Chronic intestinal pseudo-obstruction
ICD-10 K59.9 · ICD-11 DA90.2

Treatment of Chronic Intestinal Pseudo-obstruction with Intestinal Bacterial Overgrowth

In chronic intestinal pseudo-obstruction, impaired gastrointestinal motility sets the stage for intestinal bacterial overgrowth. The resulting mucosal inflammation further worsens motility, creating a self-reinforcing cycle that requires targeted intervention.

Clinical context
Abnormal motility is associated with bacterial overgrowth, which by itself causes mucosal inflammation, further impairing gastrointestinal motility and creating a vicious cycle.
Treatment approach

Management in this setting centres on cyclic antibiotic therapy — courses are given intermittently, often alongside antifungal coverage, with antibiotic-free intervals in between. The choice of agents, sequencing, and full clinical algorithm are contained in the structured protocol.

Clinical goal: Improved gastrointestinal motility.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1053/j.gastro.2005.06.081

Abnormal motility is associated with bacterial overgrowth, which by itself causes mucosal inflammation, further impairing gastrointestinal motility and creating a vicious cycle.

Treatment with antibiotics may improve motility.

Most clinicians use 1- to 2-week cycles of broad-spectrum antibiotics such as amoxicillin and clavulanic acid, cotrimoxazole, and metronidazole, often with an antifungal such as nystatin or fluconazole, interspersed by antibiotic-free periods.

View source ↗