Management of the Patient with Chronic Intestinal Pseudo-Obstruction and Intestinal Failure

Gastroenterol Clin North Am. 2019 Dec;48(4):513-524. doi: 10.1016/j.gtc.2019.08.005. Epub 2019 Oct 8.

Abstract

Chronic intestinal pseudo-obstruction (CIPO) is a severe form of intestinal dysmotility disorder, characterized by the impairment of gastrointestinal propulsion of the gut content in the absence of fixed occluding lesions. CIPO is a rare disease that can develop in both children and adults. CIPO is classified as primary/idiopathic, when no underlying disorder is demonstrated, or secondary, when related to systemic diseases. Diagnosis relies on the finding of chronic/recurrent obstructive type symptoms with radiological features of dilated intestine with air/fluid levels without any lumen occluding lesion. Therapy is based on nutrition, pharmacologic and surgical intervention and requires a multidisciplinary approach.

Keywords: Chronic intestinal failure; Chronic intestinal pseudo-obstruction; Enteral nutrition; Home parenteral nutrition; Prokinetic agents; Stoma.

Publication types

  • Review

MeSH terms

  • Chronic Disease
  • Fecal Microbiota Transplantation
  • Gastrointestinal Agents / therapeutic use
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Intestinal Pseudo-Obstruction / classification
  • Intestinal Pseudo-Obstruction / diagnosis*
  • Intestinal Pseudo-Obstruction / epidemiology
  • Intestinal Pseudo-Obstruction / therapy*
  • Intestines / transplantation
  • Liver Transplantation
  • Malabsorption Syndromes / etiology
  • Malabsorption Syndromes / therapy*
  • Parenteral Nutrition, Home
  • Trace Elements / administration & dosage
  • Vitamins / administration & dosage

Substances

  • Gastrointestinal Agents
  • Trace Elements
  • Vitamins