Question: How do doctors treat intestinal pseudo-obstruction?
Answer: Doctors recommend different treatments for chronic intestinal pseudo-obstruction and acute colonic pseudo-obstruction.

Chronic intestinal pseudo-obstruction

Doctors treat chronic intestinal pseudo-obstruction with nutrition support, medicines, decompression, and sometimes surgery. If an underlying health problem is causing chronic intestinal pseudo-obstruction, doctors will also treat the underlying health problem as needed.

Nutrition support. People with chronic intestinal pseudo-obstruction may have problems getting enough nutrients from their food and drinks. Doctors may recommend diet changes to help prevent malnutrition and weight loss. Doctors often recommend a diet low in fat and uncooked fiber.

However, people who can’t get enough nutrients from their diet may need nutrition support. Nutrition support may include

enteral nutrition, in which a person receives liquid food through a tube inserted into thestomachorsmall intestine. The tube may be inserted through the nose, or it may be inserted through the wall of theabdomenduring surgery or with the help ofendoscopy.
parenteral nutrition, in which a person receives nutrients through anintravenous(IV) tube, which is a tube inserted into avein.

Parenteral nutrition may lead to serious complications, such as blood clots in veins or infections. Doctors only recommend parenteral nutrition if a person can’t get enough nutrients from their diet or from enteral nutrition.

People who aren’t able to get enough nutrients from their diet may need nutrition support.

Medicines. Doctors may prescribe medicines to help relieve the symptoms of chronic intestinal pseudo-obstruction, including

medicines that help food move through thedigestive tractmore quickly.
medicines that help relievenauseaandvomiting.
antibiotics, which doctors may prescribe to treatsmall intestinal bacterial overgrowth.
pain medicines, if needed. Doctors may recommend avoiding pain medicines, such as opioids, that slow down food moving through the digestive tract and may worsen the pseudo-obstruction.

Decompression. Decompression means removing gas and fluids from the digestive tract to relieve pressure and symptoms of pseudo-obstruction. To decompress the digestive tract, doctors may

insert a tube through the nose and into the stomach
perform acolonoscopy
perform surgery

Surgery. In some cases, doctors recommend surgery to treat chronic intestinal pseudo-obstruction. Types of surgery include

gastrostomyorjejunostomy, in which doctors place a tube from outside your body through theabdominalwall, directly into the stomach or small intestine. The tube can be used forenteral nutritionand for decompression.
ileostomy or colostomy, which may help with decompression.
bowelresection, or surgery to remove part of the intestine, which doctors recommend rarely, usually whenimaging testsshow the pseudo-obstruction affects only a segment of the intestine.
intestinaltransplant, which doctors may recommend for people who require parenteral nutrition but cannot start or continue parenteral nutrition safely.

Acute colonic pseudo-obstruction

Doctors most often treat acute colonic pseudo-obstruction with an approach called conservative management. In some cases, other treatments may be needed.

Conservative management. Doctors may treat acute colonic pseudo-obstruction with conservative management if you are not likely to have or develop complications. As part of conservative management, doctors typically

stop any medicines that could worsen the pseudo-obstruction, especially opioid pain medicines
treat any infections or other health problems
instruct you not to eat or drink anything because pseudo-obstruction will stop the movement of food, fluid, air, and waste through your intestines
give you IV fluid andelectrolytesas needed
give you medicine to help relieve the pseudo-obstruction
insert tubes into your stomach or rectum to decompress your digestive tract
encourage you to walk if you can

As part of conservative management for acute colonic pseudo-obstruction, doctors typically encourage you to walk if you can.

Other treatments. If acute pseudo-obstruction doesn’t improve with conservative management in 2 or 3 days, doctors may recommend other treatments.6 Doctors may also recommend other treatments if you have, or are likely to develop, complications. Other treatments may include

medicine to help relieve the pseudo-obstruction.
a colonoscopy to decompress the colon. In some cases, during colonoscopy, doctors place a tube in the colon and leave it there for a few days to help with decompression. The tube will eventually pass naturally.
surgery to decompress the colon or to remove part of the colon damaged by complications, particularly perforation.

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