An Epidemiologic Survey of Chronic Intestinal Pseudo-Obstruction and Evaluation of the Newly Proposed Diagnostic Criteria

Abstract

Background and Aims: Chronic intestinal pseudo-obstruction (CIPO) is an intractable disease in which clinical symptoms of intestinal obstruction appear without mechanical cause. No clear diagnostic criteria have been established; therefore, we proposed diagnostic criteria to facilitate the diagnosis of this rare disease and aim to evaluate their usefulness and validity. Materials andMethods: A questionnaire was sent to 378 institutions belonging to the Japanese Society of Gastroenterology between December 2009 and February 2010. We summarized the returned data and performed a statistical analysis. Results: A total of 160 cases were included, and 141 cases (88.1%) fulfilled the criterion of disease duration of >6 months, 157 cases (98.1%) the criterion of the clinical symptoms of abdominal pain and/or bloating and 154 cases (96.2%) fulfilled the criterion of imaging findings. Eventually, 138 cases (86.3%) fulfilled all criteria. Conclusions: The proposed diagnostic criteria were useful, with a high sensitivity of 86.3% for Japanese patients. Improved recognition of CIPO and practical use of the criteria are desired. The criteria should be appropriately modified by additional researchers to make them more practical and internationally applicable.

Pseudo‐obstruction, stroke, and mitochondrial dysfunction: A lethal combination

“…Mid‐point 2014 census population data for the North East of England, as specified by the Office for National Statistics, UK (2,618,710),22 were used to estimate the prevalence rate of IPO in m.3243A>G‐related mitochondrial disease, as described previously 2. The minimum prevalence rate of IPO in clinically manifesting m.3243A>G carriers was estimated as 1 in 200,000 or 0.53 per 100,000 (95% confidence interval [CI]: 0.3–0.9 per 100,000), which is comparable to the previously published point prevalence of all‐cause chronic IPO (0.9 per 100,000) 23, 24. Furthermore, review of our patient cohort and the literature would suggest that this late gastrointestinal complication may occur in other primary mtDNA25, 26, 27, 28, 29 and nuclear mutations (up to 3% in POLG ‐related mitochondrial disease30, but is extremely rare.…”

Chronic Intestinal Pseudo-obstruction: Clinical and Manometric Characteristics in the Chilean Population

“…This is probably due to enrollment of patients with colonic involvement, which appear at an older age. 10,11 The frequency with which the main symptoms appeared is similar to that observed in other studies; however, in our study, as in others, their intensity was not recorded. Thus, one might speculate that since pain is a very common symptom, its intensity may have been less than that described in the literature, since painkillers are not listed among the drugs received by the patients.…”

“…As in other studies with a similar number of patients, a predominance of females was observed, and most of the cases corresponded to primary CIPO. 4,10,12,13 The average age of our patients at diagnosis was similar to that described in European studies 12 and significantly younger than the age observed in Japanese studies. This is probably due to enrollment of patients with colonic involvement, which appear at an older age.…”

“…2 The diagnosis is usually difficult and late to establish. Recently, some authors 10 have proposed basic diagnostic criteria that include intestinal obstruction symptoms, abdominal pain and bloating, bowel dilatation or fluid levels established by different methods, and the absence of structural changes explaining the dilated loops.…”

Serial Frozen Fecal Microbiota Transplantation in the Treatment of Chronic Intestinal Pseudo-obstruction: A Preliminary Study

“…Eligible CIPO patients were identified via specialist gastrointestinal clinics. To be eligible, patients had to meet the diagnostic criteria for CIPO proposed by the Japanese Ministry of Health, Labour, and Welfare, 14 including documented pathological bowel dilatation in the absence of mechanical obstruction on imaging. The patients underwent FMT between December 2014 and September 2015.…”