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Updated: Apr 18, 2026

Gastrointestinal Motility Monitor GIMM
Published on: December 1, 2010
Neostigmine for acute colonic pseudo-obstruction: A meta-analysis
Raul Guillermo Lopez Valle1, Francisco Lopez Godoy1
1San Jacinto Methodist Hospital Family Medicine Residency Program, Baytown, TX, USA.
Introduction:
Acute colonic pseudo-obstruction (ACPO) is an uncommon condition that occasionally develops in hospitalized patients with serious underlying ailments. Its early recognition is essential to reduce life-threatening complications. Few low-powered randomized clinical trials (RCTs) have confirmed the effectiveness of neostigmine for treatment.
Aim:
To analyse the effectiveness and main side effects of neostigmine in the treatment of ACPO.
Experimental:
A literature search was performed for all published RCTs, reporting on neostigmine as treatment for ACPO.
Results:
Four studies fulfilled the inclusion criteria, evaluating 127 patients: treatment group = 65, control group = 62. Neostigmine effectiveness to resolve ACPO with only one dose was 89.2% versus 14.65% (P < 0.001, NNT = 1 [95% CI 1-2]).
Conclusions:
Neostigmine is a safe and effective option for patients with ACPO who failed to respond to conservative management.
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