Intestinal Pseudo Obstruction

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Intestinal pseudo-obstruction can happen at any time of life, and its symptoms range from mild to severe. In children, it can transform into a condition called chronic intestinal pseudo-obstruction (CIP). Read More

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Intestinal Pseudo Obstruction

What is Intestinal Pseudo Obstruction?

Intestinal pseudo-obstruction can be defined as a  condition with impairment of the muscle contractions that move food through the digestive tract. 

Intestinal pseudo-obstruction can happen at any time of life, and its symptoms range from mild to severe. Intestinal pseudo-obstruction mostly results in a mass of partially digested food in the intestines which can cause abdominal swelling (distention) and pain, nausea, vomiting, and constipation or diarrhea although when examined, no blockage is found in the intestines.

Intestinal pseudo-obstruction can occur in people of any age, but it occurs more often in children and older adults.  In children, it can transform into a condition called chronic intestinal pseudo-obstruction (CIP). CIP in children can occur at birth.

Chronic Intestinal Pseudo-obstruction

Chronic intestinal pseudo-obstruction (CIP) Involves the abnormalities affecting peristaltic- the involuntary, organized muscular contractions of the gastrointestinal (GI) tract. Through Peristalsis, and with the aid of nerve controls and hormones, food and other digestive material are transported in the digestive system. CIP then occurs when peristaltic is affected by complications resulting from the muscles and nerves that are involved in peristalsis.

CIP affects males and females in equal numbers and can affect individuals of any age.  According to some research, almost 100 new cases of CIP were observed in children in the United States each year. However, CIP often goes unrecognized or misdiagnosed making it extremely difficult to determine the true frequency of CIP in the general population 

Source: www.rarediseases.org

Types of Intestinal Pseudo-obstruction.

It can be classified into different forms. They include:

Acute Colonic Pseudo-obstruction (ACPO), which mostly affects the elderly. It occurs when the colon becomes enlarged after surgery or illness. 

Chronic Intestinal Pseudo-obstruction is most common in children. It occurs due to the peristaltic function of the gastrointestinal tract that has been affected,

Primary or Idiopathic Intestinal pseudo-obstruction results when the cause of the nerve or muscle problems affecting the intestinal pseudo-obstruction is not known.

Secondary Intestinal pseudo-obstruction occurs when the cause is detected and known.

Diagnosis of Intestinal Pseudo-obstruction.

Intestinal pseudo-obstruction can be diagnosed using the following procedure:

  • First, a physical examination is carried out
  • Then, your medical history is checked and analyzed.
  • The intestinal blockage will be checked
  • Manometry to ascertain the level of intestinal contraction
  • The scan will also be taken
  • Also, there may be a need to check for eye and bladder problems, as the symptoms might be similar.
  • A blood test is some and biopsies taken to help make sure. 

Treatment of Intestinal Pseudo-obstruction 

The ways to treat and manage this disease include:

  • Medications to treat bacterial infections, pain, and intestinal muscle problems are given to treat the underlying cause. 
  • ACPO cases may need methods to aid the removal of gases from the bowel.
  • Improve the nutritional levels to prevent malnutrition and weight loss. 
  • Enteral nutrition; that is using a feeding tube inserted through the nose into the stomach to feed the patient. Sometimes, it is placed directly into the stomach or small intestine may be recommended.
  • Parenteral nutrition; is feeding the patient with a tube placed through their vein. 
  • Sometimes, intestinal pseudo-obstruction surgery might be required in extreme cases.

Symptoms

Intestinal pseudo-obstruction symptoms include:

  • Cramps, 
  • Abdominal pain,
  • Nausea and vomiting, 
  • Stomach bloating
  • Constipation. 
  • Occasionally diarrhea. 

Over time, the condition can cause:

  • Bacterial infections
  • Malnutrition
  • Weight loss
  • Muscle problems in other parts of the body. 
  • And in some cases develop problems with their esophagus, stomach, or bladder.

Causes

In adults;

  • Surgery for abdominal or pelvic 
  • diseases that affect muscles and nerves, such as lupus erythematosus, scleroderma, and Parkinson's disease
  • infections
  • medications such as opiates and antidepressants could affect the muscles and nerves
  • Also some electrolyte imbalance or endocrine disorders in the body like high calcium, low thyroid, low magnesium, etc

In children, it could result from a congenital cause.

FAQ

1. What is the management of intestinal pseudo-obstruction?

It includes fluid resuscitation with metabolic derangements, intestinal decompression, and bowel rest. This will, in some cases, result in surgery.

2. What causes intestinal pseudo-obstruction?

Intestinal pseudo-obstruction can be caused by nerve or muscle problems, resulting in abnormal contracting of the intestine and difficulty to move food, fluid, and air through the intestines. Symptoms include; cramps, abdominal pain, nausea, vomiting, bloating, constipation, and occasionally diarrhea.

3. Can intestinal pseudo-obstruction affect children?

A form of Intestinal Pseudo obstruction called chronic intestinal pseudo-obstruction can be congenital, found present at birth. This form is also common in children.

4. What is Acute Colonic Pseudo-obstruction (ACPO)

It is also called “Ogilvie syndrome”. It is characterized by the presence of severe colonic distension and the absence of mechanical obstruction. It can result in abdominal ischemia and death if left untreated.

5. Who is affected by intestinal pseudo-obstruction?

It ranges from children, in the case of chronic intestinal pseudo-obstruction, to the older adults, in the case of acute colonic pseudo-obstruction. It affects both males and females alike.