Through several blockages in the past 2 years, a pattern has emerged for me and has kind of become a strategy of sorts. I go to the ED for the following: extreme pain that only gets worse over hours (without any relief) and repeated vomiting. Once the vomiting starts the pain is usually off the charts. If I just have that colicky pain but it’s manageable and no vomiting I usually wait it out. Certainly if I’m able to drink anything without vomiting I feel comfortable watching from home. Having said that everyone is different. Three SBOs landed me in the hospital this past year and a half but there were many more little (painful!) blips that eventually cleared and I’m glad I waited. YMMV though and it’s always better safe than sorry. I just can’t deliver myself to an NGT unless I’m a complete mess. My aversion is strong ;-)