eMedicine Specialties > Gastroenterology > Colon

Ogilvie Syndrome: Follow-up

Author: Prospere Remy, MD, Assistant Professor of Medicine, Albert Einstein College of Medicine; Attending Physician, Department of Internal Medicine, Bronx-Lebanon Hospital Center
Coauthor(s): Kavita Kumbum, MD, Fellow, Division of Gastroenterology, Bronx Lebanon Hospital Center, Albert Einstein College of Medicine; Steven Carpenter, MD, Chair, Program Director, Department of Internal Medicine, Memorial Health University Medical Center; Bjorn Holmstrom, MD, Assistant Professor, Department of Internal Medicine, University of South Florida
Contributor Information and Disclosures

Updated: Jul 30, 2008

Follow-up

Further Inpatient Care

  • Treatment of the underlying medical condition: As previously mentioned, colonic pseudo-obstruction is usually precipitated by an important underlying condition. Appropriately replace electrolytes and promptly manage infections with adequate antimicrobial therapy.

Further Outpatient Care

  • In general, further outpatient care is dictated by the patient's underlying medical condition(s).
  • Outpatient care can usually be managed by the primary care physician.

Inpatient & Outpatient Medications

  • Constipation: If the patient shows a tendency toward colonic inertia, outpatient treatment is necessary. Osmotic laxatives and fiber can be useful to provide adequate stool frequency.

Transfer

  • If endoscopic or surgical expertise in the area does not allow for patient management in a timely manner, consider transferring the patient to another facility.

Complications

  • Colonic perforation: If the colon is not decompressed before it reaches critical diameter, the patient is at risk for colonic perforation. Once again, this complication may be prevented by timely diagnosis and management of the problems at hand.

Prognosis

  • Prognosis is determined by the underlying medical and/or surgical problems that placed the patient at risk for colonic pseudo-obstruction.

Patient Education

  • Advise the patient and family members of the signs and symptoms of recurrent pseudo-obstruction. Inform them that recurrent abdominal distention is an indication to seek prompt medical attention.

Miscellaneous

Medicolegal Pitfalls

  • Failure to arrive at the accurate diagnosis in a timely fashion. Ogilvie syndrome should be considered in all patients with significant abdominal distention.
  • Delay in appropriate therapy: Once the colon reaches 10 cm in diameter (usually the cecum), a risk of perforation exists; therefore, initiate therapy in a timely fashion once the diagnosis is confirmed.
 


More on Ogilvie Syndrome

Overview: Ogilvie Syndrome
Differential Diagnoses & Workup: Ogilvie Syndrome
Treatment & Medication: Ogilvie Syndrome
Follow-up: Ogilvie Syndrome
References
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References

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Further Reading

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Keywords

Ogilvie syndrome, Ogilvie's syndrome, acute colonic pseudo-obstruction, ACPO, colonic pseudoobstruction, bowel obstruction, colonic obstruction, acute large bowel obstruction, colonic perforation, intestinal perforation, peritonitis, nontoxic megacolon, bowel motility, adynamic distal colon, Hirschsprung disease, abdominal distention, obstipation, cecal perforation, cecostomy, colonoscopy, colonoscopic decompression, colectomy

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Contributor Information and Disclosures

Author

Prospere Remy, MD, Assistant Professor of Medicine, Albert Einstein College of Medicine; Attending Physician, Department of Internal Medicine, Bronx-Lebanon Hospital Center
Prospere Remy, MD is a member of the following medical societies: American College of Physicians and American Society for Gastrointestinal Endoscopy
Disclosure: Nothing to disclose.

Coauthor(s)

Kavita Kumbum, MD, Fellow, Division of Gastroenterology, Bronx Lebanon Hospital Center, Albert Einstein College of Medicine
Kavita Kumbum, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy
Disclosure: Nothing to disclose.

Steven Carpenter, MD, Chair, Program Director, Department of Internal Medicine, Memorial Health University Medical Center
Steven Carpenter, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy
Disclosure: Nothing to disclose.

Bjorn Holmstrom, MD, Assistant Professor, Department of Internal Medicine, University of South Florida
Bjorn Holmstrom, MD is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine, American Medical Association, Medical Association of Georgia, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Douglas M Heuman, MD, FACP, Director of Hepatology, McGuire Veterans Affairs Medical Center, Professor, Department of Internal Medicine, Division of Gastroenterology, Virginia Commonwealth University School of Medicine
Douglas M Heuman, MD, FACP is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Physicians, and American Gastroenterological Association
Disclosure: Nothing to disclose.

CME Editor

Alex J Mechaber, MD, FACP, Assistant Dean for Medical Curriculum, Associate Professor of Medicine, Division of General Internal Medicine, University of Miami Miller School of Medicine
Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD, Clinical Professor of Medicine, Drexel University College of Medicine; Consulting Staff, Department of Medicine, Section of Gastroenterology and Hepatology, Hospital of the Medical College of Pennsylvania
Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law Medicine and Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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