Non Specific Non Obstructive Bowel Gas Pattern on X-ray

Non specific non obstructive bowel gas pattern means the radiologist does not think that there is a bowel blockage based on the X-ray appearance.  The radiologist does believe that the appearance of gas in the bowel is not entirely normal.    This is why he says non specific.  Because the appearance of the bowel gas can represent more than one condition.

What is bowel gas?

Bowel gas is what is inside the small bowel and colon.  It gives us an idea whether a bowel blockage or other abnormality is present.    Bowel gas can be seen on X-rays of the abdomen.  Fluid inside bowel can not usually be seen on X-ray.  It can not be distinguished from the other tissues in the abdomen on X-ray.   Some serious conditions of the bowel like blockage may not be seen because the bowel loops are filled with fluid only.

What does non specific non obstructive bowel gas pattern look like?

A non specific non obstructive pattern means that there is an abnormal appearance of the bowel gas, however it does not look like a blockage.  This can be too much bowel gas throughout.  It can mean the bowel loops look dilated or there is bowel gas in only a part of the bowel and not others.  It can mean that there are some air-fluid levels in bowel.     It can also mean a normal variation.

How good are abdominal X-rays for diagnosing serious conditions?

Abdominal X-rays can tell us that something is wrong with the bowel but not every time.  Serious conditions can still be present despite what looks like a normal or non specific bowel gas pattern.  Sometimes the opposite is true.  The bowel gas pattern looks abnormal but it is simply a normal variation.

The ordering doctor must take into consideration how the patient is doing.  The ordering doctor must also decide if further testing like CT is needed.  The abdominal X-ray is a start to a workup, but by no means should be relied upon as the sole test.

What are some conditions that can look like non specific non obstructive bowel gas pattern?


An example of a non specific non obstructive bowel gas pattern can be excessive bowel gas in bowel loops throughout.  This may be an ileus.  This is when the function of the bowel is impaired and the bowel becomes dilated.  The bowel basically is paralyzed. This can occur from numerous causes like drugs, infections, surgery to name some.

Normal variant

Abundant gas throughout bowel loops can also occur as a normal variant.  A lot of swallowed gas or drinking a carbonated drink can produce a similar appearance as an ileus or paralyzed bowel.    The distinction between ileus and other possibilities can sometimes be made on clinical grounds.

Air-fluid levels

Air-fluid levels in bowel can be abnormal and seen with ileus or paralyzed bowel and blockages.  Some air-fluid levels can also be seen as a normal variant in some patients.    This appearance can be noted as being non specific non obstructive bowel gas pattern.  This assumes the rest of the bowel does not look abnormal.

What to do after a non specific non obstructive bowel gas pattern?

I think the next step forward should depend on the clinical judgement of the treating doctor.  He must decide if further testing with CT is needed based on the clinical presentation and lab test results.  He must decide if a surgical consult is needed.

A non specific non obstructive bowel gas pattern therefore means the radiologist does not think there is a bowel blockage.  He does think some other abnormality could be present.  Sometimes further testing with CT is warranted.  X-rays of the abdomen may not diagnose many serious conditions of the abdomen.    Therefore, the judgment of the clinical doctor is important after ordering an abdominal X-ray.



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