Making the Diagnosis

To help distinguish the patient with CIP from the patient with mechanical obstruction, it is important to review the history (previous surgeries, the presence of adhesions, diverticula, and intestinal cancer in the family), and perform a thorough examination. Warning signs, which include weight loss, hematemesis, hematochezia, melena, obstipation, or rebound tenderness, warrant a more urgent workup and possible early surgical intervention.

Hypoactive bowel sounds may be seen in intestinal pseudo-obstruction as opposed to the high-pitched bowel sounds in mechanical obstruction. Abdominal distension and "tympany" on percussion may be seen in both disorders. Peristaltic waves are more common in mechanical obstruction.

Initially, patients should be evaluated for organic disease with laboratory tests including serum electrolytes, complete blood count, albumin, thyroid-stimulating hormone, celiac antibodies/antigens, and specialized tests to eliminate systemic diseases, including autoimmune processes, neoplas-tic, and endocrine disorders (Figure 63-1).

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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