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.

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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.