ABSTRACT
Chronic intestinal pseudo-obstruction (CIP) is a clinical syndrome characterized by signs of intestinal obstruction without mechanical occlusion of the gut. A number of other names have been used to described the disorder, including adynamic bowel, Hirschsprung’s disease, megacystis, microcolon hypoperistalsis syndrome, visceral neuropathies and visceral myopathies. Initially, it was thought that CIP was a single disease entity without clearly defined pathology. Over the past 20 years, however, numerous reports have appeared which show that this is not the case.1-4
CIP is a heterogeneous disorder associated with a wide variety of pathologies, some intrinsic to the gut, others multisystem disorders involving the gut or altering the environment within which the gut operates. The conditions cause disordered intestinal motor activity and may present acutely or chronically. The most common forms of pseudoobstruction are acute in nature and occur as postoperative ileus or the ileus that is associated with electrolyte imbalance and metabolic disorder. Acute pseudo-obstruction episodes have also been reported in association with food-sensitive intestinal disease such as celiac disease and cow’s milk protein intolerance, together with drugs such as vincristine. CIP was originally thought to involve only the small intestine, but it is now realized that it may be restricted to one region of the gut, such as in achalasia or Hirschsprung’s disease, or it may be present diffusely throughout the gastrointestinal tract.
