Poster Session A - Sunday Afternoon
Category: Functional Bowel Disease
Yushan Wang, MD
Tufts Medical Center
Boston, MA
Acute Intestinal Pseudo-Obstruction | Chronic Intestinal Pseudo-Obstruction | |
Prevalence | 100 per 100,000* | 0.80-1.00 per 100,000 |
Course | Acute | Chronic |
Presentation | Abdominal distention Cramping pain Nausea/vomiting | Abdominal distention Abdominal pain Bloating |
Anatomic involvement | Colonic dilatation, usually cecum, right colon | Colonic or small bowel dilatation |
Pathophysiology | Multifactorial Autonomic dysfunction strongly implicated | Neuropathic disorder of enteric or extrinsic nervous system Myopathic disorder of smooth muscle Malfunction of interstitial cells of Cajal |
Management | Fluid resuscitation, correction of electrolyte abnormalities, avoidance of opioids/ anticholinergics Ambulation, bowel rest Decompression with nasogastric or rectal tubes Pharmacologic treatment with neostigmine Operative intervention in cases of colonic perforation or ischemia | Dietary modification, treatment of underlying disease Prokinetics, such as Prucalopride, for symptomatic relief (Grade 2C) Pyridostigmine in chronic phase of CIPO |