Acute colonic ileus
    
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Acute colonic ileus

Definition

Primary intestinal pseudo-obstruction is a condition that involves symptoms of intestinal blockage without physical evidence of such a blockage.

Alternative Names

Intestinal pseudo-obstruction; Acute colonic ileus; Colonic pseudo-obstruction; Idiopathic intestinal pseudo-obstruction; Ogilvie's syndrome; Chronic intestinal pseudo-obstruction

Causes

In primary intestinal pseudo-obstruction, the small or large intestines lose their ability to contract and push food, stool, and air through the gastrointestinal tract.

The condition can be acute (occurs quickly or suddenly) or chronic (occurs over time). It may occur at any age, but is most common in children and the elderly. Because the cause is unknown, it is also called idiopathic intestinal pseudo-obstruction. (Idiopathic means occurring without reason.)

However, there are some known risk factors, such as being staying in bed for long periods of time (bedridden), taking narcotic (pain) medications, or having cerebral palsy or other neurologic disorders.

Symptoms

  • Abdominal pain
  • Abdominal distention
  • Nausea and vomiting
  • Weight loss
  • Difficulty swallowing
  • Constipation

Exams and Tests

  • Abdominal x-ray
  • Barium swallow
  • Malabsorption (inadequate absorption of nutrients from the intestinal tract)
  • Intestinal radionuclide scan
  • Esophageal manometry

Treatment

  • Nasogastric suction -- a nasogastric (NG) tube is placed thru the nose into the stomach to remove air from (decompress) the bowel.
  • Intravenous fluids will replace fluids lost from vomiting or diarrhea.
  • Special diets usually do not work, although vitamin B12 supplements may be used for patients with vitamin deficiency.
  • A medication called neostigmine may be used to treat pseudo-obstruction of the large intestine.
  • Colonoscopy may be used to remove air from the intestine.
  • In severe cases, surgery may be needed.

Outlook (Prognosis)

Most cases of acute pseudo-obstruction resolve over several days with conservative treatment. The disease may be recurrent and can persist over many years.

Possible Complications

  • Weight loss
  • Diarrhea
  • Vitamin deficiencies

When to Contact a Medical Professional

Call your health care provider if persistent abdominal pain or other symptoms of this disorder develop.

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