The Disease

Visceral Myopathy

Intestinal pseudo-obstruction (false blockage) is a condition that causes symptoms like those of a bowel obstruction (blockage). But when the intestines are examined, no obstruction is found. A problem in how the muscles and nerves in the intestines work causes the symptoms.

Visceral myopathy is a disorder that falls under the category of chronic intestinal pseudo-obstruction. Microscopically, visceral myopathy is characterized by degenerating muscle cells and fibrous replacement of smooth muscle of the gastrointestinal tract.  It can affect the whole or segments of the gastrointestinal tract and occasionally the urinary tract.

In this group of disorders, the presence of ineffective intestinal propulsion and intestinal obstruction occurs in the absence of an occluding lesion of the intestinal lumen. In other words, because the smooth muscle lining the small and large intestinal wall is damaged, food travels slowly down the intestinal tract and causes symptoms. These symptoms (reflux, difficulty swallowing, abdominal fullness and bloating, nausea, vomiting, constipation, diarrhea, abdominal pain and weight loss) mimic an obstruction or blockage even though a mechanical obstruction is not present.

A family history is present in up to 30% of patients with chronic intestinal pseudo-obstruction. The mode of inheritance is still unclear.

Since Dudley's introduction of the term intestinal pseudo-obstruction back in 1958, many cases and patient series have been reported in the literature, and various classifications have been suggested; however, few large studies managed to unearth all the mysteries underlying what we have come to know as a chronic intestinal pseudo-obstruction. Only in the past few years patient series large enough to allow conclusions were published.