Ileus

An Ileus is a type of non-physical 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

Causes

An Ileus may be caused any of the following conditions:

  • Abdominal surgery.
  • Joint or spine surgery.
  • Injury or trauma.
  • Infections, such as: Abdominal infections: peritonitis , appendicitis, diverticulitis and Pneumonia.
  • Heart attack.
  • Imbalance of electrolytes.
  • Disorders that affect muscle function.
  • Use of certain drugs, such as narcotic pain drugs or high blood pressure medication.
  • Low blood supply to parts of the intestine.

Risk Factors

Factors that can increase your risk of you getting an ileus include:

  • Abdominal surgery, infection, or injury
  • Joint or spine surgery
  • A previous history of ileus
  • Use of certain pain or high blood pressure drugs
  • Certain health conditions or diseases, such as: Lower lobe pneumonia, Heart attack

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 will be done. Diagnosis of ileus is usually based on symptoms and testing.
Images may be taken of your bodily structures. This can be done with:

  • X-rays
  • CT scan
  • Barium enema

The lining of your colon may also need to be examined; this can done with a colonoscopy.

Treatment

If the ileus was caused by surgery, it will usually resolve within 48 to 72 hours. In other cases, the disease that caused the ileus will need 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 could 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 used, only required if there is a perforation or other abnormality causing the ileus.

Prevention

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