Acute Functional Colonic Dysmotility Mimicking Mechanical Bowel Obstruction Following Self-Limited Diarrheal Illness:...

Acute constipation following diarrheal illness is commonly encountered and is often benign. However, when absolute constipation persists despite adequate hydration, preserved mobility, and failure of multiple laxative classes, it can closely mimic mechanical bowel obstruction and create significant diagnostic uncertainty. We report a case of a 56-year-old female with a previously normal daily bowel habit who developed acute obstipation following a self-limited diarrheal episode, unresponsive to bulk-forming, osmotic, and stimulant laxatives. Despite adequate oral intake and activity, symptoms persisted for five days with reduced flatus and progressive abdominal distension. Escalation to contrast-enhanced computed tomography demonstrated colonic fecal loading without evidence of mechanical obstruction. The patient was successfully managed conservatively with rectal enemas and supportive care. This case highlights that functional colonic dysmotility can present with absolute constipation refractory to standard measures and may convincingly mimic surgical pathology, underscoring the importance of structured diagnostic escalation.