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Ileus

Definition

Ileus is a type of non-mechanical bowel obstruction. It results when peristalsis stops. Peristalsis is the wavelike contractions that help push stool through the colon and small bowel.

Small Bowel Distention
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Causes

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

Risk Factors

Factors that increase your risk of getting 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

Symptoms of ileus may include:

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

Diagnosis

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 colonoscopy .

Treatment

If ileus was caused by surgery, stress or trauma it will usually resolve within 48 to 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

Patients who suffer from 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

Fluids and electrolytes are given by vein to avoid dehydration.

Medications

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

Colonoscopic Decompression

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

Surgery

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

Prevention

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

Revision Information

  • American Gastroenterological Association

    http://www.gastro.org

  • International Foundation for Functional Gastrointestinal Disorders

    http://www.iffgd.org

  • Canadian Digestive Health Foundation

    http://www.cdhf.ca

  • The Canadian Association of Gastroenterology (CAG)

    http://www.cag-acg.org

  • Colonic ileus. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated March 5, 2013. Accessed July 25, 2013.

  • Intestinal obstruction and ileus. Patient UK website. Available at: http://www.patient.co.uk/doctor/Intestinal-Obstruction-and-Ileus.htm . Updated April 20, 2010. Accessed July 25, 2013.