Intestinal disorder that mimic intestinal obstruction in absance of mechanical blockage.
Low prevalence < 1 in 2000
this exclude the following conditions:
mechanical obstruction: adhesions, volvulus
colonic pseudo-obstruction:Ogilivie's syndromw
acute adynamic status: ileus
secondary pseudo-obstruction: scleroderma, paraneoplastic, IDDM, radiation, amyloid.
symptoms:
abdominal pain, distention, epidodic N/V, severe constipation, diarrhea, Wt loos.
investigation:
exclude secondary causes
small bowel manometry
full thickness biopsy
treatment:
nutrition (entral/ parentral)
analgesia
prokinatics
antibiotics
immunotherpy
sutgery in selected cases
psychlogical support
palliative care
Low prevalence < 1 in 2000
this exclude the following conditions:
mechanical obstruction: adhesions, volvulus
colonic pseudo-obstruction:Ogilivie's syndromw
acute adynamic status: ileus
secondary pseudo-obstruction: scleroderma, paraneoplastic, IDDM, radiation, amyloid.
symptoms:
abdominal pain, distention, epidodic N/V, severe constipation, diarrhea, Wt loos.
investigation:
exclude secondary causes
small bowel manometry
full thickness biopsy
treatment:
nutrition (entral/ parentral)
analgesia
prokinatics
antibiotics
immunotherpy
sutgery in selected cases
psychlogical support
palliative care
The mechanisms proposed for acute pseudo-obstruction include:
ReplyDelete(1) reflex motor inhibition through splanchnic afferents in response to noxious stimuli,
(2) excess sympathetic (inhibitory) motor input to the gut,
(3) excess parasympathetic (excitatory) motor input to the gut, (4) decreased parasympathetic (excitatory) motor input to the gut,
(5) excess stimulation of peripheral mu-opioid receptors by endogenous or exogenous opioids, and
(6) inhibition of nitric oxide release from inhibitory motoneurons.
I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
ReplyDeleteliver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.