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Intestinal Pseudo-obstruction

(Colonic Ileus; Ogilvie’s Syndrome; Acute Colonic Pseudo-obstruction; Acute Nontoxic Megacolon)

Definition

In intestinal pseudo-obstruction, foods and liquids are unable to pass through the intestine, causing a build-up of food, fluid, and gas in all or part of the colon. The symptoms of this condition act like a mechanical bowel obstruction, but no blockage is found when doctors examine the intestine.

The Intestines

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Causes    TOP

Intestinal pseudo-obstruction is caused by problems with the muscles and nerves of the intestine.

Risk Factors    TOP

The following factors are thought to increase the risk of developing intestinal pseudo-obstruction:

  • Surgery
  • Abdominal hemorrhage
  • Intestinal ischemia (insufficient blood supply to the digestive system)
  • Inflammation
  • Trauma
  • Stroke
  • Metabolic problems
  • Other medical illnesses associated with pain
  • Certain medications

Symptoms    TOP

Symptoms of intestinal pseudo-obstruction may include:

  • Cramps
  • Stomach pain
  • Nausea
  • Vomiting
  • Bloating
  • Reduction in bowel movements
  • Loose stools
  • Bladder problems

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done.

Your body fluids may be tested. This can be done with:

  • Blood tests
  • Urine tests

Images may be taken of your body structures. This can be done with:

Treatment    TOP

Talk with your doctor about the best treatment plan for you. Treatment options include:

Nutritional Support

IV feeding may be necessary to help prevent malnutrition.

Medications

Your doctor may prescribe antibiotics to help prevent bacterial infections due to your condition. In addition, medications can be used to treat muscle problems in the intestines. Changes in your medications may be made to eliminate some medications that can slow recovery from, or worsen, this condition.

Surgery    TOP

In severe cases of intestinal pseudo-obstruction, surgery to remove part or your entire intestine may be necessary.

Endoscopy    TOP

If the colon does not resume normal function after conservative management, the pressure build-up in the colon can be relieved by removing the trapped air with a colonoscope.

Prevention    TOP

Many cases of intestinal pseudo-obstruction cannot be prevented. But certain measures can be taken after surgery to help avoid the complication of intestinal pseudo-obstruction. These measures include:

  • Early oral feeding
  • Gum chewing
  • Fluid restriction
  • Medications that inhibit opioid receptors
  • Beta-blockers

RESOURCES:

International Foundation for Functional Gastrointestinal Disorders
http://www.iffgd.org
National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Digestive Health Foundation
http://www.cdhf.ca
Canadian Society of Intestinal Research
http://www.badgut.com

References:

Acute intestinal pseudo-obstruction. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated July 12, 2014. Accessed September 28, 2016.
Intestinal pseudo-obstruction. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
...(Click grey area to select URL)
Updated February 26, 2014. Accessed December 18, 2014.
Last reviewed December 2015 by Daus Mahnke, MD
Last Updated: 12/20/2014

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