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Colonic Pseudoobstruction
Dr. Scott at GastroDoxs in Houston leads specialized care for colonic pseudoobstruction (Ogilvie's syndrome). Utilizing advanced imaging, targeted medications, and minimally invasive techniques, he provides swift, prompt diagnosis, effective treatment, and compassionate support-helping patients relieve symptoms and prevent serious complications.
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
What Is Colonic Pseudoobstruction?
Colonic pseudoobstruction, also known as Ogilvie's syndrome, occurs when the large intestine stops moving stool forward despite no physical blockage. The colon becomes distended, leading to pain, bloating, and constipation. Prompt treatment is essential to prevent serious complications like perforation.
Common Causes and Risk Factors
Recent abdominal or pelvic surgery
Serious infections or critical illness during hospitalization
Medications that slow gut motility (e.g., opioids)
Low potassium or magnesium levels
Nervous system disorders (Parkinson's disease, spinal cord injury)
Age over 60 or prolonged hospital stay
Signs and Symptoms
Rapidly increasing abdominal swelling
Cramping or constant belly pain
Difficulty passing gas or stool
Nausea or vomiting
Early fullness after small meals
How Dr. Scott Diagnoses This Condition?
Dr. Scott uses a step-by-step approach:
Medical History and Physical Exam
He reviews your recent surgeries (especially abdominal or pelvic), current medications (like opioids), and any episodes of severe illness. Dr. Scott asks about the onset of bloating, epigastric or diffuse abdominal pain, and changes in your bowel habits. A focused abdominal exam checks for distension, tenderness, and bowel sounds.
Laboratory Tests
Blood work evaluates electrolytes (potassium, magnesium), complete blood count, and markers of infection or inflammation to rule out alternative diagnoses and correct any imbalances that might worsen gut motility.
Imaging Studies
Abdominal X-ray: Quickly identifies dilation of the colon and helps exclude a mechanical blockage.
CT Scan: Provides detailed cross-sectional images to rule out perforation, ischemia, or an underlying mass.
Endoscopic Evaluation & Decompression (if needed)
When noninvasive tests are inconclusive or urgent relief is required, a colonoscopic decompression both confirms the diagnosis and relieves gas pressure, reducing the risk of perforation.
Treatment
Our Team offers a full range of care for colonic pseudoobstruction.
1. Lifestyle and Diet Changes
Eat small meals that are low in fiber until symptoms improve
Stay hydrated with clear fluids or electrolyte drinks
Try short walks to help restart gut movement
2. Medications
Neostigmine: Works quickly in many cases to stimulate bowel activity
Laxatives or stool softeners: Used carefully and only as advised
Adjustment of any medications that may slow your bowels (e.g., opioids)
3. Minimally Invasive or Advanced Procedures
Colonoscopic decompression: A scope-guided tube to release excess gas
Cecostomy: A rare, targeted procedure to relieve severe pressure
Close monitoring and advanced care available through our Houston hospital partners
Dr. Scott Liu, MD, is a board-certified gastroenterologist with over six years of experience and a background in military medicine. He earned his medical degree from the University of Maryland, Baltimore, completed his Internal Medicine residency at Naval Medical Center Portsmouth, and finished his Gastroenterology fellowship through the National Capital Consortium. Dr. Liu provides comprehensive care for a broad range of digestive conditions, including abdominal pain, acid reflux, liver disease, chronic diarrhea, and colon cancer screening. He is a member of the American College of Gastroenterology and is known for his disciplined, patient-focused approach and clear communication.
Frequently Asked Questions
How is pseudoobstruction different from ileus?
Ogilvie's syndrome affects only the large bowel, whereas ileus slows motility throughout your entire digestive tract.
Is this an emergency?
Yes. If untreated, the colon can over-distend, tear, or perforate, leading to serious complications.
What's the ICD-10 code?
The code for colonic pseudoobstruction (Ogilvie's syndrome) is K59.81.
Does neostigmine really work?
Yes. Clinical studies show neostigmine relieves symptoms in up to 90% of cases, often within hours.
Can food changes help?
Absolutely. Small, low-fiber meals and adequate hydration support bowel recovery alongside medical treatment.
Will I need surgery?
Most patients improve with medications or colonoscopic decompression. Surgery is reserved for rare, severe cases.
How do I get ready for decompression?
We'll provide clear instructions-typically fasting, IV fluids, and medication adjustments-before your procedure.
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