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Acute colonic pseudo-obstruction: a pharmacological approach
1Department of Surgery, General Hospital, Birmingham.
Annals of the Royal College of Surgeons of England
|September 1, 1992
Summary
Pharmacological treatment using guanethidine and neostigmine effectively resolved acute colonic pseudo-obstruction in most patients. This approach offers a promising alternative to surgery for this condition.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Acute colonic pseudo-obstruction (ACPO) mimics mechanical obstruction, posing high mortality risks with unnecessary surgery.
- ACPO requires effective management strategies beyond conservative measures.
Purpose of the Study:
- To evaluate the efficacy of pharmacological manipulation of autonomic innervation for ACPO.
- To assess guanethidine and neostigmine as a treatment for ACPO.
Main Methods:
- Eleven patients with ACPO were treated with guanethidine and neostigmine.
- Treatment focused on modulating autonomic innervation to the colon.
Main Results:
- Eight out of eleven patients experienced symptom resolution within 10 minutes, including passage of flatus/stool.
- One patient reported postural hypotension; no other serious side effects were observed.
- Treatment failure occurred in three patients.
Conclusions:
- Pharmacological treatment with guanethidine and neostigmine is a viable alternative for ACPO.
- This method offers a potentially safer option compared to colonoscopic decompression or surgery.