# Acute Functional Colonic Dysmotility Mimicking Mechanical Bowel Obstruction Following Self-Limited Diarrheal Illness: A Case Report

## TL;DR

A patient developed severe constipation after a brief bout of diarrhea, mimicking a bowel blockage but resolving without surgery.

## Contribution

This case highlights functional colonic dysmotility as a rare but important cause of acute constipation resembling mechanical obstruction.

## Key findings

- The patient's constipation was unresponsive to multiple laxative classes and oral hydration.
- CT imaging showed fecal loading without mechanical obstruction, confirming functional dysmotility.
- Conservative treatment with rectal enemas resolved the condition without surgical intervention.

## Abstract

Acute constipation following diarrheal illness is commonly encountered and is often benign. However, when absolute constipation persists despite adequate hydration, preserved mobility, and failure of multiple laxative classes, it can closely mimic mechanical bowel obstruction and create significant diagnostic uncertainty. We report a case of a 56-year-old female with a previously normal daily bowel habit who developed acute obstipation following a self-limited diarrheal episode, unresponsive to bulk-forming, osmotic, and stimulant laxatives. Despite adequate oral intake and activity, symptoms persisted for five days with reduced flatus and progressive abdominal distension. Escalation to contrast-enhanced computed tomography demonstrated colonic fecal loading without evidence of mechanical obstruction. The patient was successfully managed conservatively with rectal enemas and supportive care. This case highlights that functional colonic dysmotility can present with absolute constipation refractory to standard measures and may convincingly mimic surgical pathology, underscoring the importance of structured diagnostic escalation.