Exaggerated precontraction relaxation in the esophageal body associated with patients with dysphagia: A new manometric finding?

Abstract

Chronic intestinal pseudo-obstruction (CIPO) is a rare gastro-intestinal motor disorder that causes a lot of suffering in those affected. Most patients are in need of continuous treatment with analgesics, often opiates, and nutritional support. However, little is known about perceived quality of life in patients with CIPO. We have therefore assessed self-reported symptoms, functional status, and health-related quality of life (HRQL) in 40 patients with CIPO and compared this to corresponding data from healthy controls and patients with other gastrointestinal diseases. -s-Methods: We used four validated questionnaires: the Gastrointestinal Symptom Rating Scale (GSRS), the Sickness Impact Profile (SIP), the Swedish Health-Related Quality of Life Questionnaire (SWED-QUAL) and the Psychological General Well-being Index (PGWB). The diagnosis of pseudo-obstruction was based on the presence of a typical history, abnormal small bowel manometry. and abnormal full thickness biopsy of the bowel or radiological dilatation of the bowel. All adult patients (18 years or older) with CIPO in the Stockholm area were asked to participate in the study. --,)Results: The average score on PGWB was 85 in patients with CIPO. The corresponding values for controls was 103. Patients with CWO had significantly higher scores on GSRS but similar scores on PGWB compared to patients with other gastrointestinal diseases. We found significant correlations between 4/5 gastrointestinal symptoms and 3/6 dimensions of the PGWB among our patients with CIPO: diarrhoea correlated with anxiety (p<O.OOl); indigestion, abdominal pain, and reflux correlated with general health and vitality (p<O.OOl). --,)Conclusion: Patients with CIPO have a comparativly poor quality of life. The general well-being of patients with CIPO is lower than that of the normal population. There was a strong correlation between severity of symptoms and quality of life. The main determinants of poor quality of life were abdominal pain, indigestion and diarrhoea.