In the majority of adult cases there is no family history of pseudo-obstruction and these are therefore referred to as sporadic or idiopathic cases. Secondary pseudo-obstruction may occur as a complication to other diseases. Difficult route to diagnosis The onset of pseudo-obstruction is usually insidious. Acute onset is rare except in acute forms of pseudo-obstruction like Ogilvie's syndrome. Once the symptoms bring the patient to the doctor, this can be the beginning of a long and winding road to the correct diagnosis.
Abdominal complaints are the third most common cause for seeking medical advice.
Only upper respiratory tract symptoms and muscle and joint problems are more common. Like most gastrointestinal diseases, pseudo-obstruction cannot be recognised from the outside of the patient. Blood tests are usually normal and even an extensive investigation including ultrasonography, computed tomography, gastroscopy, barium meal, barium enema and colonoscopy may yield normal results. Dilated bowel loops can be seen in some patients, usually with advanced myopathic pseudo-obstruction. Often the conclusion from such an investigation is that the patient suffers from a functional bowel disorder such as the irritable bowel syndrome.