Epidemiology and Clinical Experience of Chronic Intestinal Pseudo-Obstruction in Japan: A Nationwide Epidemiologic Survey

Abstract

BackgroundWe estimated the prevalence and incidence of chronic intestinal pseudo-obstruction (CIPO) in Japan, investigated the patterns of hospital visits among those with CIPO, and examined present knowledge of CIPO among medical professionals.MethodsA self-administered questionnaire survey was distributed to targeted hospitals throughout Japan, which were selected using stratified random sampling. The questionnaire asked about the number of patients receiving treatment for CIPO, the frequency of their hospital visits, and overall clinical knowledge of CIPO among medical professionals.ResultsCIPO prevalence was estimated to be 1.00 and 0.80 cases per 100 000 males and females, respectively. Incidence was 0.21 and 0.24 cases per 100 000 males and females, respectively. Prevalence and incidence did not significantly differ males and females. Mean age of patients was 63.1 years for males and 59.2 for females. Accurate diagnosis of CIPO sometimes required more than 3 months after initial presentation. Most medical professionals were unaware of or poorly understood CIPO.ConclusionsWe estimated the prevalence and incidence of CIPO in Japan, using data from a nationwide survey. The findings suggest that knowledge of CIPO should be further disseminated so that the disease is not overlooked and is diagnosed without delay.

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.…”

“…A Japanese study estimated a prevalence of 1.0 versus 0.8 cases per 100 000 inhabitants in men and women respectively. 11 Western studies have shown a higher frequency of CIPO in females, that ranges from 64% to 68%. 9,12 Intestinal manometry, not always available in all centers, has been considered to be an important contribution to the diagnosis of the syndrome, but the diagnosis cannot rely solely on the study of motility with manometry.…”

Two Cases of Chronic Intestinal Pseudo-obstruction: A Comparison of Staining Characteristics of Enteric Visceral Myopathy With Hirschsprung Disease

“…[1][2][3][4] It can be of either acute or chronic types. Chronic pseudo-obstruction can be idiopathic or secondary to a systemic disorder.…”

“…1 The age of onset and symptoms can vary, resulting in delay in diagnosis, so that repeated exploratory laparotomy or surgery is not uncommon. 1,3,[5][6][7] Myopathic CIPO is further subclassified into four types. Type I, the most common, is characterized by redundant colon, esophageal dilation, megaduodenum, megacystis, and sometimes uterine inertia.…”