Intestinal pseudo-obstruction

Definition

Intestinal pseudo-obstruction is a condition in which there are symptoms of blockage of the intestine (bowels) without any physical blockage.

Alternative Names

Primary intestinal pseudo-obstruction; Acute colonic ileus; Colonic pseudo-obstruction; Idiopathic intestinal pseudo-obstruction; Ogilvie syndrome; Chronic intestinal pseudo-obstruction; Paralytic ileus - pseudo-obstruction

Causes

In intestinal pseudo-obstruction, the intestine does not contract and push food, stool, and air through the digestive tract. The chronic disorder most often affects the small intestine, but can also occur in the large intestine (colon). The acute disorder usually affects the large intestine.

The condition may start suddenly or be a chronic or long-term problem. Sudden onset is called acute intestinal pseudo-obstruction and usually affects the small intestine and often other parts of the digestive tract. Chronic intestinal pseudo-obstruction usually affects the large intestine (colon.) It is most common in children and older people. The cause of the problem is often unknown. However, problems with the bowel's muscles or nerves may be a cause.

Risk factors include:

Symptoms

Symptoms include:

Exams and Tests

During a physical exam, the health care provider will most often see abdominal bloating.

Tests include:

Treatment

The following treatments may be tried:

In severe cases, surgery may be needed.

Outlook (Prognosis)

Most cases of acute pseudo-obstruction get better in a few days with treatment. In chronic forms of the disease, symptoms can come back and get worse over many years.

If the intestine dilates severely, a hole in the bowel (perforation) may occur and surgical removal of the involved bowel may be needed. This may result in an ostomy (attaching the bowel to the abdomen and stool passes into a bag. If malnutrition happens, you may need to be fed through a tube or the vein. Other parts of the GI tract may also have problems from poor contraction.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Contact your provider if you have abdominal pain that does not go away or other symptoms of this disorder.

References

Camilleri M. Disorders of gastrointestinal motility. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 122.

Rayner CK, Hughes PA. Small intestinal motor and sensory function and dysfunction. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 99.



Review Date: 5/14/2024
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Aria - Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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