Autonomic dysfunction in chronic intestinal pseudo-obstruction

Fifteen tests were used to assess adrenergic, non-vagal cholinergic, and ca rdiovagal functions in 11 patients with chronic intestinal pseudo-obstructi on (CIP). The three aims of this study were: 1) to ascertain the presence o f and spectrum of autonomic involvement; 2) to assess the level of autonomi c dysfunction; and 3) to compare the results of autonomic function tests wi th gastrointestinal motility patterns. Gastrointestinal motility displayed a neuropathic pattern in 10 patients. A dtenergic functions were abnormal in nine patients and non-vagal cholinergi c functions in 10 patients. Cardiovagal functions were abnormal in only sev en patients. The autonomic dysfunction was localized mostly to the postgang lionic pathways. One patient, who had a myopathic pattern and muscle degene ration on small bowel biopsy, demonstrated normal responses to autonomic fu nction tests. The patients with neuropathic CIP demonstrated widespread, mostly postgangl ionic autonomic dysfunction. Neuropathic CIP can occur with or without card iovagal involvement.