Definition: An intestinal pseudo-obstruction is an uncommon condition where the intestines have the signs of being obstructed, without an obstruction being present. Unlike a true bowel obstruction, there is no actual blockage of the intestinal tract in a pseudo-obstruction. This is why it is known as a "pseudo" obstruction: its cause is not understood, but there are known risk factors. With a pseudo-obstruction, the small or the large intestine are not moving food and waste material through as they do when the gastrointestinal tract is healthy.
Signs And Symptoms Of Intestinal Pseudo-Obstruction
Many of the signs and symptoms of a pseudo-obstruction are similar to those that occur with other digestive diseases, so it is important to see a physician if any of the following are severe, or if you have experienced a pseudo-obstruction in the past.- Abdominal pain, which may be crampy in nature
- Abdominal swelling or distention
- Constipation, which is fewer than 3 bowel movements in a week
- Nausea and vomiting
- Nutritional deficiencies
- Unintentional weight loss
Intestinal Pseudo-Obstruction Risk Factors
A pseudo-obstruction is more common in the very young and the very old, but it can happen to just about anyone. When it comes on suddenly, it is known as "acute," and when it happens more slowly or repeatedly, it is called "chronic." There are a few known risk factors.
- Nervous System Disease: A disease such as cerebral palsy that affects the nervous system can interfere with the motility of the digestive tract.
- Immobility: Being unable to get out of bed and move around is another risk factor for pseudo-obstruction.
- Pain Medications: Certain pain medications, specifically narcotics, can alter the functioning of the intestines.
Diagnosing Intestinal Pseudo-Obstruction
Diagnosis must first rule out a more common cause for the symptoms, such as a physical obstruction or a tumor. Testing will usually begin with blood tests and may next move on to x-ray studies, such as a plain x-ray or computed tomography (CT). Depending on the specific symptoms and results, further testing is sometimes necessary, but as its name suggests, pseudo-obstruction is not associated with typical findings.Treatment Of Intestinal Pseudo-Obstruction
Medical treatment of pseudo-obstruction can include drugs that stimulate the colon, such as certain antibiotics, dopamine antagonists, and somatostatin analogues. Other medications may be given to ameliorate the associated symptoms of nausea, vomiting, and pain. Any underlying nutritional deficiencies resulting from the pseudo-obstruction will also require treatment. In some cases, enteral nutrition (nutrients given via a nasogastric (NG) tube) may be needed. Decompression, to let trapped air out of the intestinal tract either through an NG tube or colonoscopy, may also be used as a treatment. In some cases, surgery might be necessary.Related Conditions: Primary Intestinal Pseudo-Obstruction, Acute Colonic Ileus, Colonic Pseudo-Obstruction, Idiopathic Intestinal Pseudo-Obstruction, Ogilvie's Syndrome
