Abstract
Chronic intestinal pseudo-obstruction (CIP) is defined by either continuous or intermittent
symptoms of bowel obstruction in the absence of fixed lumen excluding lesion. CIP
includes a heterogeneous group of disorders which result either from diseases affecting
the enteric neurons and smooth muscle lining or those involving the autonomic innervation
of the bowel. Symptoms associated with CIP are nonspecific, which can sometimes contribute
to the delay in recognizing the condition and making the correct diagnosis. The diagnostic
workup should include imaging and manometry studies and, occasionally, full-thickness
bowel biopsies for histopathological examination may be required. Multidisciplinary
team approach for the management of these patients is recommended, and the team members
should include a gastroenterologist, surgeon, chronic pain specialist, clinical nutritionist,
and a psychologist. The treatment goals should include optimizing the nutritional
status and preventing or delaying the development of intestinal failure. The majority
of the patients require enteral or parenteral nutrition support, and chronic pain
is a common and distressing symptom. Small bowel transplantation may be required if
patients develop liver complications due to parenteral nutrition, have difficult central
line access, or have poor quality of life and worsening pain despite aggressive medical
management.
Keywords
chronic intestinal pseudo-obstruction - bowel motility - antroduodenal manometry
