Background/Aims: To evaluate the quality of life (QOL) of patients with chronic intestinal pseudo-obstruction (CIPO) before and after treatment. Methods: This study enrolled 50 adult patients diagnosed with CIPO at 4 institutions, of whom 42 underwent therapy.Patient background, body mass index, treatment, palliative care intervention, numerical rating scale for abdominal pain or bloating, the medical outcomes study 36-item short-form health survey (SF-36) and summary scores (physical component summary, mental component summary, and role/social component summary), Japanese version of the Patient Assessment of Constipation Quality of Life (JPAC-QOL) and subscales (physical discomfort, psychosocial discomfort, worries and concerns, and satisfaction), and Patient Assessment of Constipation Symptoms (PAC-SYM) and subscales (stool, rectal, and abdominal symptoms) were prospectively sampled and collected. Results: The patients (n = 50; 35 females and 15 males) had an average age of onset of 44.7 years and, body mass index of 17.3 kg/m², and 38 (76%) required palliative care intervention. Effective therapeutic interventions included intestinal sterilization (19/42), decompression therapy with percutaneous endoscopic gastrojejunostomy (PEG-J) (6/42), and dietary restriction (6/42). The numerical rating scale for abdominal distension and pain decreased significantly after treatment. All SF-36 summary scores showed improvements. The JPAC-QOL and PAC-SYM both showed improvement overall and in all subscales. Conclusions Patients with CIPO have a lower physical, psychological and social QOL, which is equivalent to or lower than that of adult patients with inflammatory bowel disease or psychiatric disorders. Sterilization of the intestinal tract and PEG-J decompression effectively improve the QOL of patients.

Many techniques have been developed to reduce the number of missed lesions during colonoscopy screening. Autofluorescence imaging (AFI) is one of the newly developed image-enhanced endoscopy (IEE) techniques, which functions similar to narrow band imaging (NBI) and flexible spectral imaging color enhancement (FICE), that can improve the detection and characterization of both polypoid and non-polypoid colonic neoplasms by enhancing their macroscopic features. We have previously reported that AFI, when used in combination with a transparent hood mounted on the tip of the endoscope to maintain distance from the colonic mucosa, results in the detection of approximately 1.6 times more colorectal neoplasms than conventional white light (WLI) colonoscopy. We have also revealed that AFI results in a higher flat neoplasm detection rate than WLI. Because the images of colorectal lesions visualized using AFI differ between histological lesion types, AFI also offers the possibility of differentiating neoplastic from non-neoplastic lesions. However, the difference between neoplastic and non-neoplastic lesions in the images generated using AFI relies on the density of the magenta coloring of the image and is therefore somewhat subjective. Recent studies suggest that NBI with magnification may be a superior modality for characterizing the neoplastic status of small colonic polyps. Although further developments are needed, the recent development of IEEs allows us to efficiently detect and differentiate colorectal neoplasms during colonoscopy screening. This article reviews the use of AFI in the diagnosis of colorectal neoplasms and discusses its advantages and limitations.
Colon ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Colorectal Neoplasms ; Endoscopes ; Endoscopy ; Humans ; Light ; Mass Screening ; Mucous Membrane ; Narrow Band Imaging ; Optical Imaging