This protocol addresses patients with chronic intestinal pseudo-obstruction in whom chronic abdominal pain is the predominant symptom. When pain dominates the clinical presentation, specific management strategies directed at the pain component take priority.
Centrally acting medications form a key part of the approach for pain-predominant CIPO. Management is best delivered within a multidisciplinary framework that incorporates behavioural and nonnarcotic strategies alongside pharmacotherapy.
The complete regimen — including specific agents, sequencing, and combination considerations — is available in the full protocol below.
DOI: 10.1053/j.gastro.2005.06.081
Other centrally acting medications, such as gabapentin and tricyclic antidepressants, also may be beneficial when pain constitutes the predominant symptom.
Such problems are best approached in the context of a multidisciplinary treatment that includes behavioral or relaxation therapy and the use of nonnarcotic medicines.
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