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Health Library Home>Disease, Condition, & Injury Fact Sheets>Article

Ileus

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

by Michael Jubinville, MPH
Definition
Causes
Risk Factors
Symptoms
Diagnosis
Treatment
Prevention

Definition

Ileus is a type of bowel obstruction. It happens when wavelike contractions stop. This is called peristalsis. Peristalsis pushes material along the digestive pathway.

Small Bowel Distention
Nucleus fact sheet image

Copyright © Nucleus Medical Media, Inc.

Causes

The nerves and muscles of the intestines are not working as they should. Damage to them may be caused by:

  • Surgery
  • Infections such as:
    • Peritonitis
    • Appendicitis
    • Pneumonia
    • Sepsis
  • Parkinson disease, Alzheimer disease, or multiple sclerosis
  • Injury
  • Certain medicines such as opioids or cancer drugs
  • Low levels of electrolytes
  • Kidney or liver problems
  • Heart attack or stroke
  • Heart failure

Risk Factors

Your chances of ileus are higher for:

  • Age over 60 years old
  • Being male
  • Obesity
  • Being in a hospital or institution

Symptoms

Common symptoms:

  • Swelling in the belly
  • Pain
  • Nausea or vomiting
  • Inability to pass stool or gas

Diagnosis

Your doctor will ask about your symptoms and health history. A physical exam will be done.

Some tests will rule out other causes if it’s not clear. You may have:

  • Blood tests
  • Stool tests
  • Abdominal x-rays
  • Barium enema
  • Abdominal CT scan
  • MRI scan
  • Colonoscopy —a scope is used to look at the large intestine

Treatment

Ileus may go away on its own within 2 to 3 days. If the cause is known, it will need to be treated.

It can also be treated with:

  • Diet—You will get nutrients and fluids through an IV until you're better.
  • Nasogastric suction—A tube is placed through the nose and into the stomach. This will help ease pain and bloating.
  • Activity—You will need to move around on a regular basis.
  • Medicines—Antibiotics to treat certain infections. You may also have medicines to help the muscles move again. Some medicines causing problems may be stopped or changed.
  • Decompression—Pressure is eased during a colonoscopy.
  • Surgery—Rare, but may be needed if no other method works or there is a serious problem. It may include bringing part of the intestine through the belly wall. Solid waste passes into a bag outside of the body.

Prevention

There is no way to prevent ileus in some cases. If you’re having surgery, your healthcare team will take steps to help lower your chances of it.

RESOURCES:

American College of Gastroenterology
http://patients.gi.org

International Foundation for Functional Gastrointestinal Disorders
https://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.com/topics/dmp~AN~T114336/Acute-intestinal-pseudo-obstruction. Updated July 12, 2014. Accessed August 15, 2018.

Ileus. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/ileus. Updated January 2017. Accessed August 15, 2018.

Intestinal obstruction and ileus. Patient website. Available at: https://patient.info/doctor/intestinal-obstruction-and-ileus. Updated April 23, 2014. Accessed August 15, 2018.

Prevention and management of postoperative ileus. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T905418/Prevention-and-management-of-postoperative-ileus. Updated April 5, 2017. Accessed August 15, 2018.

Last reviewed May 2018 by EBSCO Medical Review Board Daus Mahnke, MD  Last Updated: 08/15/2018

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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