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.
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
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.
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.
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
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.
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.
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.
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(NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.