Intestinal pseudo-obstructionPrimary intestinal pseudo-obstruction; Acute colonic ileus; Colonic pseudo-obstruction; Idiopathic intestinal pseudo-obstruction; Ogilvie syndrome; Chronic intestinal pseudo-obstruction; Paralytic ileus - pseudo-obstruction
Intestinal pseudo-obstruction is a condition in which there are symptoms of blockage of the intestine (bowels) without any physical blockage.
In intestinal pseudo-obstruction, the intestine is unable to contract and push food, stool, and air through the digestive tract. The disorder most often affects the small intestine, but can also occur in the large intestine.
The condition may start suddenly or be a chronic or long-term problem. It is most common in children and older people. The cause of the problem is often unknown.
Risk factors include:
- Cerebral palsy or other brain or nervous system disorders.
- Chronic kidney, lung, or heart disease.
- Staying in bed for long periods of time (bedridden).
- Taking drugs that slow intestinal movements. These include narcotic (pain) medicines and drugs used when you are not able to keep urine from leaking out.
- Abdominal pain
- Nausea and vomiting
- Swollen abdomen (abdominal distention)
- Weight loss
Exams and Tests
During a physical exam, the health care provider will most often see abdominal bloating.
- Abdominal x-ray
- Anorectal manometry
- Barium swallow, barium small bowel follow-through, or barium enema
An upper GI and small bowel series is a set of x-rays taken to examine the esophagus, stomach, and small intestine. Barium enema is a related test th...
- Blood tests for nutritional or vitamin deficiencies
- CT scan
- Antroduodenal manometry
- Gastric emptying radionuclide scan
- Intestinal radionuclide scan
The following treatments may be tried:
- Colonoscopy may be used to remove air from the large intestine.
- Fluids can be given through a vein to replace fluids lost from vomiting or diarrhea.
- Nasogastric suction involving a nasogastric (NG) tube placed through the nose into the stomach can be used to remove air from the bowel.
- Neostigmine may be used to treat intestinal pseudo-obstruction that is only in the large bowel (Ogilvie syndrome).
- Special diets often do not work. However, vitamin B12 and other vitamin supplements should be used for people with vitamin deficiency.
- Stopping the medicines that may have caused the problem (such as narcotic drugs) may help.
In severe cases, surgery may be needed.
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.
Complications may include:
- Rupture (perforation) of the intestine
- Vitamin deficiencies
- Weight loss
When to Contact a Medical Professional
Call your provider if you have abdominal pain that does not go away or other symptoms of this disorder.
Andrews JM, Brierley SM, Blackshaw LA. Small intestinal motor and sensory function and dysfunction. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 99.
Camilleri M. Disorders of gastrointestinal motility. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 136.
Mahmoud NN, Bleier JIS, Aarons CB, Paulson EC, Shanmugan S, Fry RD. Colon and rectum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier Saunders; 2017:chap 51.
Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
Review Date: 4/7/2018
Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.