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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 acts like a mechanical bowel obstruction , but no blockage is found when doctors examine the intestine.

The Intestines


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Causes

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

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. 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
  • Some medications

Symptoms

Symptoms of intestinal pseudo-obstruction may include:

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

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Other tests may include:

  • Abdominal X-rays —a test that uses radiation to take a picture of structures inside the body
  • Abdominal CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
  • Blood tests
  • Urine tests

Treatment

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

Nutritional Support

Intravenous (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 to eliminate some medications that can slow recovery from, or worsen, this condition.

Surgery

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

Endoscopy

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

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 Digestive Diseases Information Clearinghouse
http://digestive.niddk.nih.gov

CANADIAN RESOURCES:

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

Canadian Society of Intestinal Research
http://www.badgut.com

References:

Colonic ileus. DynaMed website. Available at: http://dynamed102.ebscohost.com/Detail.aspx?style=1&docid=/dynamed/369f68330d9559c7852562b600120331 . Accessed June 25, 2007.

Intestinal pseudo-obstruction. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/intestinalpo/index.htm . Accessed June 25, 2007.



Last reviewed December 2013 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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