Rare Diseases: Diagnosing And Treating Chronic Intestinal Pseudo-Obstruction
Posted on: 9 May 2017
Chronic intestinal pesudo-obstruction (CIPO) is one of many rare diseases that is difficult to identify and treat. An accurate and prompt diagnosis can improve outcomes and reduce the risks of complications.
Causes
CIPO can be a primary of secondary disease. In its primary form, there are no know underlying conditions that have attributed to the occurrence. Many people with CIPO are considered to have the secondary form because an underlying condition, such scleroderma, multiple sclerosis, or lupus has affected the intestines. The symptoms of CIPO are much like an intestinal obstruction. When an obstruction occurs, waste, air, and fluids cannot move through the intestines as normal, which leads to significant problems, such as vomiting, abdominal distention, and possibly infection.
The difference between CIPO and an intestinal obstruction is there is no physical obstruction impairing movement through the intestines, which means the problem cannot be fixed by repairing the obstruction. A pseudo-obstruction occurs when there are problems with nerves and/or muscles in the intestines, which prevents peristalsis from moving food and waste products through the intestines.
Diagnosis
Physical symptoms are the first clue of an intestinal problem. To determine the exact cause, imaging tests are used, such as MRI and CT. With these imaging tests, doctors can visualize where there is a physical obstruction in the intestines, such as a tumor, narrowing of the intestines, or twisting of the intestines. If no obstruction if found, further testing is necessary to confirm the diagnosis of CIPO. This can include biopsies of different areas of the intestines to determine if any underlying conditions are the cause and to find out which parts of the intestines are no longer functioning as normal.
Treating CIPO
Unfortunately, treatment options are limited. The initial goal is to remove food and waste from the digestive tract, which is usually accomplished with a nasogastric tube. Nutritional support is necessary since the gastrointestinal system can no longer function as normal. Some patients start with intravenous nutrition and are transitioned to a port to receive fluids and nutrients. If CIPO is determined to be caused by a underlying condition, managing the condition may eventually improve CIPO.
Most patients with CIPO will need long-term nutritional support. There is the risk of problems with nutritional support, such as organ failure and port infections. If any complications were to arise, the next step may be an organ transplant. Transplanted organs may include the small intestines, liver, and possibly other parts of the digestive system.
Since CIPO is a rare condition, there are limited gastroenterologists available who are comfortable managing the condition. Improved awareness of the condition can make it easier for medical professionals to identify the problem and connect patients with the appropriate specialist. For more information, contact companies like Omega Diagnostic Imaging PC.
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