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

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

Risk Factors

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 (eg, infection)
  • Trauma
  • Stroke
  • Metabolic problems
  • Fluid overload (eg, congestive heart failure )
  • Other medical illnesses associated with pain
  • Certain medications

Symptoms of intestinal pseudo-obstruction may include:

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

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:


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.


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.


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


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 .


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


International Foundation for Functional Gastrointestinal Disorders

National Institute of Diabetes and Digestive and Kidney Diseases


Canadian Digestive Health Foundation

Canadian Society of Intestinal Research


Colonic ileus. EBSCO DynaMed website. Available at: Updated July 12, 2014. Accessed December 18, 2014.

Intestinal pseudo-obstruction. National Digestive Diseases Information Clearinghouse website. Available at: Updated February 26, 2014. Accessed December 18, 2014.

Last reviewed December 2014 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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