INTESTINAL PSEUDO-OBSTRUCTION

Intestinal pseudo-obstruction symptoms may include:

• abdominal swelling or bloating, also called distension
• abdominal pain
• nausea
• vomiting
• constipation
• diarrhea
• inability to pass gas

Over time, the condition can cause malnutrition, bacterial overgrowth in the intestines, and weight loss. Malnutrition is a condition that develops when the body does not get the right amount of the vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function.

DIAGNOSIS

Intestinal pseudo-obstruction can be difficult to diagnose, especially primary intestinal pseudo-obstruction. As a result, a correct diagnosis may take a long time.

Physical Exam

A physical exam is one of the first things a health care provider may do to help diagnose intestinal pseudo-obstruction. During a physical exam, a health care provider usually:

• examines a person’s body
• uses a stethoscope to listen to bodily sounds
• taps on specific areas of the person’s body

Medical History

The health care provider will ask a person to provide a medical and family history to help diagnose intestinal pseudo-obstruction.

Biopsy

A gastroenterologist can obtain a biopsy of the intestinal wall during endoscopy or during surgery, if the person has surgery for intestinal pseudo-obstruction and the cause is unknown, and if examination of the nerves in the intestinal wall is necessary.

Blood Tests

The blood test can show the presence of other diseases or conditions that may be causing a person’s symptoms.

TREATMENT

Nutritional Support

People with intestinal pseudo-obstruction often need nutritional support to prevent malnutrition and weight loss. Enteral nutrition provides liquid food through a feeding tube inserted through the nose into the stomach or placed directly into the stomach or small intestine. Enteral nutrition is possible because the intestinal lining is normal in most people with intestinal pseudo-obstruction. Enteral nutrition is preferred over parenteral nutrition because it has a much lower risk of complications.

Medications

A health care provider prescribes medications to treat the different symptoms and complications of intestinal pseudo-obstruction, such as:

• antibiotics to treat bacterial infections
• pain medication, which should be used sparingly, if at all, because most pain medications delay intestinal transit
• medication to make intestinal muscles contract
• antinausea medications
• antidiarrheal medications
• laxatives

Decompression

A person with acute colonic pseudo-obstruction and a greatly enlarged colon who does not respond to medications may need a procedure, called decompression, to remove gas from the colon. The gastroenterologist may choose to decompress the colon by using colonoscopy. During colonoscopy, the gastroenterologist inserts a flexible tube into the colon through the anus.

Surgery

In severe cases of intestinal pseudo-obstruction, a person may need surgery to remove part of the intestine. However, surgery should be performed rarely, if at all, because intestinal pseudo-obstruction is a generalized disorder that typically affects the entire intestine. Removing part of the intestine cannot cure the disease.

Eating, Diet, and Nutrition

Researchers have not found that eating, diet, and nutrition play a role in causing or preventing intestinal pseudo-obstruction. Following special diets usually does not help improve the disorder. However, eating frequent, small meals with pureed foods or liquids may ease digestion. Vitamin and trace mineral supplements may help a person who is malnourished.