PMC:2918323 / 3227-5036 JSONTXT

{"project":"NEUROSES","denotations":[{"id":"T75","span":{"begin":11,"end":16},"obj":"PATO_0000389"},{"id":"T76","span":{"begin":202,"end":217},"obj":"CHEBI_35469"},{"id":"T77","span":{"begin":538,"end":543},"obj":"PATO_0000694"},{"id":"T78","span":{"begin":702,"end":705},"obj":"CHEBI_43739"},{"id":"T79","span":{"begin":848,"end":852},"obj":"CHEBI_23888"},{"id":"T80","span":{"begin":1296,"end":1301},"obj":"CHEBI_23888"},{"id":"T81","span":{"begin":1788,"end":1793},"obj":"CHEBI_23888"},{"id":"T82","span":{"begin":937,"end":946},"obj":"CHEBI_28790"},{"id":"T83","span":{"begin":937,"end":946},"obj":"CHEBI_350546"},{"id":"T84","span":{"begin":956,"end":966},"obj":"CHEBI_35222"},{"id":"T85","span":{"begin":1092,"end":1095},"obj":"PATO_0000011"},{"id":"T86","span":{"begin":1092,"end":1095},"obj":"CHEBI_84123"},{"id":"T87","span":{"begin":1272,"end":1279},"obj":"PATO_0000467"},{"id":"T88","span":{"begin":1484,"end":1493},"obj":"PATO_0002292"},{"id":"T89","span":{"begin":1743,"end":1747},"obj":"PATO_0000304"},{"id":"T90","span":{"begin":1779,"end":1784},"obj":"CHEBI_24433"}],"text":"DISCUSSION\nAcute colonic pseudo-obstruction or Ogilvie syndrome is characterized by massive dilatation of the colon. It can occur due to various medical and surgical conditions, and as a side-effect of antidepressants.1 The literature reveals 5 reports of such cases, predominantly in the elderly.13 Only 2 of these 5 cases were surgical emergencies.2 The cases reported here are similar to those described in the literature except that in 1 case surgical exploration was done to rule out bowel cancer. Recognition of the condition at an early stage and awareness of such complications enabled us to manage the first case conservatively, whereas preoccupation with the diagnosis of probable malignancy led to management with surgical exploration in the second case. A good rapport is required between the treating doctor and the psychiatrist. Such drug-induced complications will possibly become rare due to the introduction of specific serotonin reuptake inhibitors (SSRIs), which do not have anticholinergic side-effects. It is important to educate the elderly as well as patients in other age groups about the importance of diet and fluid intake to overcome constipation. The patients presented here were unlikely to have had discontinuation syndrome, as symptoms were present even before the drugs were discontinued. The discontinuation syndrome can occur due to abrupt stoppage of antidepressant drugs. The discontinuation syndrome can involve any system of the body, is usually transient in nature, emerges 24–48 hours after discontinuation, and lasts for 7–14 days.5 The two patients whose reports are discussed here also developed the above-mentioned complications within 24 hours of discontinuation of the antidepressant drugs. Thus, slow tapering of the dosage of this group of drugs is recommended."}