Symptoms & Causes of Intestinal Pseudo-obstruction

What are the symptoms of intestinal pseudo-obstruction?

Symptoms of intestinal pseudo-obstruction vary from person to person. Symptoms may include

• abdominal pain
• bloating and feeling too full after eating a meal
• nausea and vomiting
• constipation
• diarrhea

Chronic intestinal pseudo-obstruction often causes symptoms after meals. Symptoms may be long-lasting or may come and go over time. Symptoms may be more severe at times, called acute episodes, and milder between these episodes. If chronic intestinal pseudo-obstruction affects parts of the digestive tract outside the intestines, it may cause additional symptoms. For example, if the condition affects the esophagus, it may cause problems with swallowing.

Acute colonic pseudo-obstruction symptoms may include the inability to pass stool or gas, along with the symptoms listed above. Symptoms may occur even when you don’t eat or drink.

If you or your child have symptoms of intestinal pseudo-obstruction, you should see a doctor or take your child to see a doctor right away, especially if the symptoms are severe or don’t go away. These symptoms could be a sign of either intestinal obstruction—a blockage in the intestines—or pseudo-obstruction. Without treatment, intestinal obstruction and pseudo-obstruction may lead to life-threatening complications.

What causes intestinal pseudo-obstruction?

Intestinal pseudo-obstruction occurs when nerve or muscle problems slow or stop the movement of food, fluid, air, and waste through the intestines.

Chronic intestinal pseudo-obstruction

Depending on the cause, chronic intestinal pseudo-obstruction may be primary or secondary.

Primary chronic intestinal pseudo-obstruction. Experts are still studying the causes of primary chronic intestinal pseudo-obstruction and have identified different forms of this condition.

In some forms, genes cause primary chronic intestinal pseudo-obstruction, particularly when the illness begins in the first year of life. In other forms, especially when it starts in adults, the cause is unknown. When the cause is unknown, doctors may call the condition idiopathic. People with some forms of primary chronic intestinal pseudo-obstruction also have muscle or nerve problems in other parts of the digestive tract—such as the esophagus or stomach—or, less frequently, in the urinary tract.

Most of the cases in children are primary chronic intestinal pseudo-obstruction.5

Secondary chronic intestinal pseudo-obstruction. Underlying health problems or other risk factors cause secondary chronic intestinal pseudo-obstruction. In adults, up to half of the cases of chronic intestinal pseudo-obstruction are secondary.5

A variety of health problems may cause secondary chronic intestinal pseudo-obstruction. Examples include

• diseases and disorders that affect muscles or connective tissue, such as muscular dystrophy, lupus, and scleroderma
• diseases and disorders that affect nerves, such as Parkinson’s disease and diabetic neuropathy
• endocrine disorders, such as diabetes and hypothyroidism
• health problems that affect metabolism, such as porphyria or electrolyte imbalances
• infections, such as viral infections that also cause damage to the nerves that supply the intestines, including herpes and Epstein-Barr virus
• other health problems, including celiac disease, Crohn’s disease, and some types of cancer

Other causes of secondary chronic intestinal pseudo-obstruction include

• medicines, such as opiates and antidepressants
• radiation therapy to treat cancer
• toxins—poisonous substances

Acute colonic pseudo-obstruction

Acute colonic pseudo-obstruction most often occurs in people who have a severe illness or injury or those who recently had surgery.

Health problems that may lead to acute colonic pseudo-obstruction include

• diseases and disorders that affect nerves, such as Parkinson’s disease
• heart attack, heart failure, and stroke
• infection and sepsis
• injury or physical trauma, including hip or back injury
• problems that affect metabolism, such as kidney failure, liver failure, and electrolyte imbalances
• some types of cancer, especially when cancer spreads to the area where the nerves from the spine connect with the intestines

Other factors linked to acute colonic pseudo-obstruction include

• medicines, such as opiates and antidepressants
• pregnancy, vaginal delivery, or Cesarian section
• radiation therapy to treat cancer
• surgery, such as abdominal surgery, heart surgery, organ transplantation, and joint replacement, especially knee and hip replacement

Acute colonic pseudo-obstruction most often occurs in people who have a severe illness or injury or those who recently had surgery.

References

[5] Pironi L, Sasdelli AS. Management of the patient with chronic intestinal pseudo-obstruction and intestinal failure. Gastroenterology Clinics of North America. 2019;48(4):513–524. doi: 10.1016/j.gtc.2019.08.005

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