Diagnosis of Intestinal Pseudo-obstruction

How do doctors diagnose intestinal pseudo-obstruction?

To diagnose intestinal pseudo-obstruction, the doctor will ask about symptoms, review medical and family history, perform a physical exam, and order tests.

Physical exam

During a physical exam, the doctor may

• check for bloating in the abdomen 
• use a stethoscope to listen to sounds inside the abdomen
• press on the abdomen to feel for tenderness or masses
• check for signs of complications, such as fever or a fast heart rate

To diagnose intestinal pseudo-obstruction, doctors review a patient’s history, perform a physical exam, and order tests.

What tests do doctors use to diagnose intestinal pseudo-obstruction?

Doctors may order medical tests to rule out an intestinal obstruction—a physical blockage in the intestines—and to diagnose intestinal pseudo-obstruction. Doctors may also order tests to check for causes of intestinal pseudo-obstruction.

Doctors may order different tests, depending on which type of pseudo-obstruction they think a person has.

• To diagnose chronic intestinal pseudo-obstruction, doctors may order blood tests, imaging tests such as computed tomography (CT) scans, endoscopy tests, biopsies, and other tests.
• To diagnose acute colonic pseudo-obstruction, doctors most often order blood tests and imaging tests, such as x-rays of the abdomen or CT scans.

Blood tests

For a blood test, a health care professional will take a blood sample and send the sample to a lab. Doctors may order blood tests to help find the cause of pseudo-obstruction or to check for complications.

Imaging tests

Doctors may order imaging tests, including

• x-rays, which use a small amount of radiation to create pictures of the inside of the body
• CT scans, which use a combination of x-rays and computer technology to create images
• magnetic resonance imaging (MRI), which takes pictures of the body’s internal organs and soft tissues without using x-rays
• upper GI series, which uses x-rays and water-soluble contrast medium—a special liquid that makes the digestive tract easier to see on x-rays—to view the upper GI tract, including the small intestine 
• lower GI series, which uses x-rays and water-soluble contrast medium to view the lower GI tract 

Endoscopy tests

Doctors may order endoscopy tests to help diagnose chronic intestinal pseudo-obstruction. During an endoscopy, doctors use an endoscope—a long, flexible, narrow tube with a light and tiny camera on one end—to view inside the digestive tract. Two types of endoscopy tests are

• upper GI endoscopy, which doctors use to see inside the upper GI tract
• colonoscopy, which doctors use to see inside the lower GI tract

Doctors may take biopsies during endoscopy tests.

Biopsies

To help diagnose chronic intestinal pseudo-obstruction, doctors may take biopsies—small pieces of tissue—from the digestive tract lining or intestinal wall.

A doctor may take biopsies during an endoscopy test by passing an instrument through the endoscope to take a small piece of tissue. In some cases, doctors may perform surgery to take biopsies of the intestinal wall. If a patient is having surgery to treat chronic intestinal pseudo-obstruction, doctors may take biopsies during the surgery. Biopsies of the intestinal wall may help doctors find the cause of chronic intestinal pseudo-obstruction.

A pathologist will examine the biopsy tissue under a microscope to check for signs of chronic intestinal pseudo-obstruction or health problems that could cause pseudo-obstruction.

Other tests

Doctors may order additional tests to find out how well the digestive tract is working. These tests can help diagnose chronic intestinal pseudo-obstruction, find the cause, or guide treatment. Examples include

• scintigraphy tests. These tests involve eating a meal with a small dose of a radioactive substance. Doctors use special computers and external cameras to track the substance as it passes through the digestive tract.
• manometry tests. These tests measure muscle pressure and movements in part of the digestive tract, such as the esophagus, small intestine, colon, or rectum and anus.
• gastric emptying breath test. This test involves eating a meal that contains a substance that is absorbed in the intestines and is eventually passed into the breath. After a person eats the meal, a health care professional collects samples of his or her breath over a period of a few hours. The test can show how fast the stomach empties by measuring the amount of the substance in the breath.