Ileus (Adynamic Ileus, Paralytic Ileus, Nonmechanical Bowel Obstruction, Ogilvies Syndrome, Colonic Pseudo-obstruction)
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Ileus is a type of bowel obstruction. It results when peristalsis stops. Peristalsis is the wavelike contractions that help push stool through the colon and small bowel.
Ileus is a nonmechanical bowel obstruction. The other type of obstruction is called a mechanical obstruction . Mechanical obstruction occurs when there is a physical blockage of the intestine.
Small Bowel Distention
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Ileus may be caused by:
- Abdominal surgery
- Joint or spine surgery
- Injury or trauma
- Infections, such as:
- Heart attack
- Imbalance of electrolytes
- Disorders that affect muscle function
- Use of certain drugs, such as narcotic pain drugs or high blood pressure medicine
- Low blood supply to parts of intestine (mesenteric ischemia)
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors for ileus include:
Abdominal surgery, infection, or injuryJoint or spine surgeryA previous history of ileusUse of certain pain or high blood pressure drugs Certain health conditions or diseases, such as: Lower lobe pneumoniaHeart attack Symptoms Symptoms of ileus may include: Abdominal distentionPainVomitingCrampsHiccupsInability to pass stool or gas Diagnosis Your doctor will ask about your symptoms and medical history and perform a physical exam. Diagnosis of ileus is usually based on symptoms and testing. Tests may include: X-rays a test that uses radiation to take a picture of structures inside the body CT scan a test that uses radiation to take multiple pictures of the inside of your body Barium enema a test that uses radiation to take a picture of the colon, after the colon has been filled with barium Colonoscopy a thin, lighted tube inserted through the rectum and into the colon to examine the lining of the colon TreatmentIf ileus was caused by surgery, it will usually resolve within 48 to 72 hours. In other cases, the disease that caused the ileus needs to be treated. This may involve adjusting the dose of a medication or replacing electrolytes.
Other treatments may be used to help ease symptoms. These may include: Diet LimitationPatients 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 ElectrolytesFluids are given by vein to avoid dehydration. Electrolytes are given by vein to help the ileus resolve. MedicationsThere are medications that increase peristalsis (ie, neostigmine, tegaserod) that can be used in selected patients to help ileus resolve. Colonoscopic DecompressionA flexible tube may be inserted into the colon to relieve pressure. SurgeryRarely, surgery is required to remove the part of the bowels affected. PreventionSince ileus is generally the result of injury, surgery, or a medical condition, there is little that can be done to prevent it. RESOURCES: The American College of Gastroenterologyhttp://www.acg.gi.org American Gastroenterological Associationhttp://www.gastro.org International Foundation for Functional Gastrointestinal Disordershttp://www.iffgd.org CANADIAN RESOURCES: Canadian Digestive Health Foundationhttp://www.cdhf.ca/aboutcdhf.htm The Canadian Association of Gastroenterology (CAG)
http://www.cag-acg.org/default.aspx References: Harrisons Principles of Internal Medicine . 14th ed. McGraw-Hill; 1998. Textbook of Gastroenterology . 4th ed. Lippincott Williams & Wilkins; 2003. Last reviewed February 2008 by Daus Mahnke, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.