Either of these ostomies are typically placed at or a few centimeters below the patients navel per doctor recommendation based on the affected area of the intestines as well as concerns for patient comfort and future physical growth for children.The total removal of the colon, called a colectomy or resection of affected parts of the colon may be needed if part of the gut dies (for instance toxic megacolon), or if there is a localized area of dysmotility. Gastric and colonic pacemakers have been tried. These are strips placed along the colon or stomach which create an electric discharge intended to cause the muscle to contract in a controlled manner. A potential solution, albeit radical, is intestinal transplantation. This is only appropriate in the case of intestinal failure. These procedures are most frequently described in pediatric cases of CIPO. One operation involving multi-organ transplant of the pancreas, stomach, duodenum, small intestine, and liver, and was performed by Doctor Kareem Abu-Elmagd on Gretchen Miller. Potential Treatments
Further research is necessary into other treatments which may alleviate symptoms. These include stem-cell transplantation and fecal microbiota transplantation. Cannabis has not been studied with regards to CIPO. Any claims to its efficacy for use in CIPO are speculative. Related disorders
Ogilvie syndrome: acute pseudoobstruction of the colon in severely ill debilitated patients. Hirschsprungs disease: enlargement of the colon due to lack of development of autonomic ganglia. Intestinal neuronal dysplasia: a disease of motor neurons leading to the bowels.
Risk factors
Risk factors for premature birth or stillbirth due to cervical weakness include:
diagnosis of cervical weakness in a previous pregnancy
previous preterm premature rupture of membranes
history of conization (cervical biopsy)
diethylstilbestrol exposure, which can cause anatomical defects, and
uterine anomaliesRepeated procedures (such as mechanical dilation, especially during late pregnancy) appear to create a risk. Additionally, any significant trauma to the cervix can weaken the tissues involved. Diagnosis
Diagnosis of cervical weakness can be challenging and is based on a history of painless cervical dilation usually after the first trimester without contractions or labor and in the absence of other clear pathology. In addition to history, some providers use assessment of cervical length in second trimester to identify cervical shortening using ultrasound. However, short cervical length has actually been shown to be a marker of preterm birth rather than cervical weakness. Other diagnostic tests that have been suggested which have not been validated include hysterosalpingography and radiographic imaging of balloon traction on the cervix, assessment of the patulous cervix with Hegar or Pratt dilators, the use of a balloon elastance test, and use of graduated cervical dilators to calculate a cervical resistance index.Normally, the cervix should be at least 30 mm in length. Cervical weakness is variably defined. However, a common definition is a cervical length of less than 25 mm at or before 24 weeks of gestational age.