Alternative Names: Intestinal pseudo-obstruction; Acute colonic ileus; Colonic pseudo-obstruction; Idiopathic intestinal pseudo-obstruction; Ogilvie's syndrome

Causes, incidence, and risk factors:

This disorder may be seen at any age, but is most common in children and the elderly. The cause is unknown. However, there are some known risk factors, such as being bedridden, taking narcotic medications, or having cerebral palsy or other neurologic disorders.

Symptoms:

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

Signs 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 tube placed through the nose and down the esophagus (nasogastric tube) is used to decompress the bowel.
• Intravenous fluids will replace fluids lost from vomiting or diarrhea.
• Special diets are usually ineffective, 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.
• In severe cases, surgery may be needed to divert or decompress the bowel.

Support Groups:

Expectations (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.

Complications:

• Weight loss
• Diarrhea
• Vitamin deficiencies

Calling your health care provider:

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

Prevention: