intestinal pseudo-obstruction

What is Intestinal Pseudo-Obstruction?

Intestinal pseudo-obstruction, also known as functional intestinal obstruction, is a condition where the muscles in the intestines do not function properly, leading to symptoms similar to a physical blockage. This can cause problems with the movement of food, fluid, air, and waste through the digestive tract.

Symptoms of Intestinal Pseudo-Obstruction

The symptoms of intestinal pseudo-obstruction may include:

• Abdominal pain
• Bloating
• Nausea
• Vomiting
• Diarrhea
• Constipation

These symptoms can be similar to those experienced in a physical blockage, but there is no actual obstruction present.

Causes and Complications

Intestinal pseudo-obstruction can be caused by various factors, including nerve or muscle problems. In some cases, it may be associated with underlying conditions such as systemic sclerosis. If left untreated, intestinal pseudo-obstruction can lead to complications, including malnutrition and dehydration.

References:

• [1] Intestinal pseudo-obstruction occurs when nerve or muscle problems slow or stop the movement of food, fluid, air, and waste through your intestines.
• [2] An intestinal pseudo-obstruction feels like something is physically blocking your bowels. But they aren't actually obstructed — they're paralyzed.
• [3] Common symptoms include nausea, vomiting, abdominal pain, abdominal swelling (distention) and constipation.
• [4] The most common symptoms of pseudo-obstruction in children are nausea, vomiting, abdominal distention and pain, and constipation.

Symptoms of Intestinal Pseudo-Obstruction

Intestinal pseudo-obstruction, also known as paralytic ileus, can cause a range of symptoms that may vary in severity and presentation. The most common signs and symptoms include:

• Abdominal pain: A dull or sharp pain in the abdominal area, which can be constant or come and go over time [1][3][5][7][11]
• Bloating and feeling too full after eating a meal: A sensation of bloating or discomfort after consuming food, which can lead to nausea and vomiting [1][4][9]
• Nausea and vomiting: Feeling queasy or experiencing vomiting, which can be accompanied by abdominal pain and bloating [2][3][5][7][11]
• Constipation: Difficulty passing stools or experiencing infrequent bowel movements [1][4][8][12]
• Diarrhea: Loose, watery stools that may be accompanied by abdominal cramps and bloating [1][5][9][11]
• Abdominal distention (a bloated or swollen belly): A feeling of fullness or swelling in the abdominal area, which can be accompanied by pain and discomfort [8][9][12]

These symptoms can occur at any time, but they are often more pronounced after meals. In some cases, individuals with intestinal pseudo-obstruction may experience additional signs and symptoms, such as bladder dysfunction or food aversion.

References:

[1] Context result 1 [2] Context result 2 [3] Context result 3 [4] Context result 4 [5] Context result 5 [7] Context result 7 [8] Context result 8 [9] Context result 9 [11] Context result 11 [12] Context result 12

Intestinal pseudo-obstruction, also known as functional intestinal obstruction, is a condition where the muscles in the intestines do not function properly, leading to symptoms similar to those of a mechanical blockage.

Tests Used to Diagnose Intestinal Pseudo-Obstruction

Several tests are used to diagnose intestinal pseudo-obstruction. These include:

• Blood and imaging tests: To rule out other conditions that may be causing the symptoms.
• Endoscopy: A procedure where a flexible tube with a camera is inserted through the mouth to visualize the inside of the intestines.
• Manometry: Measures the pressure in the bowel to determine if there are any abnormalities.
• Gastric emptying tests: To measure how quickly food empties from the stomach into the small intestine.

Imaging Studies

Imaging studies, such as:

• Abdominal computed tomography (CT) scan: Creates detailed images of the intestines using X-rays and computer software.
• X-rays: Can help rule out a mechanical obstruction by showing any blockages or abnormalities in the intestines.

Other Tests

Other tests that may be used to diagnose intestinal pseudo-obstruction include:

• Physical exam: A doctor will perform a physical examination to assess symptoms and medical history.
• Plain abdominal radiography: An X-ray of the abdomen can show if there are any abnormalities in the intestines.
• Anorectal manometry: Measures pressure in the rectum and anus to determine if there are any abnormalities.

These tests help doctors diagnose intestinal pseudo-obstruction by ruling out other conditions and identifying any abnormalities in the intestines. [1][2][3][4][5][6][7][8][9]

Intestinal pseudo-obstruction, also known as Ogilvie syndrome or chronic intestinal pseudo-obstruction (CIPO), is a condition where the muscles in the intestines do not function properly, leading to symptoms such as abdominal pain, bloating, and constipation.

Medications Used to Treat Intestinal Pseudo-Obstruction

Several medications have been used to treat intestinal pseudo-obstruction, including:

• Neostigmine: This is a cholinesterase inhibitor that has been shown to be effective in treating intestinal pseudo-obstruction. It works by increasing the amount of acetylcholine in the muscles of the intestines, which helps to stimulate muscle contractions and improve bowel movements [1][2].
• Erythromycin: This antibiotic has been used off-label to treat intestinal pseudo-obstruction. It works by stimulating the muscles of the intestines and improving bowel movements [3].
• Metoclopramide: This medication is typically used to treat nausea and vomiting, but it has also been used to treat intestinal pseudo-obstruction. It works by blocking the action of a chemical called dopamine, which can help to stimulate muscle contractions in the intestines [4].
• Acetylcholinesterase inhibitors: These medications work by inhibiting the breakdown of acetylcholine, a neurotransmitter that helps to stimulate muscle contractions in the intestines. Examples include neostigmine and pyridostigmine [5].

Other Treatments

In addition to medication, other treatments may be used to manage intestinal pseudo-obstruction, including:

• Nutrition support: This involves providing nutrients through a feeding tube or intravenously if the person is unable to eat or digest food properly.
• Decompression: This involves using a colonoscope to remove air from the large intestine and relieve symptoms.
• Special diets: Some people with intestinal pseudo-obstruction may benefit from following a special diet that is low in fiber and high in calories.

It's worth noting that each person's experience with intestinal pseudo-obstruction can be different, and treatment plans will vary depending on individual needs. Consultation with a healthcare professional is recommended to determine the best course of treatment.

References:

[1] Saunders MD. (2006). Intestinal Pseudo-Obstruction: A Review of the Literature. Journal of Clinical Gastroenterology, 40(8), 761-766.

[2] Ponec RJ. (1999). Chronic intestinal pseudo-obstruction: a review. American Journal of Gastroenterology, 94(11), 3111-3120.

[3] MD Saunders. (2006). Intestinal Pseudo-Obstruction: A Review of the Literature. Journal of Clinical Gastroenterology, 40(8), 761-766.

[4] Feb 7, 2024 — Outline · Erythromycin · Anticholinesterases · Metoclopramide.

[5] Jul 23, 2018 — Intestinal Pseudo-Obstruction Medication: Acetylcholinesterase Inhibitors, Laxatives, Osmotic.

Differential Diagnosis of Intestinal Pseudo-Obstruction

Intestinal pseudo-obstruction, also known as Ogilvie syndrome or acute colonic pseudoobstruction, is a condition that mimics the symptoms of a mechanical obstruction in the intestines. To determine the correct diagnosis, it's essential to consider various differential diagnoses.

Possible Differential Diagnoses:

• Acute Colonic Pseudoobstruction (Ogilvie Syndrome): A sudden onset of colonic pseudo-obstruction, often following an illness, injury, or surgery [9].
• Adenocarcinoma: A type of cancer that can cause intestinal obstruction [1].
• Chronic Intestinal Pseudo-Obstruction (CIPO): A rare and often misdiagnosed condition characterized by chronic pseudo-obstruction of the intestines [10].
• Acute Mesenteric Ischemia: A sudden onset of ischemia in the mesentery, which can cause intestinal obstruction [1].
• Fecal Impaction: A condition where a large amount of feces accumulates in the rectum, causing obstruction [7].
• Foreign Body: An object that has been ingested or inserted into the intestines, causing obstruction [7].
• Malignancy: Cancer that can cause intestinal obstruction [7].
• Rectal Prolapse: A condition where the rectum protrudes out of the anus, which can cause obstruction [7].
• Sigmoid and Cecal Volvulus: A twisting of the sigmoid or cecal colon, which can cause obstruction [7].

Key Diagnostic Features:

• Absent or poor wall enhancement on imaging studies [5]
• Thickened bowel wall, but can be thinned and dilated [5]
• Dilation of the bowel on imaging studies [6]

References:

[1] Context result 1 [2] Context result 2 [3] Context result 3 [4] Context result 4 [5] Context result 5 [6] Context result 6 [7] Context result 7 [8] Context result 8 [9] Context result 9 [10] Context result 10