Decompression Measures

Ideally, the best therapy for CIP would be to treat the underlying process. Unfortunately, however, for the vast majority of patients palliation of symptoms is all that can be offered at present. One such measure includes decompression of distended intestinal segments via intermittent nasogastric suction, rectal tubes, or endoscopy. A lack of clinical studies addressing this issue means there are no firm guidelines on when such intervention should be undertaken. However, most practitioners use endoscopic decompression in acute colonic distension (Ogilvie's syndrome) when there is a rapid increase in luminal disten

^Editor's Note: Some patients with intestinal failure secondary to CIP have gone on to small bowel transplantation, as discussed in Chapter 65, "Intestinal and Multivisceral Transplantation".

sion, or when the cecum or transverse colon diameter approximates 10 cm or more. To prevent recurrence after endoscopic decompression a fluroscopically guided cecos-tomy tube may be placed by radiology to allow venting as needed. Other more invasive measures to provide adequate decompression of the distended intestinal segment may include a "venting" enterostomy. These are typically placed in the stomach, although some patients with feeding J-tubes also use them for venting purposes. As described by Pitt and colleagues (1985), patients with surgically placed gastrostomy tubes had a lower rate of hospital admissions (0.2 admissions per patient-year) after the procedure than before the procedure (1.2 admissions per patient-year).

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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