Ileus (patient information)

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Ileus (patient information)
Overview
What are the symptoms?
What are the causes?
Diagnosis
When to seek urgent medical care?
Treatment options
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maheep Singh Sangha, M.B.B.S.

Overview

Intestinal obstruction is a partial or complete blockage of the bowel that prevents the contents of the intestine from passing through.

What are the symptoms?

• Abdominal swelling (distention)
• Abdominal fullness, gas
• Abdominal pain and cramping
• Breath odor
• Constipation
• Diarrhea
• Inability to pass gas
• Vomiting

What are the causes?

Obstruction of the bowel may due to:

• A mechanical cause, which means something is in the way.
• Ileus, a condition in which the bowel doesn't work correctly but there is no structural problem.

Paralytic ileus, also called pseudo-obstruction, is one of the major causes of intestinal obstruction in infants and children. Causes of paralytic ileus may include:

• Bacteria or viruses that cause intestinal infections (gastroenteritis)
• Chemical, electrolyte, or mineral imbalances (such as decreased potassium levels)
• Complications of abdominal surgery
• Decreased blood supply to the intestines (mesenteric ischemia)
• Infections inside the abdomen, such as appendicitis
• Kidney or lung disease
• Use of certain medications, especially narcotics

Mechanical causes of intestinal obstruction may include:

• Adhesions or scar tissue that forms after surgery
• Foreign bodies (eaten materials that block the intestines)
• Gallstones (rare)
• Hernias
• Impacted stool
• Intussusception (telescoping of one segment of bowel into another)
• Tumors blocking the intestines
• Volvulus (twisted intestine)

Diagnosis

During a physical exam, the health care provider may find bloating, tenderness, or hernias in the abdomen.

Tests that show obstruction include:

• Abdominal CT scan
• Abdominal x-ray
• Barium enema
• Upper GI and small bowel series

When to seek urgent medical care?

Call your health care provider if you:

• Cannot pass stool or gas
• Have a swollen abdomen (distention) that does not go away
• Keep vomiting

Treatment options

Treatment involves placing a tube through the nose into the stomach or intestine to help relieve abdominal swelling (distention) and vomiting. Volvulus of the large bowel may be treated by passing a tube into the rectum.

Surgery may be needed to relieve the obstruction if the tube does not relieve the symptoms, or if there are signs of tissue death.

Medications to avoid

Patients diagnosed with paralytic ileus should avoid using the following medications:

• Hyoscyamine
• Oxycodone
  If you have been diagnosed with paralytic ileus, consult your physician before starting or stopping any of these medications.

Prevention

Prevention depends on the cause. Treating conditions, such as tumors and hernias, that can lead to obstruction may reduce your risk of getting an obstruction.

Some causes of obstruction cannot be prevented.

What to expect (Outlook/Prognosis)?

The outcome depends on the cause of the blockage. Most of the time the cause is easily treated.

Possible complications

Complications may include or may lead to:

• Electrolyte (blood chemical and mineral) imbalances
• Dehydration
• Hole (perforation) in the intestine
• Infection
• Jaundice (yellowing of the skin and eyes)

If the obstruction blocks the blood supply to the intestine, it may cause infection and tissue death (gangrene). Risks for tissue death are related to the cause of the blockage and how long it has been present. Hernias, volvulus, and intussusception carry a higher gangrene risk.

In a newborn, paralytic ileus that destroys the bowel wall (necrotizing enterocolitis) is life-threatening and may lead to blood and lung infections.

Sources

National Library of Medicine