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Autonomic dysfunction in chronic intestinal pseudo-obstruction

R K Khurana1, M M Schuster

  • 1The Union Memorial Hospital, Baltimore, Maryland 21218, USA.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|December 30, 1998
PubMed
Summary
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Chronic intestinal pseudo-obstruction (CIP) often involves widespread autonomic dysfunction, primarily affecting postganglionic pathways. This study reveals significant adrenergic and non-vagal cholinergic deficits in most neuropathic CIP patients.

Area of Science:

  • Gastroenterology
  • Neurology
  • Autonomic Neuroscience

Background:

  • Chronic intestinal pseudo-obstruction (CIP) is a debilitating condition affecting gastrointestinal motility.
  • Autonomic nervous system dysfunction is implicated in the pathophysiology of CIP.
  • Understanding the specific patterns of autonomic involvement is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate the spectrum and level of autonomic nervous system involvement in patients with chronic intestinal pseudo-obstruction.
  • To correlate autonomic function test results with gastrointestinal motility patterns in CIP.
  • To differentiate neuropathic from myopathic causes of CIP based on autonomic function.

Main Methods:

  • Utilized fifteen distinct tests to evaluate adrenergic, non-vagal cholinergic, and cardiovagal functions.

Related Experiment Videos

  • Assessed gastrointestinal motility patterns in 11 patients diagnosed with chronic intestinal pseudo-obstruction.
  • Correlated autonomic function test outcomes with small bowel biopsy findings and motility patterns.

    • Main Results:

    • Gastrointestinal motility showed a neuropathic pattern in 10 out of 11 patients.
    • Abnormalities in adrenergic and non-vagal cholinergic functions were observed in 9 and 10 patients, respectively.
    • Cardiovagal functions were abnormal in 7 patients, with autonomic dysfunction predominantly localized to postganglionic pathways.

    Conclusions:

    • Neuropathic chronic intestinal pseudo-obstruction is characterized by widespread, predominantly postganglionic autonomic dysfunction.
    • Autonomic dysfunction in CIP may involve adrenergic and non-vagal cholinergic systems significantly.
    • Cardiovagal involvement is not a universal feature of neuropathic CIP, highlighting the heterogeneity of autonomic involvement.