Advancement in the clinical management of intestinal pseudo-obstruction

Expert Rev Gastroenterol Hepatol. 2015 Feb;9(2):197-208. doi: 10.1586/17474124.2014.940317. Epub 2014 Jul 14.

Abstract

Intestinal pseudo-obstruction is more commonly known in its chronic form (CIPO), a cluster of rare diseases characterized by gastrointestinal muscle and nerve impairment, so severe to result in a markedly compromised peristalsis mimicking an intestinal occlusion. The management of CIPO requires the cooperation of a group of specialists: the disease has to be confirmed by a number of tests to avoid mistakes in the differential diagnosis. The treatment should be aimed at relieving symptoms arising from gut dysmotility (ideally using prokinetic agents), controlling abdominal pain (possibly with non-opioid antinociceptive drugs) and optimizing nutritional support. Furthermore, a thorough diagnostic work-up is mandatory to avoid unnecessary (potentially harmful) surgery and to select patients with clear indication to intestinal or multivisceral transplantation.

Keywords: chronic intestinal pseudo-obstruction; enteral nutrition; intestinal diseases; intestinal motility; jejunostomy; manometry; parenteral nutrition; prokinetics; transplantation.

Publication types

  • Review

MeSH terms

  • Analgesics / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Antiemetics / therapeutic use
  • Diagnosis, Differential
  • Disease Management*
  • Humans
  • Intestinal Pseudo-Obstruction / diagnosis*
  • Intestinal Pseudo-Obstruction / therapy*
  • Parenteral Nutrition
  • Treatment Outcome

Substances

  • Analgesics
  • Anti-Bacterial Agents
  • Antiemetics