Prognostic yield of esophageal manometry in chronic intestinal pseudo‐obstruction: a retrospective cohort of 116 adult patients

Amiot, Aurélien; Joly, Francisca; Cazals–Hatem, Dominique; Merrouche, M.; Jouët, Pauline; Coffin, Benoït; Bouhnik, Yoram

doi:10.1111/j.1365-2982.2012.01973.x

Cited by 32 publications

(27 citation statements)

References 39 publications

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“…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.…”

Section: Discussionsupporting

confidence: 62%

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

Arce

Landskron

Hirsch

et al. 2017

J Neurogastroenterol Motil

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Background/AimsChronic intestinal pseudo-obstruction (CIPO) is a rare syndrome characterized by a failure of the propulsion of intraluminal contents and recurrent symptoms of partial bowel obstruction in the absence of mechanical obstruction. Regional variations of the intestinal compromise have been described. Intestinal manometry can indicate the pathophysiology and prognosis. Our objective is to establish the demographic and clinical characteristics of group Chilean patients and analyze the motility of the small intestine and its prognostic value. MethodsPatients with symptoms of intestinal pseudo-obstruction with dilated bowel loops were included, in all of whom a manometry of the small intestine was performed using perfused catheters. ResultsOf the 64 patients included, 51 women (average age 41.5 ± 17.6 years), 54 primary and 10 secondary CIPO were included. Dilatation of the small intestine was the only finding in 38 patients; in the remaining, the compromise was associated with other segments, primarily the colon. Forty-nine patients underwent 65 surgeries, mainly exploratory laparotomies and colectomies. Intestinal manometry was performed on all patients; 4 "patterns" were observed: neuropathic (n = 26), myopathic (n = 3), mixed (n = 24), and a group without motor activity (n = 11). The most relevant findings were the complex migrating motor disorders and decreased frequency and propagation of contractions. The 9 patients who died had a severe myopathic compromise. ConclusionsIn our series, isolated small bowel compromise was the most common disorder. Neuropathic motor compromise was observed in most of the patients. Mortality was associated with severe myopathic compromise.

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Section: Discussionsupporting

confidence: 62%

“…While in one of them 18 only neuropathic disorders were mentioned, motility alterations have been found in 60% of other reports. 12,13 The hypomotility varied between 20% and 79%. It is possible that these differences reside in the characteristics of patients or could be related to the criteria which were cataloged the motor disorders.…”

Section: Discussionmentioning

confidence: 99%

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

Arce

Landskron

Hirsch

et al. 2017

J Neurogastroenterol Motil

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“…4 In most cases, operative treatment is unable to circumvent the course of CIPO since dysmotility is a diffuse process that could affect the whole gastrointestinal tract. 5 Furthermore, surgery in CIPO patients could be associated with a risk of postoperative intra-abdominal adhesions, leading to potentially worsen the symptoms of the underlying dysmotility. When all other therapeutic options have failed, small bowel subtotal resection and intestinal transplantation should also be considered.…”

Section: Introductionmentioning

confidence: 99%

Non‐transplantation surgical approach for chronic intestinal pseudo‐obstruction: analysis of 63 adult consecutive cases

Sabbagh

Amiot

Maggiori

et al. 2013

Neurogastroenterology Motil

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“…4 Recently, the ability to maintain oral feeding was found to be an independent predictor of survival in patients with CIPO. 2 The etiology and cause of CIPO are not well clarified. When impairment of gut motility and transit are severe, small intestinal bacterial overgrowth (SIBO) may occur, further contributing to malnutrition and vitamin deficiency.…”

Section: Introductionmentioning

confidence: 99%

“…In most cases, operative treatment cannot circumvent the course of CIPO and can actually worsen the motility disorder. 2 Inadequate oral intake, recurrent episodes of obstruction, and malabsorption are the main clinical features of CIPO, with 20% to 60% of patients needing long-term home parenteral nutrition. 3 Thus, the main goals in CIPO management are improvement of intestinal propulsion and maintenance of adequate nutritional status.…”

Section: Introductionmentioning

confidence: 99%

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

Ding

Tian

et al. 2017

J Neurogastroenterol Motil

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Background/AimsChronic intestinal pseudo-obstruction (CIPO) is a serious, life-threatening motility disorder that is often related to bacterial overgrowth. Fecal microbiota transplantation (FMT) results in restoration of the normal intestinal microbial community structure. We investigated the efficacy of FMT in the treatment of CIPO patients. MethodsNine patients (age 18-53 years) with CIPO were enrolled in this prospective, open-label study. Patients received FMT for 6 consecutive days through nasojejunal (NJ) tubes and were followed up for 8 weeks after treatment. We evaluated the rate of clinical improvement and remission, feeding tolerance of enteral nutrition, and CT imaging scores of intestinal obstructions. Lactulose hydrogen breath tests were performed before FMT and 8 weeks after FMT to evaluate for the presence small intestinal bacterial overgrowth (SIBO). ResultsFMT significantly alleviated bloating symptoms, and symptoms of pain were relieved 2 weeks after FMT. Enteral nutrition administered through a NJ tube after FMT was well-tolerated by 66.7% (6/9) of patients. CT scores of intestinal obstructions were significantly reduced after FMT (P = 0.014). SIBO was eliminated in 71.0% (5/7) of patients. ConclusionsThis pilot study demonstrated the safety of using FMT. FMT may relieve symptoms in selected patients with CIPO. FMT may also improve patient tolerance of enteral nutrition delivered via a NJ tube.

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Prognostic yield of esophageal manometry in chronic intestinal pseudo‐obstruction: a retrospective cohort of 116 adult patients

Abstract: Our study showed that CIPO was associated with a diffuse involvement of all parts of the GI tract and was not restricted to the small intestine in 90% of the cases studied. Esophageal manometry had a significant prognostic yield and should be systematically performed in CIPO patients.

Cited by 32 publications

References 39 publications

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

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

Non‐transplantation surgical approach for chronic intestinal pseudo‐obstruction: analysis of 63 adult consecutive cases

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

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