What is Ogilvie Syndrome?

Ogilvie syndrome is an intestinal disorder where the colon dilates radically and appears obstructed, although there is no physical obstruction present. This condition is usually seen in patients who are already ill and hospitalized for other conditions. Surgery, neurological problems, and certain medications are known to increase the risk of developing Ogilvie syndrome. Treatment requires providing supportive care and working on management of the underlying cause.

A patient with Ogilvie syndrome can develop abdominal pain and swelling and may be nauseous or constipated. On an X-ray, dilation of the colon can be seen. Doctors must rule out potential issues like an actual obstruction or intestinal perforation before diagnosing the patient. Immediate care usually involves reducing oral intake of food and water, using intravenous delivery of fluids to balance electrolytes, and encouraging patients to move to express gas. Sometimes, a nasogastric tube will be inserted.

If patients do not experience an improvement within one to two days or appear to be getting rapidly worse, surgery may be considered as a treatment option. Surgery can be risky, as the patient is usually already sick and may be at increased risk of complications during the procedure. Care is taken by the surgical team to monitor the patient throughout the procedure for any signs of distress.

Also known as acute colonic pseudo-obstruction because it onsets rapidly and acts like a colonic obstruction even though it is not, Ogilvie syndrome can be associated with a high mortality rate. Studies on patients with this condition suggest the condition itself is not usually fatal when managed, but the comorbidities that lead to the development of the intestinal distress are the problem. Patients are often seriously ill and in intensive care, and their bodies have difficulty coping with the physical stress associated with the onset of this condition.

When a patient is diagnosed with Ogilvie syndrome, it can be helpful to get information about what led to the development of the problem and how the doctors plan to proceed with treatment. Treatment options can be highly varied and it may be helpful to consult a specialist for a second opinion. Management of acutely ill patients can be complex and involves a number of factors. It is important to be aware that even with very attentive care and aggressive treatment, some patients do not recover because the strain on their bodies has been so severe. Doctors may recommend more conservative approaches paired with pain management in cases where they feel recovery is unlikely.