Presentation
Involvement is often present throughout the intestine so that patients may present with a variety of symptoms deriving from the esophagus, stomach, small intestine, and colon. [ncbi.nlm.nih.gov]
The frequencies present were determined by autoregressive modelling using a running spectral analysis method. 6 After running spectral analysis of gastric ECA the dominant frequency was determined if present. [adc.bmj.com]
At present, medical therapy of CIPO remains limited. [scholars.northwestern.edu]
Gastrointestinal
- Vomiting
Nutrition supplementation is required for many patients with CIP due to symptoms of dysphagia, nausea, vomiting, and weight loss. [ncbi.nlm.nih.gov]
They tell you to breathe and relax while they insert the probe, but you are busy, choking, gagging, and often vomiting the probe back up on it's way down. [sarasarmy.com]
If affective the pacemaker will calm your nausea and vomiting and allow you to eat on a very strict diet. This does not take away flares (days where vomiting and pain is worse). [customink.com]
- Abdominal Pain
At the age of 9 years, an isolated colonic stenosis without dilatation responsible for severe abdominal pain and altered quality of life led to digestive derivation contributing to rapid disappearance of chronic abdominal pain. [ncbi.nlm.nih.gov]
- Nausea
Nutrition supplementation is required for many patients with CIP due to symptoms of dysphagia, nausea, vomiting, and weight loss. [ncbi.nlm.nih.gov]
Symptoms include but are not limited to: nausea vomiting severe pain abdominal distention constipation and or diarrhea weight loss early satiety (feeling very full very quickly) Diagnosing CIPO can be very difficult. [sarasarmy.com]
Compazine - Used for nausea in IV and oral form but it causes me severe blurry vision so I discontinued it’s use. Phenergan - Used for nausea. I have had this in injection, IV, tablet and liquid form. [inflamed-and-untamed.com]
- Abdominal Distension
A 59-year-old woman presented to our hospital with a 6-month history of nausea, weight loss, and abdominal distension. [ncbi.nlm.nih.gov]
- Early Satiety
Symptoms include but are not limited to: nausea vomiting severe pain abdominal distention constipation and or diarrhea weight loss early satiety (feeling very full very quickly) Diagnosing CIPO can be very difficult. [sarasarmy.com]
Diarrhea, early satiety (fullness), food aversion, and weight loss may also be present. Over time, pseudo-obstruction can cause bacterial infections, malnutrition, and muscle problems in other parts of the body. [nationwidechildrens.org]
Musculoskeletal
- Brachydactyly
The patient also had a short small bowel without malrotation, brachydactyly, and absence of the 2(nd) to 4(th) middle phalanges of both hands. The patient was treated with cisapride and combined parenteral and enteral nutritional support. [ncbi.nlm.nih.gov]
Workup
Histopathologists need to follow a systematic approach comprising of diligent histological examination and use of immunohistochemistry, immunocytochemistry, and electron microscopy in CIP workup. [ncbi.nlm.nih.gov]
Other Pathologies
- Lymphocytic Infiltrate
On full-thickness biopsies of the small intestine, a dense lymphocytic infiltrate of the muscularis propria was seen, mainly consisting of cytotoxic T lymphocytes. [ncbi.nlm.nih.gov]
some case reports have described an association between pseudo-obstruction with lymphocytic infiltration of the myenteric plexus or smooth muscle. [ucsfmed.wordpress.com]
Inflammatory neuropathies can be idiopathic or secondary (e.g. infections, paraneoplastic syndrome) and are characterised by the presence of a dense lymphocytic infiltrate involving the myenteric plexus (ganglionitis) causing neuronal degeneration. 5 [elsevier.pt]
Treatment
Treatment with cisapride substantially improved the patient's symptoms and improved feeding tolerance. It improved his prognosis remarkably and prevented the need for end-of-life care. [ncbi.nlm.nih.gov]
Prognosis
It improved his prognosis remarkably and prevented the need for end-of-life care. He experienced no adverse effects throughout the course of therapy. The treatment regimen is discussed in this case report. [ncbi.nlm.nih.gov]
Etiology
The latter form can be diagnosed early in life due to a genetic etiology or in adulthood when a viral origin may be considered. [ncbi.nlm.nih.gov]
Recent advances into the autoimmune nature of etiologies such as Chagas' disease and paraneoplastic dysmotility and into the genetic basis of mitochondrial neurogastrointestinal encephalomyopathy, multiple endocrine neoplasia IIB and Hirschsprung's disease [scholars.northwestern.edu]
Epidemiology
This review discusses the epidemiology, etiology, pathogenesis, diagnosis, and treatment of patients with CIP, with an emphasis on nutrition assessment and treatment options for patients with nutrition compromise. [ncbi.nlm.nih.gov]
Epidemiology and Clinical Experience of Chronic Intestinal Pseudo-Obstruction in Japan: A Nationwide Epidemiologic Survey. J Epidemiol 2013;23:288-294. Ohkubo H, Nakajima A et al. [cipo-information.com]
Summary Epidemiology The prevalence remains unknown. The male-to-female ratio is about 1.5:1 to 4:1. [orpha.net]
An epidemiologic survey of chronic intestinal pseudo-obstruction and evaluation of the newly proposed diagnostic criteria. Digestion. 2012. 86(1):12-9. [Medline]. Saunders MD. Acute colonic pseudo-obstruction. [emedicine.medscape.com]
Pathophysiology
The two pathophysiologic types of this motility disorder are myopathic and neuropathic. The latter may affect extrinsic or intrinsic neural control of gut motility. [ncbi.nlm.nih.gov]
Although the underlying cause of idiopathic intestinal pseudoobstruction is unknown, the primary pathophysiologic dysfunction in patients with idiopathic pseudoobstruction is a disorganization or lack of smooth muscle contractility that results in disordered [pediatrics.aappublications.org]
Prevention
It improved his prognosis remarkably and prevented the need for end-of-life care. He experienced no adverse effects throughout the course of therapy. The treatment regimen is discussed in this case report. [ncbi.nlm.nih.gov]
It usually prevents the body from absorbing nutrients. As a result, many children suffer from malnutrition, failure to thrive, and weight loss. [childrenshospital.org]
The main aim of management is to deliver adequate nutrition to the child and prevent damage occurring to the bowel. Most children manage to feed orally (by mouth), but may require supplements to meet their nutritional needs. [gosh.nhs.uk]