Acute colonic pseudo-obstruction: a pharmacological approach

Ann R Coll Surg Engl. 1992 Sep;74(5):364-7.


Acute colonic pseudo-obstruction is a functional disorder that closely mimics mechanical large bowel obstruction, and in which inadvertent laparotomy carries a high mortality. Eleven such patients were treated by pharmacological manipulation of the autonomic innervation to the colon with guanethidine and neostigmine. Eight responded to treatment with passage of flatus and/or stool within 10 min with complete resolution of symptoms. In three patients the treatment failed. Postural hypotension occurred in only one patient and no other serious side-effect was apparent. This pharmacological approach to the management of acute colonic pseudo-obstruction is suggested as an alternative to the other treatment options of colonoscopic decompression or surgery, when conservative management has failed.

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Colonic Diseases / drug therapy*
  • Drug Therapy, Combination
  • Female
  • Guanethidine / therapeutic use*
  • Humans
  • Intestinal Pseudo-Obstruction / drug therapy*
  • Male
  • Middle Aged
  • Neostigmine / therapeutic use*
  • Prospective Studies


  • Neostigmine
  • Guanethidine