intestinal pseudo-obstruction

WordNet

1. the physical condition of blocking or filling a passage with an obstruction (同)blockage
2. any structure that makes progress difficult (同)obstructor, obstructer, impediment, impedimenta
3. getting in someones way
4. the act of obstructing; "obstruction of justice"
5. of or relating to or inside the intestines; "intestinal disease" (同)enteric, enteral
6. (often used in combination) not genuine but having the appearance of; "a pseudo esthete"; "pseudoclassic"

PrepTutorEJDIC

1. 〈U〉(…への)妨害,障害《+『to』+『名』》 / 〈C〉(…への)妨害物,障害物《+『to』+『名』》
2. 腸[内]の
3. 偽りの;見せかけの

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/02/09 21:47:17」(JST)

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Intestinal Pseudo-Obstruction
Classification and external resources
ICD-9	560.89
OMIM	155310
DiseasesDB	10868
MedlinePlus	000253
eMedicine	med/2699 med/3570
MeSH	D003112

Intestinal Pseudo-obstruction is a clinical syndrome caused by severe impairment in the ability of the intestines to push food through. It is characterised by the signs and symptoms of intestinal obstruction without any lesion in the intestinal lumen. Clinical features can include abdominal pain, nausea, severe distension, vomiting, dysphagia, diarrhoea and constipation, depending upon the part of the gastrointestinal tract involved. The condition can begin at any age and it can be a primary condition (idiopathic or inherited) or caused by another disease (secondary).

It can be chronic or acute.

Causes

In primary chronic intestinal pseudo-obstruction (the majority of chronic cases), the condition may be caused by a injury to the smooth muscle (myopathic) or the nervous system (neuropathic) of the gastrointestinal tract.

In some cases there appears to be a genetic association. One form has been associated with DXYS154.

Secondary chronic intestinal pseudo-obstruction can occur as a consequence of a number of other conditions, including Kawasaki disease, Parkinson's disease, Chagas' Disease, Hirschsprung's Disease, Intestinal Hypoganglionosis, collagen vascular diseases, endocrine disorders and use of certain medications. The term may be used synonymously with Enteric neuropathy if a neurological cause is suspected.

Clinical manifestations

Clinical features of intestinal pseudo-obstruction can include abdominal pain, nausea, severe distension, vomiting, dysphagia, diarrhoea and constipation, depending upon the part of the gastrointestinal tract involved. In addition, in the moments in which abdominal colic occurs, abdominal x-ray shows intestinal air fluid level. All of these features are also similar in true mechanical obstruction of the bowel.

Diagnosis

Attempts must be made to determine whether there is a secondary cause amenable to treatment.

Primary (idiopathic) intestinal pseudo-obstruction is diagnosed based on motility studies, x-rays and gastric emptying studies.

Treatment

Secondary chronic intestinal pseudo-obstruction is managed by treating the underlying condition.

There is no cure for primary chronic intestinal pseudo-obstruction. It is important that nutrition and hydration is maintained, and pain relief is given. Drugs that increase the propulsive force of the intestines have been tried, as have different types of surgery.

Medical treatment

Prucalopride, Pyridostigmine, Metoclopramide, cisapride, and erythromycin may be used, but they have not been shown to have great efficacy. In such cases, treatment is aimed at managing the complications. Linaclotide is a new drug that has not yet received approval by Food and Drug Administration but in the future looks promising in the treatment of Chronic intestinal pseudo-obstruction , Gastroparesis and Inertia coli.

Intestinal stasis, which may lead to bacterial overgrowth and subsequently, diarrhea or malabsorption is treated with antibiotics.

Nutritional deficiencies are treated by encouraging patients to avoid food high in fat and fibre, which increase abdominal distention and discomfort, and have small, frequent meals (5-6 per day), focusing on liquids and soft food. Reducing intake of poorly absorbed sugar alcohols may be of benefit. Referral to an accredited dietitian is recommended. If dietary changes are unsuccessful in meeting nutritional requirements and stemming weight loss, enteral nutrition is used. Many patients eventually require parenteral nutrition.

Use of octreotide has been described.

Surgical and other procedures

Intestinal decompression by colostomy or tube placement in a small stoma can also be used to reduce distension and pressure within the gut. The stoma may be a gastrostomy, enterostomy or cecostomy, and may also be used to feed or flush the intestines.

Colostomy or ileostomy can bypass affected parts if they are distal to (come after) the stoma. For instance, if only the large colon that is affected, an ileostomy may be helpful.

Resection of affected parts may be needed if part of the gut dies (for instance toxic megacolon), or if there is a localised area of dysmotility.

Gastric and colonic pacemakers have been tried. These are strips placed along the colon which create an electric discharge intended to cause the muscle to contract in a controlled manner.

A potential solution, albeit radical, is a multi-organ transplant. The operation involved transplanting the pancreas, stomach, duodenum, small intestine, and liver, and was performed by Doctor Kareem Abu-Elmagd on Gretchen Miller, the subject of the Discovery Channel program Surgery Saved My Life.

Related disorders

• Ogilvie syndrome: acute pseudoobstruction of the colon in severely ill debilitated patients.
• Hirschsprung's disease: enlargement of the colon due to lack of development of autonomic ganglia.
• Intestinal neuronal dysplasia: a disease of motor neurons leading to the bowels.
• Bowel obstruction: mechanical or functional obstruction of the bowel most commonly due to adhesions, hernias or neoplasms.
• Enteric neuropathy: alternative name sometimes used for diagnosis in UK

References

External links

• 00530 at CHORUS

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 慢性偽性腸閉塞 chronic intestinal pseudo obstruction
• 2. 急性偽性腸閉塞（オギルビー症候群） acute colonic pseudo obstruction ogilvies syndrome
• 3. 悪心および嘔吐を伴う成人に対するアプローチ approach to the adult with nausea and vomiting
• 4. Immune-mediated neuropathies
• 5. 悪性腫瘍関連胃不全麻痺：病態生理およびマネージメント malignancy associated gastroparesis pathophysiology and management

English Journal

• New perspectives in the diagnosis and management of enteric neuropathies.

• Knowles CH, Lindberg G, Panza E, Giorgio RD.SourceCentre for Digestive Diseases, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Turner Street, London E1 2AD, UK.
• Nature reviews. Gastroenterology & hepatology.Nat Rev Gastroenterol Hepatol.2013 Feb 12. doi: 10.1038/nrgastro.2013.18. [Epub ahead of print]
• Chronic disturbances of gastrointestinal function encompass a wide spectrum of clinical disorders that range from common conditions with mild-to-moderate symptoms to rare diseases characterized by a severe impairment of digestive function, including chronic pain, vomiting, bloating and severe consti
• PMID 23399525

• Intestinal failure in children: the European view.

• D'Antiga L, Goulet O.SourcePediatric Hepatology, Gastroenterology and Transplantation, Ospedali Riuniti di Bergamo, Italy. ldantiga@ospedaliriuniti.bergamo.it
• Journal of pediatric gastroenterology and nutrition.J Pediatr Gastroenterol Nutr.2013 Feb;56(2):118-26. doi: 10.1097/MPG.0b013e318268a9e3.
• Intestinal failure (IF) is a condition in which severe intestinal malabsorption mandates artificial nutrition through a parenteral route. Causes of severe protracted IF include short bowel syndrome, congenital diseases of enterocyte development, and severe motility disorders (total or subtotal agang
• PMID 22820123

Japanese Journal

• シネMRIによる機能性消化管障害の病態 (特集 機能性消化管障害の病態と治療)

• 大久保 秀則,中島 淳
• 消化器内科 58(2), 141-147, 2014-02
• NAID 40020007542

• 症例報告 外科治療が奏功したmegacystis microcolon intestinal hypoperistalsis syndromeの1例

• 清水 裕史,伊勢 一哉,山下 方俊 [他]
• 日本小児外科学会雑誌 49(6), 1117-1121, 2013-10
• NAID 40019831928

• Epidemiology and Clinical Experience of Chronic Intestinal Pseudo-Obstruction in Japan: A Nationwide Epidemiologic Survey

• Iida Hiroshi,Ohkubo Hidenori,Inamori Masahiko,Nakajima Atsushi,Sato Hajime
• Journal of Epidemiology 23(4), 288-294, 2013
• … Background: We estimated the prevalence and incidence of chronic intestinal pseudo-obstruction (CIPO) in Japan, investigated the patterns of hospital visits among those with CIPO, and examined present knowledge of CIPO among medical professionals.<BR>Methods: A self-administered questionnaire survey was distributed to targeted hospitals throughout Japan, which were selected using stratified random sampling. …
• NAID 130003364501

Related Links

• Intestinal Pseudo-obstruction - National Digestive Diseases ...

Discusses chronic and acute forms of intestinal pseudo-obstruction and briefly describes symptoms, diagnosis, and treatment of this rare condition. ... Intestinal Pseudo-obstruction On this page: What is intestinal ...

• Intestinal Pseudo-obstruction - Home - National Digestive ...

5 Intestinal Pseudo-obstruction • Upper GI series. A health care provider may order an upper GI series to look at the small intestine. An x-ray technician performs the test at a hospital or an outpatient center, and a radiologist

Related Pictures

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★リンクテーブル★

リンク元	「腸偽閉塞」「visceral myopathy」「偽性腸閉塞」
拡張検索	「idiopathic intestinal pseudo-obstruction」「chronic idiopathic intestinal pseudo-obstruction」
関連記事	「intestinal」「obstruction」「pseudo」

「腸偽閉塞」

　　[★]

英

intestinal pseudo-obstruction、intestinal pseudoobstruction

関

麻痺性イレウス、腸管仮性閉塞症、偽性腸閉塞、特発性偽性腸閉塞症、腹部ミオパチー、偽性結腸閉塞

「visceral myopathy」

　　[★]

腹部ミオパチー

関

idiopathic intestinal pseudo-obstruction、intestinal pseudo-obstruction、intestinal pseudoobstruction、paralytic ileus

「偽性腸閉塞」

　　[★]

英

intestinal pseudo-obstruction

関

腸偽閉塞

「idiopathic intestinal pseudo-obstruction」

　　[★]

特発性偽性腸閉塞、特発性偽性腸閉塞症

関

intestinal pseudo-obstruction、intestinal pseudoobstruction、paralytic ileus、visceral myopathy

「chronic idiopathic intestinal pseudo-obstruction」

　　[★] 慢性特発性仮性腸閉塞症 CIIPS

「intestinal」

　　[★]

• adj.

• 腸の、腸管の、腸管内の、消化器系の

関

alimentary system、bowel、digestive system、enteric、enteric canal、entero、gastrointestinal、gastrointestinal system、GI、gut、intestinal tract、intestine

　 　

「obstruction」

　　[★]

• n.

• 妨害、障害、支障、差し障り。妨害物、
• 閉塞、閉塞症。

関

blockage、deterrent、obliteration、occlude、occlusion、stasis

　 　 　 　 　

「pseudo」

　　[★]

• n.

• 仮性、偽性、ニセ

関

counterfeit、false、mock、sham、spurious