Intestinal pseudo-obstruction
Intestinal pseudo-obstruction is a condition where symptoms of a bowel obstruction (like abdominal pain, bloating, and constipation) occur despite no physical blockage being present, due to problems with the muscles or nerves controlling the intestines.
What it is:
- Intestinal pseudo-obstruction, also known as paralytic ileus, is a condition where the intestines struggle to move food, fluid, and waste through the digestive tract, even though there's no physical blockage like a tumor or a stricture.
Causes:
- Muscle problems: The muscles that normally contract to push food through the intestines (peristalsis) may not be working correctly.
- Nerve problems: The nerves that control these muscles may not be sending the right signals.
Other causes:
- Abdominal or pelvic surgery.
- Infection
- Certain medications (antidepressants, opioids).
- Muscle and nerve disorders (Parkinson's disease).
- Metabolic or electrolyte imbalances.
- Systemic illness.
Types:
- Acute colonic pseudo-obstruction (ACPO), also known as Ogilvie syndrome: This usually affects the large intestine, often after surgery or illness.
- Chronic intestinal pseudo-obstruction (CIPO): This is a rarer, long-term condition that can affect both the small and large intestines.
Symptoms:
- Abdominal pain and bloating.
- Nausea and vomiting.
- Constipation or diarrhea.
- Inability to pass gas or stool.
- Swollen abdomen (abdominal distention).
- Weight loss.
Diagnosis:
- Doctors will look for a physical blockage, but if none is found, they may suspect pseudo-obstruction.
- Imaging tests (X-rays, CT scans) can help show if the intestines are dilated (widened) without a clear cause.
- Manometry studies can help assess the function of the muscles and nerves in the intestines.
Treatment:
- Treatment depends on the cause and severity of the condition.
- Conservative management: Bowel rest, nasogastric decompression, intravenous fluids, and addressing the underlying cause.
- Medications: Neostigmine (a medication that stimulates muscle contractions) or other medications to improve motility.
- Decompression: Removing gas and fluids from the digestive tract.
- Surgery: In some cases, surgery may be necessary.
- Nutrition support: People with chronic pseudo-obstruction may need dietary changes or nutritional support to prevent malnutrition.