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Diseases & Conditions

Intestinal Pseudo-Obstruction



Intestinal pseudo-obstruction describes an intestinal disorder that can mimic intestinal obstruction (blockage of the intestine). However, when tests are performed, no blockage is found. For proper absorption, food needs to move in an orderly way along the intestine. Like the stomach, normal contractions and movement depend on the coordination between the muscles of the intestine, its nerves and various hormones.

Causes

In adults, unlike children, most causes are not congenital. Some of the reasons are: medications, diseases that affect the muscle of the intestine (Scleroderma), or certain types of cancers.

Symptoms

Abdominal distension and discomfort, bloating and nausea are common, particularly after meals. When the condition worsens, patients may have episodes of severe nausea, vomiting, pain and distension with X-ray picture that looks like a bowel blockage.

Diagnosis

Comparable to gastroparesis, a mechanical blockage of the bowel (such as one caused by adhesions), needs to be excluded first, usually done so by performing x-ray studies of the bowel. Manometry (pressure measurements from the bowel) helps determine the kind of abnormality. Additionally, many of these patients may also suffer from bladder and eye problems, making it necessary to check those as well. Various blood tests, x-rays and biopsies can help determine the cause of the problem.

Treatment

The principals of treatment are similar in many ways to those applied to gastroparesis.

Special diet, antibiotics and drugs that make the intestine muscle contract more strongly are first tried. If episodes of severe distension are more frequent, then tubes may need to be inserted in the stomach or small bowel for venting (removal of air and secretions) and for feeding with special formulas.

If the bowel is too diseased and the patient cannot take enough food, then at that point, feeding will be provided through a needle placed in a large vein.

Surgery is rarely recommended for this condition.