Chronic Intestinal Pseudo-obstruction Overview

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Chronic intestinal pseudo-obstruction (CIP) is a rare disorder that is is often diagnosed in childhood.

While intestinal pseudo-obstruction may affect people at any age, once present it is a life-long condition. Approximately 100 infants are born with congenital CIP in the U.S. every year.

In patients with CIP, nerve and muscle problems affect how food, fluid, stool and air move through the intestines. The disorder is called pseudo-obstruction because the symptoms are similar to those caused by an obstruction blocking the intestines, though there is no real anatomic obstruction.

Symptoms of Chronic Intestinal Pseudo-obstruction (CIP)

CIP prevents  fluids and food from moving though the gastrointestinal tract (stomach and intestines). Symptoms vary, depending on which portion of the intestinal tract is affected. Common symptoms include:

  • Abdominal distention (bloating or swelling)
  • Vomiting
  • Constipation
  • Abdominal pain
  • Sepsis
  • Diarrhea

The lack of movement prevents the body from absorbing the  nutrients it needs to function. As a result, many children suffer from symptoms of malnutrition, such as failure to thrive, and do not gain weight normally. As a result, it is common for doctors to suspect and diagnose this condition soon after birth or before age 1.

 

 

How is Chronic Intestinal Pseudo-obstruction Diagnosed?

Because the symptoms of CIP may mimic those of other conditions, including a real obstruction, your child’s doctor may need to order several tests before a formal diagnosis.

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

  • Imaging studies, such as X-rays, to rule out intestinal obstruction
  • Antroduodenal and colonic manometry: This test places a small, flexible tube through the nose or an existing gastrostomy (feeding tube) into the stomach and small intestine, or in the colon to measure pressure. These tests allow the diagnosis without the need for more invasive testing like surgery.  Read more about antroduodenal manometry at Boston Children’s.
  • Laparotomy, a surgical procedure in which the surgeon makes an abdominal incision so he or she can examine and biopsy the intestines. This test is rarely needed.

Read more about GI motility testing services at Boston Children’s.

Chronic Intestinal Pseudo-obstruction Treatment at Boston Children’s

There is no cure for chronic intestinal pseudo-obstruction. Our approach to care focuses on treating symptoms and preventing complications, but at Boston Children’s, it goes beyond that. We take into account all of your child’s health needs, physical and emotional, to provide complete support.

Our comprehensive treatment plans involve specialists across disciplines – including gastroenterologists, surgeons, pain management specialists, psychologists, a nutritional support team, and others – who work together to treat every aspect of this disorder.

 Children with CIP are not able to eat normally, so they require alternative methods of nutrition. They   may experience vomiting, pain and discomfort.

At our Motility and Functional Gastrointestinal Disorders Center, we develop a personalized care plan for your child that draws from the latest therapies and research available today.

  • Nutritional support therapy: Making sure children with CIP receive proper nutrition is a top priority. Children who cannot eat even small meals may need enteral nutrition, which provides a liquid diet through feeding tubes in the stomach or intestines. In more severe cases, parenteral nutrition supplies nutrients directly into the veins through a catheter.
  • Surgical decompression through a gastrostomy: (insertion of feeding tube directly into stomach) or ileostomy (surgical procedure that creates an opening in the abdomen through which the intestines empty stool, bypassing the rectum and anus).
  • Medications to help intestinal movement: Prokinetic drugs may improve motility in some children by aiding intestinal contractions. We also offer special medications like cisapride, which is only available at selective specialized centers. These medications should be prescribed and managed by physicians with pediatric expertise, such as the specialists at our Motility and Functional Gastrointestinal Disorders Center.
  • Pain management: There are several options to control and relieve pain and discomfort associated with CIP, including oral medications and even epidural anesthesia.
  • Small bowel transplantation: In severe cases, the intestines as well as organs may need to be replaced with donor organs. Read more about the Intestine and Multivisceral Transplant Program at Boston Children’s.

Learn more about our GI motility treatments and approach to care at Boston Children’s.

 

Make an Appointment

For an appointment, more information or to obtain a second opinion for your child, please contact the Motility and Functional Gastrointestinal Disorders Center at 617-355-6055 or request an appointment online.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

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