Chronic Intestinal Pseudo-Obstruction | Diagnosis & Treatment

How is chronic intestinal pseudo-obstruction diagnosed?

Because the symptoms of chronic intestinal pseudo-obstruction (CIP) are similar to those of other gastrointestinal conditions, your child's doctor may need to order several tests before making a formal diagnosis.

Your child's doctor may order one or more of the following tests and procedures:

  • Imaging studies, such as X-rays, can rule out an intestinal obstruction.
  • Antroduodenal and colonic manometry measure pressure in the bowel and can help diagnose CIP without more invasive testing. During an antroduodenal manometry test, a doctor feeds a small, flexible tube through the nose or an existing gastrostomy (feeding tube), into the stomach and small intestine to measure pressure. For a colonic manometry, the doctor does the same thing but feeds a tube into the intestine through the colon.
  • Laparotomy is a surgical procedure that is rarely necessary. A surgeon makes an abdominal incision so they can examine and biopsy the intestines.

How is intestinal pseudo-obstruction treated?

While there is no known cure for pseudo-obstruction, proper medical treatment can stabilize the condition, prevent complications and improve the child’s quality of life so they can participate in typical childhood activities.

Treatment may include:

  • Nutritional support therapy: Proper nutrition is a top priority for children with CIP. Children with CIP should eat several small meals throughout the day of easy-to-digest, pureed foods. Children who cannot eat even small meals may need enteral nutrition, which delivers a liquid diet into the stomach or intestines through a feeding tube. In more severe cases, a child’s doctor may recommend parenteral nutrition, which supplies nutrients directly into the veins through a catheter.
  • Surgical decompression: To relieve pressure in the intestines, a surgeon may insert a feeding tube directly into the stomach or create an opening in the abdomen through which the intestines can release gas and empty stool.
  • Medications: Prokinetic drugs may improve motility, the ability to move food through the intestines, in some children by aiding contractions. Depending on the child's symptoms, the child's clinician may also prescribe antibiotics, anti-nausea medications, anti-diarrheal medications or laxatives.
  • Pain management: There are several options to control and relieve pain and discomfort associated with CIP, including oral medications and even epidural anesthesia. However, pain medication can also slow digestion and should be used sparingly for children with CIP.
  • Small bowel transplantation: In severe cases, the intestines and possibly other organs may need to be replaced with an intestinal and multivisceral transplant.