Intestinal pseudo-obstruction (IPO) is a clinical syndrome caused by severe impairment in the ability of the intestines to push food through. It is characterized by the signs and symptoms of intestinal obstruction without any lesion in the intestinal lumen. Clinical features mimic those seen with mechanical intestinal obstructions and can include abdominal pain, nausea, abdominal distension, vomiting, dysphagia and constipation depending upon the part of the gastrointestinal tract involved. It is a difficult condition to diagnose, requiring exclusion of any other mechanical cause of obstruction. Many patients are diagnosed late in the course of disease after additional symptoms are seen. Mortality is also difficult to accurately determine. One retrospective study estimated mortality to be between 10 and 25% for chronic intestinal pseudo-obstruction (CIPO) and to vary greatly depending on the etiology of the condition. When present for less than six months, it is diagnosed as acute IPO or Ogilvies Syndrome. Longer than this is considered chronic. Owing to the difficulty of diagnosis, few studies are available which have attempted to estimate its prevalence.The condition can begin at any age. Most studies describing CIPO are in pediatric populations. It can be a primary condition (idiopathic or inherited) or caused by another disease (secondary). It can be a result of myriad of etiologies including infectious, parasitic, autoimmune, genetic, congenital, neurologic, toxic, endocrinological, or anatomical pathology. Treatment targets nutritional support, improving intestinal motility, and minimizing surgical intervention.
One form has been associated with DXYS154.Secondary chronic intestinal pseudo-obstruction can occur as a consequence of a number of other conditions including:

Hirschsprungs disease - the absence of colonic nerve cells
Chagas disease - a chronic parasitic infection of the colon leading to loss of nerve endings
Kawasaki disease - a rare presentation for this particular autoimmune disorder of the vasculature
Parkinsons disease - related to the neurodegeneration of gastrointestinal tract
Autoimmune conditions - conditions including systemic lupus erythematosus and scleroderma lead to collagen vascular deposition and gastrointestinal motility disruption
Mitochondrial disease - IPO is a known presentation for mitochondrial disease
Endocrine disorders
Certain medications.The term may be used synonymously with enteric neuropathy if a neurological cause is suspected. Diagnosis
The symptoms of IPO are nonspecific. It is not unusual for patients to present repeatedly and to undergo numerous tests. Mechanical causes of intestinal obstruction must be excluded to reach a diagnosis of pseudo-obstruction. Attempts must also be made to determine whether the IPO is the result of a primary or secondary condition. A diagnostic work-up may include:
Gastric motility studies
Imaging studies:
 X-rays - may show intestinal air fluid levels (seen with true mechanical intestinal obstruction)
CT scans
Barium enema
Blood tests
Upper and lower endoscopies
Manometry - used to measure pressure of esophagus and stomach

Treatment
Treatment for IPO (acute or chronic) is aimed at removing the disease process and/or managing the complications present. Focus is placed on management of pain, gastrointestinal symptoms, nutritional deficiencies, fluid status, infection control, and improving quality of life. When CIPO is secondary to another disease, treatment is addressed towards the underlying condition.