Chronic intestinal pseudo-obstruction

Chronic intestinal pseudo-obstruction, or CIPO, is a very rare syndrome whose chronic and recurrent symptoms suggest a blocked intestine although no mechanical blockage of the lumen is present. Common symptoms are abdominal pain, constipation, nausea, vomiting, difficulty swallowing and abdominal distention, and it can lead to malnutrition. It may be idiopathic or follow from other disorders, including certain genetic disorders, and the mechanisms involve abnormalities of smooth muscle cells, the interstitial cells of Cajal and intrinsic and extrinsic neurons. Diagnosis rests on clinical symptoms and radiographic studies, and treatment centres on adequate nutrition, sometimes enteral or parenteral, and symptom control. The long-term outlook is poor, with mortality of 10 to 25 percent in affected children before adulthood. Ogilvie syndrome is an acute form of intestinal pseudo-obstruction.