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Chronic intestinal pseudo-obstruction in children and adults: diagnosis and therapeutic options

Di Nardo, G; Di Lorenzo, C; Lauro, A; Stanghellini, V; Thapar, N; Karunaratne, TB; Volta, U; (2017) Chronic intestinal pseudo-obstruction in children and adults: diagnosis and therapeutic options. Neurogastroenterology & Motility , 29 (1) , Article e12945. 10.1111/nmo.12945. Green open access

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Abstract

BACKGROUND: Chronic intestinal pseudo-obstruction (CIPO) represents the most severe form of gastrointestinal dysmotility with debilitating and potentially lethal consequences. Symptoms can be non-specific, and result in this condition being diagnosed incorrectly or too late with consequences for morbidity and even mortality. PURPOSE: The present article aims to provide pediatric and adult gastroenterologists with an up to date review about clinical features, diagnosis and therapeutic options for CIPO. Although pediatric and adult CIPO share many clinical aspects distinctive features can be identified. There is no single diagnostic test or pathognomonic finding of CIPO, thus a stepwise approach including radiology, endoscopy, laboratory, manometry, and histopathology should be considered in the diagnostic work-up. Treatment of patients with CIPO is challenging and requires a multidisciplinary effort with participation of appropriately experienced gastroenterologists, pathologists, dieticians, surgeons, psychologists, and other subspecialists based on the presence of comorbidities. Current treatment options invariably involve surgery and specialized nutritional support, especially in children. Medical therapies are mainly aimed to avoid complications such as sepsis or intestinal bacterial overgrowth and, where possible, restore intestinal propulsion. More efficacious therapeutic options are eagerly awaited for such difficult patients.

Type: Article
Title: Chronic intestinal pseudo-obstruction in children and adults: diagnosis and therapeutic options
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/nmo.12945
Publisher version: http://dx.doi.org/10.1111/nmo.12945
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: chronic intestinal pseudo-obstruction, clinical manifestations, histopathology, manometry, nutritional therapy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1518093
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