Intestinal Pseudo Obstruction

What is Intestinal Pseudo Obstruction

Intestinal pseudo obstruction is a condition that causes symptoms of a blockage in the intestines without an actual obstruction. The intestinal tract is made up of the hollow organs that digest food after it leaves the stomach.

Most digestion takes place in the upper part of the intestines (small intestine). Undigested food leaves the small intestine and passes into the lower part (large intestine). There, water is absorbed and stools are formed. Intestinal pseudo-obstruction can take place anywhere along this tract. The condition can be a short-term problem (acute) or a long-term (chronic) disease.

What are the causes?

Causes of this condition are categorized as primary or secondary.

  • Primary causes are abnormalities in the nerves and muscles that move food through the intestines. These abnormalities can be caused by gene defects (genetic mutations) that are passed down through families (inherited).
  • Secondary causes are problems that result from other diseases or treatments that may affect the intestines. These include:
    • Muscle and nervous system diseases.
    • Infections.
    • Cancer or cancer treatments.
    • Medicines.
    • Surgery.

In some cases, the cause of this condition cannot be found (idiopathic).

What are the signs or symptoms?

Symptoms can vary from person to person. The symptoms depend on the cause of the condition and whether it is acute or chronic. Symptoms may include:

  • Pain, swelling, or bloating in the abdomen.
  • Nausea and vomiting.
  • Difficulty passing stool (constipation) or passing watery stool (diarrhea).
  • Poor nutrition and weight loss.

How is this diagnosed?

This condition may be diagnosed based on:

  • Symptoms and medical history.
  • Physical exam.
  • Tests to confirm the diagnosis. These may include:
    • Blood tests.
    • Exams to look into the small intestine or the large intestine (endoscopy or colonoscopy).
    • Taking an X-ray of the digestive tract after swallowing a substance that makes images clear (barium study).
    • CT scan of the digestive tract.
    • Placing a tube into the intestine to measure pressure (manometry).
    • Removing a small piece of tissue from the intestinal wall to be examined under a microscope (biopsy).

Intestinal pseudo-obstruction can be hard to diagnose because it can have many causes. Symptoms can also be similar to the symptoms of many other diseases. Most people need to have several exams. You may also need to see a health care provider who specializes in the digestive tract (gastroenterologist).

How is this treated?

Treatment depends on the causes of your condition. It may include:

  • Treating an underlying disease.
  • Changing medicines that may be causing the symptoms.
  • Using antibiotic medicines to treat an infection.

Other treatments may include:

  • Placing a tube (colonoscope) into the large intestine to remove gas.
  • Placing a tube (nasogastric tube) through the nose and down into the small intestine to remove gas or fluids.
  • Placing a tube (feeding tube) into the stomach or small intestine for liquid nutrition.
  • Medicines for:
    • Pain.
    • Nausea.
    • Diarrhea.
    • Constipation.
    • Stimulating the movement of the muscles of the intestines.
  • Surgery to remove part of the intestine. This is rare. It is needed if other treatments have not worked.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Eating and drinking

  • Make any changes to your diet or your eating habits as recommended by your health care provider. This might include:
    • Eating smaller meals more often. Try having 5 or 6 smaller meals each day instead of 3 large meals.
    • Eating low fiber foods.
    • Eating pureed foods or liquid food supplements. This may ease symptoms.
    • Taking vitamin and mineral supplements to help prevent poor nutrition. Ask your health care provider to recommend a multivitamin.

General instructions

  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your symptoms do not go away or get worse.

Get help right away if you:

  • Have severe pain in the abdomen.
  • Cannot eat or drink without vomiting.

Summary

  • Intestinal pseudo-obstruction is a condition that causes symptoms of a blockage in your intestinal tract without an actual obstruction.
  • Primary causes are abnormalities in the nerves and muscles that move food through the intestines. Secondary causes are problems that result from other diseases or treatments that affect the intestines.
  • Symptoms depend on the cause of the condition and whether it is short-term or long-term. They may include pain in the abdomen, nausea and vomiting, constipation or diarrhea, or poor nutrition and weight loss.
  • Treatment depends on the cause of your condition, but it may include changes to your diet or eating habits, medicines, or surgery.
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