11. Obstipation, subileus, diverticulosis. GIT motility disorders
Obstipation and constipation
Constipation is the condition where you’re not passing stools regularly. The faeces are usually hard and difficult to pass. Obstipation is a more severe form where hard feces block the intestines so that not even gas is passed. Many consider constipation and obstipation to be the same thing.
Common causes include:
- Idiopathic forms
- Autonomic neuropathy
- Hypokalaemia
Common symptoms include malaise and bloating. The mechanism of the malaise is that stretch of the intestinal wall induces reflex mechanisms that give the feeling of malaise.
Constipation should be treated with:
- Exercise
- Fibre-rich diet
- Laxatives – should not be used regularly
Subileus
Subileus is a condition of partial obstruction of the intestinal lumen. There is an obstruction, however it’s not complete. It’s often due to a tumor.
Diverticulosis
A diverticulum in the intestine is a hernia-like outpouching. All diverticula in the GI-tract are pseudodiverticula. It’s commonly found in the colon and rarely in the ileum.
Diverticula themselves don’t impair passage but they may become inflamed. Diverticulitis does impair passage and can cause peritonitis, which can cause paralytic ileus.
Motility disorders of the large intestine
Hirschsprung disease, or congenital megacolon, is a condition where some elements of the myenteric plexus are absent in the colon. The affected segments of the colon are paralytic and will dilate, often severely.
Colonic motility is decreased in autonomic neuropathies.