title: Dysmotility disorders: a nutritional approach.
abstract: OBJECTIVE
  Chronic intestinal pseudo-obstruction (CIPO) results in markedly compromised peristalsis mimicking an intestinal occlusion. The main goals of CIPO management are to improve intestinal propulsion and to maintain adequate nutrition status. The review describes the global management of CIPO including methods of diagnosis and nutritional, pharmacological and surgical therapies.
  
  
  RESULTS
  The principles of CIPO management are to perform a physiological assessment of the gastrointestinal tract involved, to improve symptoms and to prevent malnutrition. We shall discuss the place of physiological motility tests such as intestinal manometry and the cine-magnetic resonance imaging to facilitate diagnosis. Home parenteral nutrition (HPN) is a frequently used therapy with a high dependence level. However, recent data are consistent with a good long-term prognosis. Currently, CIPO becomes a significant cause of chronic intestinal failure. We discuss the outcomes of HPN and surgery.
  
  
  CONCLUSIONS
  CIPO is a rare and complex disease. Small bowel manometry remains a gold standard for diagnosis, but new imaging tools appear promising. The management of CIPO requires the cooperation of specialists involved in the intestinal failure field. The better knowledge of CIPO prognosis should encourage clinicians to propose intestinal transplantation in selected cases.
authors.affiliation: aDepartment of Gastroenterology and Nutrition Support, Beaujon Hospital, Clichy bGastrointestinal and Metabolic Dysfunctions in Nutritional Pathologies, Inserm UMR 1149, Centre de Recherche sur l'Inflammation Paris Montmartre, UFR de Médecine Paris Diderot, France.
authors.forename: Lore
authors.initials: L
authors.lastname: Billiauws
authors.forename: Olivier
authors.initials: O
authors.lastname: Corcos
authors.forename: Francisca
authors.initials: F
authors.lastname: Joly
mesh_terms: D002908:Chronic Disease; D005769:Gastrointestinal Motility; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D007422:Intestines / Q000601:surgery; D044342:Malnutrition / Q000517:prevention & control; D016331:Parenteral Nutrition, Home