Ileus

The intestine (bowel, or gut) is a long muscular tube connecting your stomach to your rectum. If the intestine stops working, food cannot pass through. This is called an ileus. This can happen for a variety of reasons. Ileus is a major medical problem that usually requires hospitalization. If your intestine stops working because of a blockage, this is called a bowel obstruction, and is a different condition.

CAUSES

  • Surgery in your abdomen. This can last from a few hours to a few days.

  • An infection or inflammation in the belly (abdomen). This includes inflammation of the lining of the abdomen (peritonitis).

  • Infection or inflammation in other parts of the body, such as pneumonia or pancreatitis.

  • Passage of gallstones or kidney stones.

  • Damage to the nerves or blood vessels which go to the bowel.

  • Imbalance in the salts in the blood (electrolytes).

  • Injury to the brain and or spinal cord.

  • Medications. Many medications can cause ileus or make it worse. The most common of these are strong pain medications.

SYMPTOMS

Symptoms of bowel obstruction come from the bowel inactivity. They may include:

  • Bloating. Your belly gets bigger (distension).

  • Pain or discomfort in the abdomen.

  • Poor appetite, feeling sick to your stomach (nausea) and vomiting.

  • You may also not be able to hear your normal bowel sounds, such as "growling" in your stomach.

DIAGNOSIS

  • Your history and a physical exam will usually suggest to your caregiver that you have an ileus.

  • X-rays or a CT scan of your abdomen will confirm the diagnosis. X-rays, CT scans and lab tests may also suggest the cause.

TREATMENT

  • Rest the intestine until it starts working again. This is most often accomplished by:

  • Stopping intake of oral food and drink. Dehydration is prevented by using IV (intravenous) fluids.

  • Sometimes, a naso-gastric tube (NG tube) is needed. This is a narrow plastic tube inserted through your nose and into your stomach. It is connected to suction to keep the stomach emptied out. This also helps treat the nausea and vomiting.

  • If there is an imbalance in the electrolytes, they are corrected with supplements in your intravenous fluids.

  • Medications that might make an ileus worse might be stopped.

  • There are no medications that reliably treat ileus, though your caregiver may suggest a trial of certain medications.

  • If your condition is slow to resolve, you will be re-evaluated to be sure another condition, such as a blockage, is not present.

Ileus is common and usually has a good outcome. Depending on cause of your ileus, it usually can be treated by your caregivers with good results. Sometimes, specialists (surgeons or gastroenterologists) are asked to assist in your care.

HOME CARE INSTRUCTIONS

  • Follow your caregiver's instructions regarding diet and fluid intake. This will usually include drinking plenty of clear fluids, avoiding alcohol and caffeine, and eating a gentle diet.

  • Follow your caregiver's instructions regarding activity. A period of rest is sometimes advised before returning to work or school.

  • Take only medications prescribed by your caregiver. Be especially careful with narcotic pain medication, which can slow your bowel activity and contribute to ileus.

  • Keep any follow-up appointments with your caregiver or specialists.

SEEK MEDICAL CARE IF:

  • You have a recurrence of nausea, vomiting or abdominal discomfort.

  • You develop fever of more than 102° F (38.9° C).

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have severe abdominal pain.

  • You are unable to keep fluids down.