Although no trials have actually been performed, it is common to use a different antibiotic for seven to 10 days each month to avoid development of bacterial resistance. These measures usually result in significant symptomatic relief in those patients with diarrhea and steatorrhea. Decompression Decompression is rarely necessary in patients with chronic pseudo-obstruction and should be restricted to patients with severe motility disorders being cared for at tertiary care centers. Venting enterostomy creates a means to relieve abdominal distention and bloating and has proved to significantly reduce the frequency of nasogastric intubations or hospitalizations for acute exacerbations in patients with severe intestinal pseudo-obstruction that require central parenteral nutrition. Access to the small intestine may also provide a way to deliver nutrients by the enteral route.
Enteral tubes are available that facilitate both aspiration and feeding using the same apparatus.
Surgical Treatment Surgical treatment should be considered whenever the motility disorder is localized to a portion of the gut that can be resected. The role of small bowel transplantation in patients with pseudo-obstruction is unclear. The prognosis depends on the severity of the case. Patients with suspected postviral gastroparesis appear to have a good overall prognosis, with restoration of nutrition and reduction of symptoms within two years. On the other hand, patients with myopathic, dilated bowel have persistent symptoms, are more prone to develop bacterial overgrowth, and usually require long-term parenteral nutrition, which carries inherent morbidity.