Intestinal Pseudo-Obstruction

  • What is intestinal pseudo-obstruction?
  • What causes intestinal pseudo-obstruction?
  • What are the symptoms of intestinal pseudo-obstruction?
  • How is intestinal pseudo-obstruction diagnosed?
  • How is intestinal pseudo-obstruction treated?
  • Points to Remember
  • Hope through Research
  • For More Information
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    What is intestinal pseudo-obstruction?

    Drawing of the digestive tract showing the mouth; esophagus; stomach; small intestine; large intestine, also called colon; ileum; rectum; and anus. Caption:  The intestines, or bowel, include the small intestine and the large intestine, also called the colon.Intestinal pseudo-obstruction is a rare condition with symptoms like those caused by a bowel obstruction, or blockage. But when the intestines are examined, no blockage is found. Instead, the symptoms are due to nerve or muscle problems that affect the movement of food, fluid, and air through the intestines.

     

    Intestinal pseudo-obstruction can occur in people of any age, but it occurs more often in children and older adults. Children can have a long-lasting form of the condition called chronic intestinal pseudo-obstruction (CIP). CIP in children is usually present at birth.

     

    In another form of intestinal pseudo-obstruction that mostly affects older adults, the colon becomes enlarged after surgery or illness. This condition is known as acute colonic pseudo-obstruction (ACPO), also called Ogilvie syndrome or acute colonic ileus. ACPO can lead to serious complications and can be life-threatening.

     

    What causes intestinal pseudo-obstruction?

    Normally, nerves and muscles work together to produce wavelike contractions that push food through the intestines. In intestinal pseudo-obstruction, nerve or muscle problems prevent normal contractions. As a result, people with the condition have problems with the movement of food, fluid, and air through the intestines.

     

    When the cause of the nerve or muscle problems leading to intestinal pseudo-obstruction is not known, the condition is called primary or idiopathic intestinal pseudo-obstruction. If the cause is known, the condition is called secondary intestinal pseudo-obstruction. Causes of secondary intestinal pseudo-obstruction include:

  • abdominal or pelvic surgery
  • diseases that affect muscles and nerves, such as lupus erythematosus, scleroderma, and Parkinson’s disease
  • infections
  • medications such as opiates and antidepressants that affect muscles and nerves
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    What are the symptoms of intestinal pseudo-obstruction?

    Intestinal pseudo-obstruction symptoms may include cramps, abdominal pain, nausea, vomiting, bloating, and constipation. Occasionally, intestinal pseudo-obstruction may cause diarrhea. Over time, the condition can cause bacterial infections, malnutrition, weight loss, and muscle problems in other parts of the body. Some people develop problems with their esophagus, stomach, or bladder.

     

    How is intestinal pseudo-obstruction diagnosed?

    To diagnose intestinal pseudo-obstruction, the doctor will take a complete medical history, do a physical exam, and take x rays. The doctor will make sure that symptoms are not due to an intestinal blockage and will look for the cause of the condition, such as an underlying illness. Other testing may be needed, such as manometry to measure the patterns of intestinal contractions.

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    How is intestinal pseudo-obstruction treated?

    People with intestinal pseudo-obstruction often need nutritional support to prevent malnutrition and weight loss. Enteral nutrition provides liquid food through a feeding tube inserted through the nose into the stomach or placed directly into the stomach or small intestine. Some people need intravenous feeding, also called parenteral nutrition, which provides liquid food through a tube placed in a vein.

     

    If intestinal pseudo-obstruction is caused by an illness or medication, the doctor will treat the underlying illness or stop the medication.

     

    Treatment may include medications, such as antibiotics to treat bacterial infections, pain medication, and medication to treat intestinal muscle problems. People with ACPO may need procedures to remove gas from the bowel. In severe cases of intestinal pseudo-obstruction, surgery to remove part of the intestine or other intestinal surgery might be necessary.

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    Points to Remember

  • Intestinal pseudo-obstruction is a condition with symptoms like those caused by a bowel obstruction, or blockage. But when the intestines are examined, no blockage is found.
  • Intestinal pseudo-obstruction is caused by nerve or muscle problems that prevent the intestines from contracting normally to move food, fluid, and air through the intestines.
  • Symptoms may include cramps, abdominal pain, nausea, vomiting, bloating, constipation, and occasionally diarrhea.
  • Treatment depends on the type and severity of intestinal pseudo-obstruction and may involve nutritional support, medications, surgery, or other procedures.
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    Hope through Research

    The National Institute of Diabetes and Digestive and Kidney Diseases conducts and supports research to help people with digestive diseases. A complete listing of clinical research studies can be found at www.ClinicalTrials.gov.

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    For More Information

    Association of Gastrointestinal Motility Disorders, Inc.
    (formerly American Society of Adults with Pseudo-Obstruction, Inc.)
    AGMD International Corporate Headquarters
    12 Roberts Drive
    Bedford, MA 01730
    Phone: 781–275–1300
    Fax: 781–275–1304
    Email: digestive.motility@gmail.com
    Internet: www.agmd-gimotility.org

     

    International Foundation for Functional Gastrointestinal Disorders, Inc.
    P.O. Box 170864
    Milwaukee, WI 53217–8076
    Phone: 1–888–964–2001 or 414–964–1799
    Fax: 414–964–7176
    Email: iffgd@iffgd.org
    Internet: www.iffgd.org

     

    National Digestive Diseases Information Clearinghouse
    2 Information Way
    Bethesda, MD 20892–3570
    Phone: 1–800–891–5389
    Fax: 703–738–4929
    Email: nddic@info.niddk.nih.gov
    Internet: www.digestive.niddk.nih.gov

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