Surgical Intervention for CIP

Surgery should be performed rarely, if at all, because intestinal pseudo-obstruction is a generalized disorder that typically affects the entire intestine. Removing part of the intestine cannot cure the disease.  Only rare cases can benefit from surgical resections.

The role of surgery in the management of CIP is to provide access to the stomach or small bowel for venting (decompression to relieve symptoms) and feeding, both of which may be performed laparoscopically.

Some individuals with CIP may be treated by intestinal decompression, a procedure that reduces the pressure within the GI tract. Intestinal decompression is most commonly performed by inserting a tube (such as a J-tube) within the intestines in order to decompress abnormally swollen (distended) segments of the intestines. Gastrostomies (G-tube) and enterostomies can effectively decrease retching, vomiting and abdominal distension and represent a possible option in patients who can be fed by enteral nutrition. By decompressing the areas of distention, improvement may be seen in nutrient absorption, while also decreasing the need for frequent hospitalizations and repeat surgeries. 

Rarely, and in very specific and severe cases of CIP, surgery to remove a section of the intestines (enterectomy) may be necessary. Because surgery can potentially worsen CIP, it only has a limited role in the treatment of specific cases. When CIP is limited to an isolated portion of the bowel, surgical bypass of the affected segment may be beneficial. Certain surgeries can potentially decrease the frequency of certain symptoms such as retching, vomiting and abdominal distention.

Pacing of the intestine and electrical stimulation of intestine are considered experimental at this time.

Surgical complications can and do occur.  In fact, surgery can make the situation and underlying disease worse and should be performed only if absolutely necessary. It is important to have a thorough and informed discussion with your surgeon and regular doctor before making a decision to pursue surgery.