After Lisa Marie Presley died on January 12, headlines swirled about cardiac arrest being the potential cause of her death. Now the Los Angeles County Medical Examiner has delivered a sobering update: Presley died of small bowel obstruction, which developed due to scar tissue that formed after she had bariatric surgery, a term that encompasses various types of weight-loss procedures. (Presley’s family has not publicly commented on the autopsy findings at the time of publication.)
The singer-songwriter, who was Elvis Presley’s only child and 54 at the time of her death, experienced severe abdominal pain, per the coroner’s report. She was found unresponsive at her home and in cardiac arrest by her ex-husband, who called 911. Paramedics then took her to the hospital, where she went back into cardiac arrest.
The report says Presley had a “distended abdomen for years” and she didn’t seek medical attention, despite also dealing with abdominal pain for several months before her death. The report also notes that Presley had severe metabolic acidosis, a buildup of acid in the blood due to kidney disease or failure. She also complained of fevers, nausea, and vomiting for months before her death.
It’s understandable to have some questions about what happens in the body during a bowel obstruction, as the condition can be caused by all sorts of things. Here’s what you should know.
A bowel obstruction isn’t always fatal—but it can be.
A bowel obstruction happens when food, fluid, or poop can’t move through your intestines, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “It can happen in the large or small intestine, but it’s more common in the small intestine,” Mir Ali, MD, FACS, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California, tells SELF.
There are partial bowel obstructions, meaning some food, fluid, air, or poop can still makes its way through the intestine, or complete bowel obstructions, in which the intestine is totally blocked, the NIDDK says. A complete obstruction can be life-threatening and requires immediate medical care. In this situation, crucial blood supply gets cut off, which causes the tissues of the intestinal walls to die. This can lead to a perforation in the intestines, which spikes the risk of infection in the abdominal cavity (the region of your body that supports the organs of your digestive system).
The most common causes of these blockages are abdominal adhesions (bands of scar-like tissue that form inside the abdomen), hernias (a sac formed by the lining of the intestines), certain cancers, and certain medications, the US National Library of Medicine notes. People may even develop bowel obstruction from severe constipation, Dr. Ali says. (The coroner’s report notes that Presley also “experienced issues with constipation for years.”)
There is a well-known link between bariatric surgery and bowel obstruction.
The coroner’s report states that Presley developed adhesions after she had bariatric surgery “years ago,” and this scarring caused the small bowel obstruction. “In bariatric surgery, bowel obstruction is a very well-known complication,” Vitaliy Poylin, MD, a gastroenterologist with Northwestern Medicine, tells SELF.
People who undergo one of these procedures are usually advised to watch out for symptoms of bowel obstruction after their surgery because it’s not exactly unexpected. In fact, a BMC case report published in 2021 calls small bowel obstruction “a known and potentially lethal complication after gastric bypass surgery.” (Gastric bypass is one form of bariatric surgery.)
“Around the world, the main reason a bowel obstruction happens is a hernia,” Dr. Poylin says. “In the United States, the most common cause is abdominal adhesions. Every time people have surgery, adhesions form.” They help the body heal, but “the side effect is that sometimes the bands in the bowel wrap around it, causing a blockage.”
It’s also worth noting that any form of bariatric surgery is considered to be a major medical procedure that comes with real risks and potential complications, including chronic acid reflux; nausea and vomiting; malnutrition and nutrient deficiencies; infections; ulcers and hernias; and, most notably, a failure to lose weight or maintain weight loss, research shows. (What’s more, BMI—a deeply flawed and highly criticized measure of health—is a key marker used to approve someone for one of these surgeries.)
If you suspect you have possible symptoms of bowel obstruction, it’s crucial to seek care as soon as you can.
Unfortunately the signs of a bowel obstruction can be pretty easy to ignore because they’re not all that different from digestive symptoms you’ve probably experienced at some point. These can include severe abdominal pain, cramping, or swelling; vomiting; bloating; loud sounds coming from the bowel; having trouble passing gas; and constipation.
“Some of the more mild symptoms can actually be due to constipation and they don’t progress,” Dr. Ali says. “But if the symptoms are progressing, you should seek attention at the emergency room.” Basically, if things feel like they’re getting worse—and especially if you’re extremely uncomfortable or in straight-up pain—get it checked out.
Depending on how severe the situation is, a doctor may recommend bowel rest (IV fluids and eating nothing for a short period of time) and medications to help ease nausea and vomiting. Usually they’ll also monitor a person for a day or two to see if things resolve themselves or worsen, Dr. Ali says. If the intestine is completely blocked, surgery may be needed.
The important thing to remember is to seek care if you’re not feeling well, Dr. Poylin says. “It can be very serious.”
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