Ileus (patient information): Difference between revisions
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==Overview== | ==Overview== | ||
Ileus is temporary absence of intestinal movements leading to decreased movement of food contents. Ileus occurs in the absence of intestinal obstruction and is most commonly seen in postoperative conditions. | Ileus is temporary absence of intestinal movements leading to decreased movement of food contents. Ileus occurs in the absence of [[Bowel obstruction (patient information)|intestinal obstruction]] and is most commonly seen in [[Surgery|postoperative]] conditions. | ||
==What are the symptoms?== | ==What are the symptoms?== | ||
*Abdominal swelling (distention) | *Abdominal swelling ([[Abdominal distension (patient information)|distention]]) | ||
*Abdominal fullness, gas | *Abdominal fullness, gas | ||
*Abdominal pain and cramping | *[[Abdominal pain (patient information)|Abdominal pain]] and cramping | ||
*Breath odor | *Breath odor | ||
*[[Constipation]] | *[[Constipation]] | ||
*Inability to pass gas | *Inability to pass gas | ||
*[[Vomiting]] | *[[Nausea and vomiting (patient information)|Vomiting]] | ||
==What are the causes?== | ==What are the causes?== | ||
Ileus may due to: | [[Ileus (patient information)|Ileus]] may due to: | ||
Paralytic ileus, also called pseudo-obstruction, is one of the major causes in infants and children. Causes of paralytic ileus may include: | [[Ileus (patient information)|Paralytic ileus]], also called pseudo-obstruction, is one of the major causes in infants and children. Causes of [[Ileus (patient information)|paralytic ileus]] may include: | ||
*Bacteria or viruses that cause intestinal infections ([[gastroenteritis]]) | *Bacteria or viruses that cause intestinal infections ([[Gastroenteritis (patient information)|gastroenteritis]]) | ||
*Chemical, electrolyte, or mineral imbalances (such as decreased potassium levels) | *Chemical, [[Electrolyte disturbance|electrolyte]], or mineral imbalances (such as decreased potassium levels) | ||
*Complications of abdominal surgery | *Complications of [[Abdominal surgery|abdominal surgery]] | ||
*Decreased blood supply to the intestines ([[mesenteric ischemia]]) | *Decreased blood supply to the intestines ([[Mesenteric ischemia (patient information)|mesenteric ischemia]]) | ||
*Infections inside the abdomen, such as [[appendicitis]] | *Infections inside the abdomen, such as [[appendicitis]] | ||
*Kidney or lung disease | *Kidney or lung disease | ||
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==Diagnosis== | ==Diagnosis== | ||
During a physical exam, the health care provider may find bloating, tenderness, or [[hernias]] in the abdomen. | During a physical exam, the health care provider may find bloating, tenderness, or [[Hernia (patient information)|hernias]] in the abdomen. | ||
Tests that show obstruction include: | Tests that show obstruction include: | ||
*Abdominal CT scan | *Abdominal [[Computed tomography|CT scan]] | ||
*[[Abdominal x-ray]] | *[[Abdominal x-ray]] | ||
*[[Barium enema]] | *[[Barium enema]] | ||
*Upper GI and small bowel series | *Upper [[Gastrointestinal tract|GI]] and small bowel series | ||
==When to seek urgent medical care?== | ==When to seek urgent medical care?== | ||
Call your health care provider if you: | Call your health care provider if you: | ||
*Cannot pass stool or gas | *Cannot pass stool or gas | ||
*Have a swollen abdomen (distention) that does not go away | *Have a swollen abdomen ([[Abdominal distension (patient information)|distention]]) that does not go away | ||
*Keep vomiting | *Keep [[Nausea and vomiting (patient information)|vomiting]] | ||
==Treatment options== | ==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. | Treatment involves placing a tube through the nose into the stomach or intestine to help relieve abdominal swelling ([[Abdominal distension (patient information)|distention]]) and [[Nausea and vomiting (patient information)|vomiting]]. [[Volvulus (patient information)|Volvulus]] of the large bowel may be treated by passing a tube into the [[rectum]]. | ||
Surgery may be needed | [[Surgery]] may be needed in case symptoms do not resolve over the course of days with treatment to relieve the obstruction if the tube does not relieve the symptoms, or if there are signs of [[Gangrene (patient information)|tissue death]]. | ||
===Medications to avoid=== | ===Medications to avoid=== | ||
{{MedCondContrPI | {{MedCondContrPI | ||
|MedCond =paralytic ileus|Hyoscyamine|Oxycodone|Polyethylene glycol-electrolyte solution (PEG-ES)}} | |MedCond =paralytic ileus|[[Hyoscyamine]]|[[Oxycodone]]|[[Polyethylene glycol-electrolyte solution (PEG-ES)]]}} | ||
==Prevention== | ==Prevention== | ||
Prevention depends on the cause. Treating conditions, such as electrolyte abnormalities, thyroid disorders, and | [[Prevention (medical)|Prevention]] depends on the cause. Treating some conditions, such as [[Electrolyte disturbance|electrolyte abnormalities]], thyroid disorders, and [[Diabetes mellitus type 2 (patient information)|diabetes]], that can predispose to ileus may reduce your risk. | ||
==What to expect (Outlook/Prognosis)?== | ==What to expect (Outlook/Prognosis)?== | ||
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Complications may include or may lead to: | Complications may include or may lead to: | ||
*Electrolyte (blood chemical and mineral) imbalances | *[[Electrolyte disturbance|Electrolyte (blood chemical and mineral) imbalances]] | ||
*[[Dehydration]] | *[[Dehydration (patient information)|Dehydration]] | ||
* | *Pierce ([[Gastrointestinal perforation|perforation]]) in the [[intestine|bowel wall]] | ||
*Infection | *Infection | ||
*[[Jaundice]] (yellowing of the skin and eyes) | *[[Jaundice (patient information)|Jaundice]] (yellowing of the skin and eyes) | ||
When ileus persists for more than 7 days the cause is usually intestinal obstruction. 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. | When ileus persists for more than 7 days the cause is usually [[Bowel obstruction (patient information)|intestinal obstruction]]. The [[Bowel obstruction (patient information)|obstruction]] blocks the blood supply to the [[intestine|bowel]], it may cause infection and [[Gangrene (patient information)|tissue death]] ([[Gangrene (patient information)|gangrene]]). Risks for [[Gangrene (patient information)|tissue death]] are related to the cause of the blockage and how long it has been present. [[Hernia (patient information)|Hernias]], [[Volvulus (patient information)|volvulus]], and [[Intussusception (patient information)|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. | In a newborn, paralytic ileus that destroys the bowel wall ([[necrotizing enterocolitis]]) is life-threatening and may lead to blood and lung infections. | ||
==Sources== | ==Sources== | ||
[http://www.nlm.nih.gov/medlineplus/ency/article/000260.htm National Library of Medicine] | [http://www.nlm.nih.gov/medlineplus/ency/article/000260.htm National Library of Medicine] | ||
Revision as of 20:06, 18 October 2020
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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
Ileus is temporary absence of intestinal movements leading to decreased movement of food contents. Ileus occurs in the absence of intestinal obstruction and is most commonly seen in postoperative conditions.
What are the symptoms?
- Abdominal swelling (distention)
- Abdominal fullness, gas
- Abdominal pain and cramping
- Breath odor
- Constipation
- Inability to pass gas
- Vomiting
What are the causes?
Ileus may due to:
Paralytic ileus, also called pseudo-obstruction, is one of the major causes 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
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 in case symptoms do not resolve over the course of days with treatment 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]]
- [[Polyethylene glycol-electrolyte solution (PEG-ES)]]
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 some conditions, such as electrolyte abnormalities, thyroid disorders, and diabetes, that can predispose to ileus may reduce your risk.
What to expect (Outlook/Prognosis)?
The outcome depends on the cause of the ileus. 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
- Pierce (perforation) in the bowel wall
- Infection
- Jaundice (yellowing of the skin and eyes)
When ileus persists for more than 7 days the cause is usually intestinal obstruction. The obstruction blocks the blood supply to the bowel, 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.