Identifying the Cause and Mechanism of Chronic Intestinal Pseudo-Obstruction
Intestinal pseudo-obstruction can be divided into acute and chronic categories. CIP is generally categorized as primary (neuropathic or myopathic), secondary (collagen vascular disease, endocrine, neoplastic, neurologic, etc), or idiopathic in nature.
The unifying characteristic of CIP is that of disordered GI motility. In primary Chronic Intestinal Pseudo-Obstruction this may stem from an intrinsic defect in the normal mechanisms that control GI tract motility, for example, either a muscle (myopathy) or nerve (neuropathy) injury process. To simplify an already complex classification system, we can separate the primary myopathic and primary neuropathic categories into congenital, familial, or sporadic.
These subcategories may then be further divided to represent areas of intestinal involvement and potential causes. Thus, any primary CIP patient with an identifiable family history of pseudo-obstruction would be considered to have primary myopathic or neuropathic familial intestinal pseudo-obstruction, and, similarly, those patients without an identifiable family history of pseudo-obstruction would be classified as having sporadic CIP, whether it is primary or secondary in nature.