- healthdirect Australia. Mental health helplines.
Stories in this article are composites, drawn from the experiences of many families I have worked with, combined and changed so that no one can be identified. They do not describe any individual client.
Dr Rosemary Listing, PhD (Law), Medical negligence lawyer since 2014 · Of Counsel, Peter Evans & Associates. Rosemary's doctorate examined patterns of failure in medical negligence, and she teaches health law at the University of Newcastle. She is not medically qualified. About Rosemary.
Last updated: 10 November 2026 · First published: 10 November 2026 · Next review: May 2027
Cite this article: Listing R. “They kept saying constipation”: When a bowel obstruction is missed. Reframe Legal. Published 10 November 2026. https://reframelegal.com/bowel-obstruction-missed/
This article is general information, not legal or medical advice. It does not create a lawyer–client relationship. Speak to your treating clinicians about your health, and get legal advice about your own situation.
If you are in danger or need urgent medical help, call 000. For crisis support, call Lifeline on 13 11 14.
Legal services are provided by Peter Evans & Associates.