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Ileus

(Adynamic Ileus; Paralytic Ileus; Nonmechanical Bowel Obstruction; Ogilvie’s Syndrome; Colonic Pseudo-obstruction)

Definition

Ileus is a type of nonmechanical bowel obstruction. It results when peristalsis stops. Peristalsis is the wavelike contractions that push contents through the digestive system.

Small Bowel Distention

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Causes    TOP

Ileus is caused by damage to the nerves controlling the intestines from surgery, infection, low blood flow, trauma, medications, or changes in the body chemistry.

Risk Factors    TOP

Factors that increase your chance of ileus include:

  • Abdominal, joint, or spine surgery
  • Intestinal injury or trauma
  • Severe generalized trauma
  • Abdominal bleeding.
  • Infections, such as:
  • Heart attack or stroke
  • Imbalance of electrolytes, especially potassium and calcium
  • Disorders that affect muscle function
  • Use of certain drugs, such as narcotic pain drugs, high blood pressure medication, or chemotherapy
  • A previous history of ileus

Symptoms    TOP

Symptoms of ileus may include:

  • Abdominal swelling
  • Pain
  • Vomiting
  • Cramps
  • Hiccups
  • Inability to pass stool or gas

Diagnosis    TOP

Your doctor will ask about your symptoms and medical history. A physical exam and blood tests will be done. A diagnosis of ileus is usually based on symptoms and results of imaging studies.

Images may be taken of your bodily structures. This can be done with:

The lining of your colon may need to be examined. This can be done with a colonoscopy.

Treatment    TOP

If ileus was caused by surgery, stress, or trauma it will usually resolve within 48-72 hours. In other cases, the disease or abnormality that caused the ileus needs to be treated. This may involve adjusting the dose of or stopping a medication, treating an infection, or replacing electrolytes.

Other treatments may be used to help ease symptoms. These may include:

Diet Limitation

People who have ileus should not be fed until the ileus has resolved.

Nasogastric Suction (NG Tube)

A tube is inserted through the nose and into the stomach to remove digestive fluids. This will help relieve pain and bloating.

Intravenous Fluids and Electrolytes    TOP

IV fluids and electrolytes are given to avoid dehydration.

Medications    TOP

There are medications that increase peristalsis, such as neostigmine and tegaserod, which can be used in some to help ileus resolve.

Colonoscopic Decompression    TOP

A flexible tube may be inserted into the colon to relieve pressure.

Surgery    TOP

Rarely, surgery is required if there is a perforation or other abnormality causing the ileus.

Prevention    TOP

Since ileus is generally the result of injury, surgery, or a medical condition, there is little that can be done to prevent it.

RESOURCES:

American Gastroenterological Association
http://www.gastro.org
International Foundation for Functional Gastrointestinal Disorders
http://www.iffgd.org

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
https://www.cag-acg.org
Canadian Digestive Health Foundation
http://www.cdhf.ca

References:

Acute intestinal pseud-obstruction. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated July 12, 2014. Accessed July 25, 2015.
Intestinal obstruction and ileus. Patient UK website. Available at:
...(Click grey area to select URL)
Accessed July 25, 2015.
Last reviewed June 2016 by Daus Mahnke, MD
Last Updated: 6/16/2014

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