Diagnosis, Treatment and Nutritional Management of Chronic Intestinal Pseudo-Obstruction

INTRODUCTION Chronic intestinal pseudo-obstruction (CIP) is a rare and potentially life-threatening disorder of the gastrointestinal tract characterized by symptoms and signs suggestive of mechanical obstruction but in the absence of a true anatomical lesion. Normal antegrade propulsive activity of the gastrointestinal tract is defective in CIP; when significant, chronic intestinal failure ensues with an inability to maintain normal weight and achieve adequate nutrition. This disease entity typically goes unrecognized for long periods of time before the correct diagnosis is established. In the interim, patients often undergo repeated and potentially dangerous tests and treatments. This monograph will focus on the following aspects of CIP: understanding the impact of intestinal pseudo-obstruction; describing the etiology and pathophysiology of CIP; reviewing common symptoms and signs; discussing the accurate diagnosis of CIP; and finally, reviewing treatment options. NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #77