Ileus and colonic pseudo-obstruction cause functional obstruction of intestinal transit,
without mechanical obstruction, because of uncoordinated or attenuated intestinal
muscle contractions. Ileus usually arises from an exaggerated intestinal reaction
to abdominal surgery that is often exacerbated by numerous other conditions. Colonic
pseudo-obstruction is induced by numerous metabolic disorders, drugs that inhibit
intestinal motility, severe illnesses, and extensive surgery. It presents with massive
colonic dilatation with variable, moderate small bowel dilatation. Both conditions
are initially treated with supportive measures that include intravenous rehydration,
correction of electrolyte abnormalities, discontinuation of antikinetic drugs, and
treatment of other contributing disorders. Specific therapies for colonic pseudo-obstruction
include neostigmine (an anticholinesterase) for pharmacologic colonic decompression
and colonoscopic decompression.
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References
- Deflating postoperative ileus.Gastroenterology. 1999; 117: 489-492
- Systematic review: acute colonic pseudo-obstruction.Aliment Pharmacol Ther. 2005; 22: 917-925
- Assessment of predictors of response to neostigmine for acute colonic pseudo-obstruction.Am J Gastroenterol. 2002; 97: 3118-3122
- Pseudo-obstruction of the colon (Ogilvie's syndrome), a genuine clinical condition? Review of the literature (1948–1975) and report of five cases.Dis Colon Rectum. 1977; 20: 487-491
- Intestinal obstruction and ileus.in: Feldman M. Friedman L.S. Brandt L.J. Sleisenger and Fordtran's gastrointestinal and liver disease: pathophysiology, diagnosis, and management. 8th edition. Elsevier Saunders, Philadelphia2006: 2653-2678
- Effect of adrenergic and nitrergic blockade on experimental ileus in rats.Br J Pharmacol. 1997; 120: 464-468
- Ileus in critical illness: mechanisms and management.Curr Opin Crit Care. 2002; 8: 152-157
- Inhibition of macrophage function prevents intestinal inflammation and postoperative ileus in rodents.Gut. 2007; 56: 176-185
- Selective jejunal manipulation causes postoperative pan-enteric inflammation and dysmotility.Gastroenterology. 2004; 126: 159-169
- Effects of mu- and kappa-opioid receptors on postoperative ileus in rats.Eur J Pharmacol. 1997; 339: 63-67
- Corticotropin-releasing factor receptors and stress-related alterations of gut motor function.J Clin Invest. 2007; 117: 33-40
- Postoperative ileus: a preventable event.Br J Surg. 2000; 87: 1480-1493
- Human colonic smooth muscle electrical activity during and after recovery from postoperative ileus.Am J Physiol. 1995; 269: G408-G417
- Postoperative ileus.Dig Dis Sci. 1990; 35: 121-132
- Opioid-induced bowel-dysfunction: pathophysiology and potential new therapies.Drugs. 2003; 63: 649-671
- Morphine, constipation and performance status in advanced cancer patients.Palliat Med. 1999; 13: 159-160
- Small intestine.in: Townsend C.M. Beauchamp R.D. Evers B.M. Mattox K.L. Sabiston textbook of surgery: the biologic basis of modern surgical practice. 17th edition. Elsevier Saunders, Philadelphia2004: 1323-1380
- The management of patients with suspected early postoperative small bowel obstruction.Ann Surg. 1989; 210: 216-219
- Early enteral feeding, compared with parenteral, reduces postoperative septic complications: the results of a meta-analysis.Ann Surg. 1992; 216: 172-183
- Must early postoperative oral intake be limited to laparoscopy?.Dis Col Rectum. 1994; 37: 584-589
- Randomized trial of safety and efficacy of immediate postoperative enteral feeding in patients undergoing gastrointestinal resection.Br Med J. 1996; 312: 869-871
- Does enteral nutrition affect clinical outcome? A systematic review of the randomized trials.Am J Gastroenterol. 2007; 102: 412-429
- A prospective controlled trial of early postoperative oral intake following major abdominal gynecologic surgery.Gynecol Oncol. 1997; 67: 235-240
- Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy.J Am Coll Surg. 2002; 195: 30-32
- Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized, placebo-controlled trial.J Am Coll Surg. 2006; 202: 773-778
- Does gum chewing reduce postoperative ileus following open colectomy for left-sided colon and rectal cancer? A prospective randomized controlled trial.Colorect Dis. 2006; 8: 64-70
- Gum chewing reduces ileus after elective open sigmoid colectomy.Arch Surg. 2006; 141: 174-176
- The effect of ambulation on the recovery from postoperative ileus.Ann Surg. 1990; 212: 671-677
- A meta-analysis of selective versus routine nasogastric decompression after elective laparotomy.Ann Surg. 1995; 221: 469-476
- Nasogastric intubation after intestinal resection.Surg Gynecol Obstet. 1984; 158: 354-358
- Postoperative ileus: etiologies and intervention.Clin Gastroenterol Hepatol. 2003; 1: 71-80
- Effect of intravenous erythromycin on postoperative ileus.Am J Gastroenterol. 1993; 88: 208-211
- Treatment of postoperative ileus after bowel surgery with low-dose intravenous erythromycin.Urology. 2007; 69: 611-615
- Prokinetic effect of erythromycin after colorectal surgery: randomized, placebo-controlled, double-blinded study.Dis Col Rectum. 2000; 43: 333-337
- Beta-adrenoreceptor blockade in the treatment of postoperative adynamic ileus.Scand J Gastroenterol. 1987; 22: 149-155
- Does metoclopramide reduce the length of ileus after colorectal surgery? A prospective randomized trial.Dis Colon Rectum. 1991; 34: 437-441
- Minerva Chir. 1994; 49 ([in Italian]): 451-455
- Prospective trial of early feeding and bowel stimulation after radical hysterectomy.Am J Obstet Gynecol. 2000; 182: 996-998
- Effect of laxatives on gastrointestinal function recovery in fast-track hysterectomy: a double-blind, placebo-controlled randomized study.Am J Obstet Gynecol. 2007; 196 (311.e1–311.e7)
- Homeopathy for postoperative ileus? A meta-analysis.J Clin Gastroenterol. 1997; 25: 628-633
- Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials.Lancet. 1997; 350: 834-843
- Alvimopan for the management of postoperative ileus.Ann Pharmacother. 2005; 39: 1502-1510
- Meta-analysis: alvimopan vs. placebo in the treatment of post-operative ileus.Aliment Pharmacol Ther. 2007; 25: 47-57
- Treatment of opioid-induced gut dysfunction.Expert Opin Investig Drugs. 2007; 16: 181-194
- Laparoscopic versus open appendectomy in children: a meta-analysis.Ann Surg. 2006; 243: 17-27
- The evolution of postoperative ileus after laparoscopic cholecystectomy: a comparative study with conventional cholecystectomy and sympathetic blockade treatment.Surg Endosc. 1993; 7: 416-419
- Operative stress response is reduced after laparoscopic compared to open cholecystectomy: the relationship with postoperative pain and ileus.Dig Dis Sci. 2000; 45: 1703-1713
- Nonopioid analgesics shorten the duration of postoperative ileus.Am Surg. 1995; 61: 1079-1083
- On the relevance of non-steroidal anti-inflammatory drugs in the prevention of paralytic ileus in rodents.J Pharm Pharmacol. 1989; 41: 757-761
- Strategies in pain management: new and potential indications for COX-2 inhibitors.J Pain Symptom Manage. 2003; 25: S21-S31
- Prospective randomized, double-blind, placebo-controlled study of pre- and postoperative administration of a COX-2-specific inhibitor as opioid-sparing analgesia in major colorectal surgery.Colorectal Dis. 2007; 9: 52-60
- Epidural local anaesthetics versus opioid-based analgesic regimens on postoperative gastrointestinal paralysis, PONV and pain after abdominal surgery.Cochrane Database Syst Rev. 2000; (CD001893)
- Epidural anesthesia and gastrointestinal motility.Anesth Analg. 1998; 86: 837-844
- Large-intestine colic due to sympathetic deprivation: a new clinical syndrome.Br Med J. 1948; 2: 671-673
- Intestinal pseudo-obstruction.J R Coll Surg Edinb. 1958; 3: 206-217
- Pseudo-obstruction in the critically ill.Best Pract Res Clin Gastroenterol. 2003; 17: 427-444
- Acute pseudo-obstruction of the colon (Ogilvie's syndrome): an analysis of 400 cases.Dis Colon Rectum. 1986; 29: 203-210
- Ileus: use of sympathetic blocking agents in its treatment.Surgery. 1969; 66: 811-820
- Acute colonic pseudo-obstruction: a possible role for the colocolonic reflex.J Clin Gastroenterol. 1985; 7: 256-260
- Acute colonic pseudo-obstruction (Ogilvie's syndrome): presentation of 14 of our own cases and analysis of 1027 cases reported in the literature.Surg Endosc. 1987; 1: 169-174
- Ogilvie's syndrome (acute colonic pseudo-obstruction): review of the literature (October 1948 to March 1980) and report of four additional cases.Dis Colon Rectum. 1982; 25: 157-166
- Changing perspective on gastrointestinal complications in patients undergoing cardiac surgery.Am J Surg. 1992; 163: 525-529
- Acute pseudo-obstruction in critically ill patients with burns.J Burn Care Rehabil. 1995; 16: 132-135
- Bowel obstruction and pseudo-obstruction.Gastroenterol Clin North Am. 2003; 32: 1229-1247
- Adynamic ileus of the colon: an indication for cecostomy.Arch Surg. 1974; 109: 503-507
- The acute contrast enema in suspected large bowel obstruction: value and technique.Clin Radiol. 1992; 46: 273-278
- Intestinal obstruction: role of CT.Gastroenterol Clin North Am. 2002; 31: 777-799
- Computed tomography in the assessment of suspected large bowel obstruction.ANZ J Surg. 2007; 77: 160-165
- Ogilvie's syndrome: successful management without colonoscopy.Dig Dis Sci. 1988; 33: 1391-1396
- Retrospective study of neostigmine for the treatment of acute colonic pseudo-obstruction.Am Surg. 2001; 67: 265-269
- Factors predicting successful outcome following neostigmine therapy in acute colonic pseudo-obstruction. A prospective study.J Gastroenterol Hepatol. 2006; 21: 459-461
- Treatment of acute colonic pseudo-obstruction with neostigmine.J Am Coll Surg. 2000; 190: 315-318
- Neostigmine for the treatment of acute colonic pseudo-obstruction.N Engl J Med. 1999; 341: 137-141
- Effect of polyethylene glycol electrolyte balanced solution on patients with acute colonic pseudo obstruction after resolution of colonic dilation: a prospective, randomised, placebo-controlled trial.Gut. 2006; 55: 638-642
- Ogilvie's syndrome: a new approach to an old problem.Dis Colon Rectum. 1995; 38: 424-427
- Neostigmine: safe and effective treatment for acute colonic pseudo-obstruction.Dis Colon Rectum. 2000; 43: 599-603
- Early resolution of Ogilvie's syndrome with intravenous neostigmine: a simple, effective treatment.Dis Colon Rectum. 1997; 40: 1353-1357
- Neostigmine resolves critical illness-related colonic ileus in intensive care patients with multiple organ failure: a prospective, double-blind, placebo-controlled trial.Intensive Care Med. 2001; 27: 822-827
- Infusion of neostigmine-glycopyrrolate for bowel evacuation in persons with spinal cord injury.Am J Gastroenterol. 2005; 100: 1560-1565
- Death due to a combination of treatment and disease.Br Med J. 1969; 4: 344
- An unusual case of neostigmine bromide poisoning.Gastroenterology. 1959; 36: 877-880
- Cisapride as successful treatment for acute intestinal pseudo-obstruction.South Med J. 1996; 89: 828-830
- Cisapride in Ogilvie's syndrome.Gastroenterology. 1990; 99: 1194-1195
- Spinal anesthesia and Ogilvie's syndrome.J Clin Anesth. 2005; 17: 122-123
- Erythromycin for reflex ileus in Ogilvie's syndrome.Lancet. 1991; 337: 378
- Acute colonic pseudo-obstruction (Ogilvie's syndrome) treated with erythromycin.Intensive Care Med. 1997; 23: 798
- Erythromycin as therapy for acute colonic pseudo-obstruction (Ogilvie's syndrome).J Clin Gastroenterol. 1991; 13: 475-476
- Mu opioid receptor antagonists: recent developments.Chem Med Chem. 2007; 2: 1552-1570
- Peripheral opioids for functional GI disease: a reappraisal.Dig Dis. 2006; 24: 91-98
- Alvimopan (ADL 8-2698) is a novel peripheral opioid antagonist.Am J Surg. 2001; 182: 27S-38S
- Spinal anaesthesia in acute colonic pseudo-obstruction.Anaesthesia. 1995; 50: 1103
- Epidural anesthesia for acute pseudo-obstruction of the colon (Ogilvie's syndrome).Dis Colon Rectum. 1988; 31: 686-691
- Ogilvie's syndrome: colonoscopic decompression and analysis of predisposing factors.Dis Colon Rectum. 1992; 35: 1135-1142
- Colonoscopy and acute colonic pseudo-obstruction.Gastrointest Endosc Clin N Am. 1997; 7: 499-508
- Colonoscopic decompression for acute pseudoobstruction of the colon (Ogilvie's syndrome). Report of 22 cases and review of the literature.Am J Surg. 1984; 147: 243-245
- Therapeutic and diagnostic endoscopy in nonobstructive colonic dilatation.Ann Surg. 1983; 197: 416-421
- Radiographic changes after colonoscopic decompression for acute pseudo-obstruction.Dis Colon Rectum. 1999; 42: 1586-1591
- Treatment of acute nontoxic megacolon during colonoscopy: tube placement versus simple decompression.Gastrointest Endosc. 1988; 34: 23-27
- Ogilvie's syndrome: results of endoscopic exsufflation in a series of 29 cases.Gastroenterol Clin Biol. 1986; 10: 147-151
- Polyethylene glycol matrix reduces the rates of photochemical and thermal release of nitric oxide from S-niroso-N-acetylcysteine.Photochem Photobiol. 2000; 71: 273-280
- Diagnostic laparoscopy and laparoscopic cecostomy for colonic pseudo-obstruction.Dis Colon Rectum. 1993; 36: 65-70
- Percutaneous colonoscopic cecostomy for management of chronic constipation in children.Gastrointest Endosc. 2001; 53: 225-228
- Percutaneous endoscopic cecostomy: a case series.Gastrointest Endosc. 2003; 57: 752-755
- Percutaneous cecostomy for Ogilvie syndrome: laboratory observations and clinical experience.Radiology. 1990; 175: 679-682
- Controlled transperitoneal percutaneous cecostomy as a therapeutic alternative to the endoscopic decompression for Ogilvie's syndrome.Am J Gastroenterol. 2002; 97: 471-474
- Percutaneous decompression of the colon using CT guidance in Ogilvie syndrome.AJR Am J Roentgenol. 1985; 144: 475-476
- Abdominal wall cellulitis and sepsis secondary to percutaneous cecostomy.Cardiovasc Intervent Radiol. 1993; 16: 328-331
- Percutaneous endoscopic cecostomy: a new approach to nonobstructive colonic dilation.Gastrointest Endosc. 1986; 32: 108-111
- Percutaneous endoscopic cecostomy in adults: a case series.Gastrointest Endosc. 2006; 64: 279-282
- Endoscopic management of acute colonic pseudo-obstruction.Endoscopy. 2005; 37: 760-763
- Acute colonic pseudo-obstruction (Ogilvie's syndrome) after renal transplantation.Am J Surg. 1999; 177: 492-496
- Minerva Chir. 1997; 52 ([in Italian]): 1311-1320
- Colonoscopic decompression of massive nonobstructive cecal dilatation.Arch Surg. 1977; 122: 512-517
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