Health Library

Ileus

Definition

Ileus is a type of non-mechanical 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
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Causes

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 medication
  • Low blood supply to parts of the intestine

Risk Factors

Factors that increase your risk of getting 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:

The lining of your colon may need to be examined. This can be done with colonoscopy.

Treatment

If 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 or stopping a medication, treating an infection, or replacing electrolytes.

Other treatments may be used to help ease symptoms. These may 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, surgery is required if there is a perforation or other abnormality causing the ileus.

Prevention

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

Resources

American Gastroenterological Association
http://www.gastro.org
International Foundation for Functional Gastrointestinal Disorders
http://www.iffgd.org

Canadian Resources

Canadian Digestive Health Foundation
http://www.cdhf.ca
The Canadian Association of Gastroenterology (CAG)
http://www.cag-acg.org

References

Colonic ileus. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 5, 2013. Accessed July 25, 2013.
Intestinal obstruction and ileus. Patient UK website. Available at: http://www.patient.co.uk/doctor/Intestinal-Obstruction-and-Ileus.htm. Updated April 20, 2010. Accessed July 25, 2013.