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Intestinal Pseudo-obstruction

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

Definition

An intestinal pseudo-obstruction is a group of conditions that make it hard for foods and liquids to pass through the intestine. This leads to signs and symptoms of a blockage in the intestines even though one does not exist.

The Intestines

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Causes

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

This problem may be caused by conditions, such as:

  • Taking certain medicines, such as opioids, narcotics, and calcium channel blockers
  • Trauma
  • Abnormal tissue growth
  • Connective tissue diseases, such as scleroderma and lupus
  • Surgery
  • Infections
  • Neurological diseases, such as Parkinson disease
  • Metabolic problems, such as diabetes
  • Heart disease

Risk Factors

This problem is more common in men who are over 60 years of age. Other things that may raise the risk are:

  • Being hospitalized or in a care center
  • Obesity

Symptoms

Problems may be:

  • Belly pain
  • Nausea and vomiting
  • A swollen belly
  • Problems passing gas or stool (poop)
  • Diarrhea (less common)

Diagnosis

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

Blood and urine tests will be done to look for problems.

Images may be taken of the abdomen. This can be done with:

A colonoscopy may be done to view the inside of the large intestine.

Treatment

Any underlying problems will need to be treated. The goal of treatment is to make it easier for foods and liquids to pass through the intestines. Options are:

Nutritional Support

IV feeding may be needed to lower the risk of malnutrition.

Medications

Medicines that are causing this problem may be stopped or changed. Medicine may also be given to:

  • Lower the risk of bacterial infections
  • Treat muscle problems in the intestines

Decompression

People who are not helped by other methods may need colonoscopic decompression therapy. A colonoscope will be used to remove trapped air from the colon.

Surgery

People with severe problems may need surgery. Part of the intestine may be removed.

Prevention

This problem cannot always be prevented. Some steps that may help are:

  • Avoiding medicines that may cause symptoms, such as opioids
  • Following home care advice after surgery
RESOURCES:

International Foundation for Functional Gastrointestinal Disorders
https://www.iffgd.org

National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES:

Bad Gut—Canadian Society of Intestinal Research
https://www.badgut.org

Canadian Digestive Health Foundation
http://www.cdhf.ca

REFERENCES:

Acute intestinal pseudo-obstruction. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/prevention-and-management-of-postoperative-ileus. Accessed September 15, 2021.

Intestinal pseudo-obstruction. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/intestinal-pseudo-obstruction. Accessed September 15, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board Mary-Beth Seymour, RN  Last Updated: 9/15/2021