Alternative names
Intestinal pseudo-obstruction; Acute colonic ileus; Colonic pseudo-obstruction; Idiopathic intestinal pseudo-obstruction; Ogilvie’s syndrome

Definition
Primary or idiopathic intestinal pseudo-obstruction is a condition characterized by symptoms of intestinal obstruction without physical evidence of such a blockage. In this disorder, the bowels (small or large intestines) become very quiet and lose their ability to contract and push food, stool, and air through the gastrointestinal tract.

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.

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.