Ileus is a temporary lack of the normal muscle contractions of the intestines.
Abdominal surgery and medications that interfere with the intestine’s movements are common causes.
Bloating, vomiting, constipation, cramps, and loss of appetite occur.
The diagnosis is made by x-ray.
Most people get better with fluids given by vein and by temporarily not eating or drinking anything.
Some people need a thin suction tube passed through their nose into their stomach to relieve the buildup of gas and liquid.
(See also Overview of Gastrointestinal Emergencies.)
Like intestinal obstruction (blockage), ileus prevents the passage of food, fluid, digestive secretions, and gas through the intestines. However, unlike intestinal obstruction, ileus is not caused by a physical blockage (such as a tumor or scar tissue) and rarely leads to rupture.
The most common cause of ileus is
Abdominal surgery
Ileus commonly occurs for 24 to 72 hours after abdominal surgery, particularly when the intestines have been manipulated.
Other causes include medications, especially opioid analgesics and anticholinergic medications (see sidebar Anticholinergic: What Does It Mean?). Ileus may also be caused by an infection inside the abdomen, such as appendicitis or diverticulitis. Disorders outside the intestine, such as kidney failure, an underactive thyroid gland, heart attack, or abnormal levels of blood electrolytes (low potassium levels or high calcium levels, for example), may cause ileus.
Symptoms of Ileus
The symptoms of ileus are abdominal bloating and pain caused by a buildup of gas and liquids. Nausea, vomiting, severe constipation, loss of appetite, and cramps also occur. People may pass watery stool.
Diagnosis of Ileus
A doctor's examination
X-rays
A doctor hears few of the sounds normally made by a functioning intestine (bowel sounds) or none at all through a stethoscope.
An x-ray of the abdomen shows bulging loops of intestine.
Treatment of Ileus
Temporary restriction of food and fluids by mouth
Fluids given by vein
Suction via nasogastric tube
With restriction of food and fluids by mouth, ileus usually resolves on its own after 1 to 3 days. During this time, fluids and electrolytes (such as sodium, chloride, and potassium) are given by vein (intravenously). Whenever possible, powerful pain relievers called opioid analgesics are stopped or reduced.
Severe vomiting is rare, but if it occurs, the buildup of gas and liquid caused by ileus must be relieved. Usually, a tube is passed through the nose into the stomach or small intestine (nasogastric tube), and suction is applied to relieve pressure and expansion (distention). The person is not allowed to eat or drink anything until normal intestinal function returns. Sometimes, if the problem involves mainly the large intestine, a tube is passed through the anus into the large intestine to relieve the pressure.
