What Is the Treatment for Chronic Intestinal Pseudo-Obstruction?

Chronic intestinal pseudo-obstruction (CIPO) is characterised by recurrent or persistent signs and symptoms of bowel obstruction without an underlying mechanical cause, reflecting a failure of coordinated intestinal motility. Management aims to restore gut movement and re-establish tolerance of enteral nutrition.

Treatment approach

First-line treatment is based on prokinetic medical therapy — agents that act on the motility pathways of the gut. The appropriate agent, and whether combined approaches are required, depends on the distribution of involvement and clinical severity. The full protocol outlines the sequencing and selection criteria in detail.

Treatment goals: Increased antroduodenal motility index and improved tolerance of enteral feeds.

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References

DOI: 10.1053/j.gastro.2005.06.081

Prokinetic therapy with cisapride, erythromycin, octreotide, and tegaserod should be attempted.

Cisapride increases the antroduodenal motility index and may improve tolerance of enteral feeds.

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