Acute Colonic Pseudoobstruction (Acute Megacolon, Ogilvie Syndrome) Medication

Updated: Jan 24, 2020
  • Author: Roberto M Gamarra, MD; Chief Editor: BS Anand, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.

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Cholinergic agents

Class Summary

Increase peristalsis and secretions in the intestine and relax the sphincter.

Neostigmine (Prostigmin)

Improves acute colonic megacolon; may increase cholinergic activity by reducing acetylcholine degradation.

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Other agents with limited evidence

Class Summary

Erythromycin

Response to treatment was inconsistent with gradual improvement over 24 hours. [30]

Methylnaltrexone

Resulted in successful decompression in one case with ACPO on opioids that was refractory to neostigmine.  [31]

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