Postoperative ileus is a prolonged absence of bowel function after surgical procedures, usually abdominal surgery. It is a common postoperative complication with unclear etiology and pathophysiology. It is a benign condition that usually resolves with minimal intervention.
Prolonged postoperative ileus is said to occur when the patient has symptoms or signs of paralytic ileus (obstipation and intolerance of oral intake) that persist for more than three to five days (depending on the nature of the surgery and what is considered "typical"), without evidence for mechanical bowel obstruction ...
Pain is usually diffuse, persistent without peritoneal signs. Other common signs and symptoms include nausea and vomiting, as well as delayed or inability to pass flatus, and inability to tolerate oral diet. The patient is often distended and tympanic on physical exam with mild diffuse tenderness.
Frequently, ileus occurs after major abdominal operations, but it may also occur after retroperitoneal and extra-abdominal surgery, as well as general anesthesia alone. The longest duration of ileus is noted to occur after colon and rectal surgery.
If ileus persists, it can cut off blood supply to the intestines and cause tissue death. This can result in an intestinal tear or infection of the abdominal cavity that can be life threatening.
Complications of postoperative ileus include prolonged hospital stay and increased healthcare costs. Postoperative ileus typically resolves within a few days, although continued ileus introduces complications associated with lack of enteral intake, electrolyte derangements, malnutrition, and poor patient satisfaction.
In most cases, time and TLC will resolve your ileus and lessen your symptoms, but in severe cases you need immediate medical attention. An ileus is a condition in which the small intestine doesn't work normally. Normally, the muscles of the small intestines squeeze to move air, fluid, and food through it.
In postoperative ileus, inhibition of small-bowel motility is transient, and the stomach recovers within 24 to 48 hours, whereas colonic function takes 48 to 72 hours to return. Determination of the end of postoperative ileus is somewhat controversial.
Normally, paralytic ileus passes within a few days. If it lasts more than five days, your healthcare provider may investigate further to see if there's something else going on. Most cases improve without medication.
Conservative management. One of the most important steps in tackling ileus is early mobilization. That means getting patients out of the bed to walk in order to exert a mechanical stimulation of intestines.
Ileus is an occlusion or paralysis of the bowel preventing the forward passage of the intestinal contents, causing their accumulation proximal to the site of the blockage. The passage of intestinal contents can be blocked either partially (subileus, incomplete ileus) or totally (complete ileus).
In the majority of patients, postoperative ileus resolves within 5 to 7 days. Passage of flatus signifies the return of colonic function and usually indicates that the ileus has resolved.
Peripherally selective opioid antagonists are an option for the treatment of postoperative ileus. Methylnaltrexone (Relistor) and alvimopan (Entereg) are approved by the Food and Drug Administration.
Postoperative ileus (POI) is a common complication following colon and rectal surgery, with reported incidence ranging from 10 to 30%.
Treatment of ileus involves continuous nasogastric suction, nothing by mouth, IV fluids and electrolytes, a minimal amount of sedatives, and avoidance of opioids and anticholinergic medications. Maintaining an adequate serum potassium level (> 4 mEq/L [> 4.00 mmol/L]) is especially important.
Patients with post-operative ileus, opioid-induced constipation, or a soft stool will benefit from a stimulant laxative, such as senna or picosulphate. *In resistant cases, additional therapy can be given via manual evacuation.
Prucalopride is a safe and effective treatment to reduce postoperative ileus and systemic inflammation without affecting postoperative complications in patients undergoing elective gastrointestinal surgery.
The doctor may do a number of tests. These tests may include X-rays, blood tests, and a CT scan. Testing can help the doctor be sure that nothing is blocking the intestines. Most people who have ileus need to be treated in the hospital.
Obstruction of the bowel may be due to: A mechanical cause, which means something is blocking the bowel. Ileus, a condition in which the bowel does not work correctly, but there is no structural problem causing it.
The severity of signs and symptoms often depends on the presence of intestinal obstruction and may include abdominal pain, bloating, loss of appetite, feeling of fullness, nausea, vomiting, and inability to pass gas or stool. During an abdominal assessment, healthcare providers may hear reduced bowel sounds.
Signals from nerves tell the muscles when to contract. With ileus, this movement slows down or stops completely. As a result, waste can't move through the bowels and out of the body.
Remove stalks, stems, pips, seeds and skins from fruit and vegetables. Chop and cook vegetables well. Reduce tough, fibrous fruit and vegetables – chop these foods finely where possible (e.g. celery, mango). Avoid dried fruits, nuts and seeds.
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. People may pass watery stool.