Chronic Intestinal Pseudo-Obstruction (CIPO)

Chronic intestinal pseudo-obstruction (CIPO) is characterized by failure of intestinal peristalsis in the absence of any organic causes occluding the intestinal lumen. Patients with CIPO present with recurrent subocclusive episodes, which may resemble an intestinal mechanical obstruction.

From a pathophysiological standpoint, CIPO can be divided into 2 major forms—myogenic and neurogenic —which can be caused by an underlying inflammatory condition that affects the neuromuscular layer.

Symptoms

• The clinical presentation of some patients affected by inflammatory neurogenic CIPO either may follow an acute flulike episode (which usually remains unnoticed in the patient’s clinical history) or may result from a progressive impairment of gut function because of a paraneoplastic or systemic disorder.
• Similar to other forms of neuropathy, CIPO related to an underlying inflammatory neuropathy should be recognized on the basis of clinical history and presentation, as well as exclusion of mechanical obstruction. Gastrointestinal manometry may aid in the diagnosis by showing patterns suggestive of neurogenic CIPO.

Also see: Enteric Ganglionitis for neurologic features