Clinical Presentation

A cross-sectional analysis by Mann and colleagues (1997) demonstrated that the median age of symptom onset was 17 years with a range of 2 weeks to 59 years (11 males, 9 females). The frequency and severity of symptoms may vary remarkably depending upon the section and the extent of the GI tract involved. The most common symptoms included pain (80%), vomiting (75%), constipation (40%), and diarrhea (20%) (Stanghellini et al, 1987).When the esophagus is involved, decreased esophageal motility and lower esophageal sphincter (LES) tone may lead to complaints of dysphagia and reflux symptoms. The complete absence of bowel movements or flatus indicates complete obstruction as opposed to the more common finding of constipation. However, diarrhea may also occur in patients with CIP and is likely secondary to intestinal stasis promoting bacterial overgrowth. Some suffer from malabsorption and develop nutritional deficiencies secondary to bacterial overgrowth. Loss of appetite and weight loss can be seen as well as nausea and vomiting. Patients may complain of early satiety and epigastric fullness if the stomach is involved. Bloating and abdominal distention are frequently seen and patients may complain about "looking pregnant" or having to loosen their clothes in order to allow them to fit properly. Patients with CIP typically have complaints of abdominal pain. For some patients, the pain is episodic in nature and occurs only during an acute episode or crisis. For other patients, however, the pain is more chronic in nature. The pain can be located anywhere in the abdomen, depending on the location and the extent of the segment of bowel that is involved. Many patients characterize the pain as sharp, stabbing, or twisting, whereas others describe it as more of a pressure, ache, or discomfort. Pain typically worsens as bloating and abdominal distension progress and improves as the crisis resolves.

Extraintestinal manifestations may also be present in patients with CIP. The most common extraintestinal manifestation, as demonstrated in the Stanghellini and colleagues cross-sectional analysis, was genitourinary involvement. Genitourinary involvement may present as dilatation of the ureter, pelvis or calyces, or abnormal bladder function, and commonly leads to complaints of difficulty voiding (Sullivan et al, 1977).

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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