Intestinal pseudoobstruction chronic idiopathic

Intestinal Pseudo-Obstruction, Chronic Idiopathic

Intestinal pseudo-obstruction, chronic idiopathic (CIPO) is a rare disorder characterized by symptoms of intestinal blockage without any physical obstruction. This condition mimics a true mechanical obstruction of the intestines, but upon investigation, no blockage is found. CIPO is a serious condition that can lead to significant morbidity due to its impact on the digestive system.

Pathophysiology

CIPO is believed to result from abnormalities in the nerves, muscles, or interstitial cells of Cajal in the gastrointestinal tract. These abnormalities lead to impaired motility, which is the ability of the intestines to move contents through the digestive system. The exact cause of these abnormalities is often unknown, which is why the condition is termed "idiopathic."

Clinical Presentation

Patients with CIPO typically present with symptoms similar to those of a bowel obstruction, including:

• Abdominal pain
• Bloating
• Nausea and vomiting
• Constipation or diarrhea
• Malnutrition and weight loss

These symptoms can vary in severity and may be chronic or episodic.

Diagnosis

Diagnosing CIPO involves ruling out mechanical causes of obstruction. This typically includes:

• Abdominal X-ray
• CT scan
• MRI
• Endoscopy

Additionally, motility studies such as manometry can be used to assess the function of the intestines.

Treatment

There is no cure for CIPO, and treatment focuses on managing symptoms and maintaining nutrition. Treatment options may include:

• Nutritional support, such as enteral or parenteral nutrition
• Medications to enhance motility, such as prokinetic agents
• Pain management
• Surgical interventions, although these are typically reserved for specific complications

Prognosis

The prognosis for CIPO varies. Some patients may experience a relatively stable course, while others may have progressive symptoms leading to significant complications. Long-term management often requires a multidisciplinary approach.

Also see

• Intestinal obstruction
• Gastroparesis
• Irritable bowel syndrome
• Chronic intestinal pseudo-obstruction