The only way they can tell is through x-ray. My x-rays are hard to read (too many scars and adhesions, I'm told) because I've had 8 abdominal surgeries. So when they see an obstruction it's a very good guess made together with my symptoms. I vomit and I'm in extreme pain and I can't go number 2 when I have these pains. Do you have any other symptoms at all when you're in pain? I have to have a very strong pain killers, morphine doesn't help my pain at all. I need Dilaudid.