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<PublisherName>journal-jmsr</PublisherName>
<JournalTitle>Journal of Medical and Surgical Research</JournalTitle>
<PISSN>I</PISSN>
<EISSN>S</EISSN>
<Volume-Issue>Vol. XII, n 1</Volume-Issue>
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<IssueTopic>Multidisciplinary</IssueTopic>
<IssueLanguage>English</IssueLanguage>
<Season>June 2025</Season>
<SpecialIssue>N</SpecialIssue>
<SupplementaryIssue>N</SupplementaryIssue>
<IssueOA>Y</IssueOA>
<PubDate>
<Year>2025</Year>
<Month>08</Month>
<Day>31</Day>
</PubDate>
<ArticleType>JMSR Gastroenterology</ArticleType>
<ArticleTitle>Safety And Effectiveness of Subcutaneous Methylnaltrexone for the Treatment of Acute Colonic Pseudo-Obstruction: A 9 Year-Period Study</ArticleTitle>
<SubTitle/>
<ArticleLanguage>English</ArticleLanguage>
<ArticleOA>Y</ArticleOA>
<FirstPage>1432</FirstPage>
<LastPage>1439</LastPage>
<AuthorList>
<Author>
<FirstName>Muhammad F.</FirstName>
<LastName>Mubarak</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>N</CorrespondingAuthor>
<ORCID/>
<FirstName>Harleen</FirstName>
<LastName>Chela</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>Y</CorrespondingAuthor>
<ORCID/>
<FirstName>Ebubekir</FirstName>
<LastName>Daglilar</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>Y</CorrespondingAuthor>
<ORCID/>
<FirstName>Fadi</FirstName>
<LastName>Aljamaan</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>Y</CorrespondingAuthor>
<ORCID/>
<FirstName>Yezaz</FirstName>
<LastName>Ghouri</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>Y</CorrespondingAuthor>
<ORCID/>
<FirstName>Veysel</FirstName>
<LastName>Tahan</LastName>
<AuthorLanguage>English</AuthorLanguage>
<Affiliation/>
<CorrespondingAuthor>Y</CorrespondingAuthor>
<ORCID/>
</Author>
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<DOI>10.46327/msrjg.1.000000000000269</DOI>
<Abstract>Introduction: Acute colonic pseudo-obstruction (ACPO) or Ogilvie syndrome is a condition characterized by acute atonic dilation of the colon in the absence of mechanical obstruction. The underlying etiology for the development of ACPO is unclear. Short-acting cholinesterase inhibitor, neostigmine is frequently used for treating ACPO. Due to the possible deleterious adverse effect of neostigmine including cardiovascular suppression, it is usually administered under controlled settings in a critical care unit. Methylnaltrexone, a peripherally acting __ampersandsignmu;-opioid receptor agonist, is indicated for use in treating constipation secondary to systemic opioid use. In this study, we looked into the efficacy and safety of the use of subcutaneous methylnaltrexone in treating patients with ACPO. Materials __ampersandsign methods: This is a single-centered retrospective study assessing the efficacy and safety of utilizing subcutaneous methylnaltrexone in the treatment of ACPO. The search period was conducted over a period of 9 years. Radiological findings of large bowel ileus without obstruction was the search criterion for allocating ACPO patients. Exclusion criteria included mechanical large bowel obstruction, intervention by fluoroscopic decompression, and patients who received neostigmine but not subcutaneous methylnaltrexone. Patients received a standard dose of methylnaltrexone 12 mg every 24 hours until a bowel movement (BM) was achieved. Results: A total of 39 patients who received at least one dose of subcutaneous methylnaltrexone for the treatment of ACPO were identified. 97.44% of studied patients had received systemic opioids for pain control within 30 days prior to the diagnosis of ACPO. Twenty-two (56.4%) patients had pain improvement after receiving the drug. A total of 35/39 (89.74%) had a BM following methylnaltrexone administration (p-value= 0.01246). Among the responders, an average dose of 1.17 doses (range of 1-2) was administered to achieve the result. The average time of first BM occurrence after receiving methylnaltrexone was 12.85 hours ---PlusMinusSymbol--- 12.29. Pain associated with ACPO measured by difference in pain scale 1-10/10, improved 5.47 hours ---PlusMinusSymbol--- 7.43 following first dose of methylnaltrexone administration (p-value= 0.02265). No adverse events were reported in patients who received methylnaltrexone. Conclusion: In setting of reported increase in ACPO incidence worldwide, non-invasive and effective medical management with safe medication profile is called for. Our study delineated objective clinical resolution of symptoms and signs of ACPO through the use of subcutaneous methylnaltrexone with a significant safety profile. Further studies are required to better differentiate the overall efficacy of subcutaneous methylnaltrexone for treatment of ACPO overall and, more specifically, in setting of recent systemic opioid treatment.</Abstract>
<AbstractLanguage>English</AbstractLanguage>
<Keywords>Ogilvie, Methylnaltrexone, Constipation, and Neostigmine.,Safety, Effectiveness</Keywords>
<URLs>
<Abstract>https://www.journal-jmsr.net/ubijournal-v1copy/journals/abstract.php?article_id=15953&title=Safety And Effectiveness of Subcutaneous Methylnaltrexone for the Treatment of Acute Colonic Pseudo-Obstruction: A 9 Year-Period Study</Abstract>
</URLs>
<References>
<ReferencesarticleTitle>References</ReferencesarticleTitle>
<ReferencesfirstPage>16</ReferencesfirstPage>
<ReferenceslastPage>19</ReferenceslastPage>
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