I am sorry I could not get back to you earlier....
I will try to answer your questions at best but naturally I am not a medical person.
As far as the connection between CIP and bladder issues goes: From the age of 14 I often had urinary tract infections (when I had not had the bladder catheter through my abdomen yet). However, I already experienced difficulties in urinating/emptying my bladder.
I know that some people with CIP have similar bladder issues. It is quite "common" that there are multiple UTI that are not treatable by antibiotics. This is mostly due to the incapacity of the bladder to empty completely so that there is always a residual amount of urine in it. And this is an ideal place for bacteria to grow.
Do you also expereince difficulties in urinating?
Maybe you should have a testing of the bladder function (I think it is callled urodynamic).
Like the gut the bladder is an internal organ consisting of smooth muscles that have to be innervated by a similar neuronal architecture. Since CIP often affects the smooth muscles and/or the neuronal architecture you can have symptoms both from the bladder and the gut.
That's why I asked you whether you know the underlying mechanism (neuropathic=damage to the nerves or myopathic= damage to the smooth muscles)...a small bowel manometry can give some hint as there are typical contractile pattern for the myopathic and for the neuropathic version. An exact diagnosis in this regard can only be made by full thickness biopsies obtained in a little surgery.
However, a small bowel manometry is not mandatory for the diagnosis if there are obvious signs of sub-occlusion-like states without a mechanical obstruction. If there are air-fluid levels and distended bowel loops and an appropriate medical history and symptoms you fulfil the diagnostic criteria for CIP.
As far as your question about
the difference between CIP and CI and small bowel inertiais concerned: well, I am not sure, I think it is a very good question I have also asked myself a few times. CI is the term for severe slow transit constipation caused by a severe dysmotility of the colon. That's "all", it "only" affects the large intestine but for sure you can also experience symptoms like fullness, stomach pain that are secondary to the backing up of the colon. If the colon doesn't push the stuff forward the small bowel and the stomach can't empty adequately. However, I have got the impression that people with CI tends to expereince less severe upper/mid abdominal symptoms and there are some who never have nausea etc. (for example hoddaya wrote this once in "colectomy")
Small bowel inertia - well I have never heard of the term before but I think that it describes a similar motility disorder of the small bowel. And since those people who have been told this diagnosis mostly also have colonic dysmotility it's likely that they have CIP. CIP is the correct name, small bowel inertia doesn't exist in medical terms. So I think it is a name some docs use since they see the symptoms, adapt the name for CI and just transfer it to the small bowel but they don't know about
CIP in particular.
It seems that there are only very few people with small bowel inertia and that this is also a hint that they suufer from what we correctly call CIP.
CIP can vary in its first presentation. Some people fisrt have severe gastroparesis and experience severe constipation over time. In these cases the disease has spread on the large bowel. Others have the small bowel disorder first and continue with the large bowel. Other people only have small bowel involvement (though is a disease that affects the entire GI tract in most cases), sometimes the colon is the organ that is first affected. Usually, the first affect organ of the GI tract is where the disease is worst. That's why a colectomy/ileostomy can ideed bring some relief when the CIP firstly manifests in the colon - even if it is possible that this improvement is only temporary since the general character of the disease is progressive.. However, noone can say how bad and how fast this deterioration process will go.
Ok, I think I have rambled enough. I will look for the articles, they really contain much info - but they don't write about
YOUR case. And that's why I can relate to your feelings and thoughts very well. Even if I know some things I would like to know which path MY CIP will take.
Let me ask you some more questions:
You say your gastric emptying study was normal in 2007.
was it a breath test or was it a scintigraphic scan with a radioactive labled meal?
Did you already have the extreme nausea etc when you did the test?
If yes, it is likely that your stomach would function quite well if it could empty into the small bowel which is way too slow. In consequence the stuff is captured in the small bowel and pushes on the stomach that can't empty which all together makes the stomach pain, nausea etc.
Post Edited (pelztier86) : 8/11/2009 1:16:35 PM (GMT-6)