Ileus overview: Difference between revisions
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Ileus is a disruption of the normal propulsive [[gastrointestinal tract|gastrointestinal]] motor activity from non-mechanical mechanisms.<ref>Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. The biological basis of modern surgical practice. 17/e. Elsevier Saunders, 2004.</ref><ref>Livingston EH, Passaro EP. Postoperative ileus. Dig Dis Sci 1990;35:121.</ref> Motility disorders that result from structural abnormalities are termed mechanical [[bowel obstruction]]. Some mechanical obstructions are misnomers, such as gallstone ileus and [[Meconium|meconium ileus]], and are not true examples of ileus by the classic definition. <ref>Feldman M, Friedman LS, Brandt LJ, Sleisenger MH. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Intestinal Obstruction and Ileus. 8/e. Elsevier Saunders, 2006.</ref> | Ileus is a disruption of the normal propulsive [[gastrointestinal tract|gastrointestinal]] motor activity from non-mechanical mechanisms.<ref>Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. The biological basis of modern surgical practice. 17/e. Elsevier Saunders, 2004.</ref><ref>Livingston EH, Passaro EP. Postoperative ileus. Dig Dis Sci 1990;35:121.</ref> Motility disorders that result from structural abnormalities are termed mechanical [[bowel obstruction]]. Some mechanical obstructions are misnomers, such as gallstone ileus and [[Meconium|meconium ileus]], and are not true examples of ileus by the classic definition. <ref>Feldman M, Friedman LS, Brandt LJ, Sleisenger MH. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Intestinal Obstruction and Ileus. 8/e. Elsevier Saunders, 2006.</ref> | ||
==Treatment== | |||
===Medical Therapy=== | |||
[[Nil per os]] (NPO or Nothing by Mouth) is mandatory in all cases. [[Nasogastric intubation|Nasogastric suction]] and [[parenteral]] feeds may be required until passage is restored. There are several options in the case of paralytic ileus. Most treatment is supportive. If caused by medication, the offending agent is discontinued or reduced. Bowel movements may be stimulated by prescribing [[lactulose]], [[erythromycin]] or in severe cases, ([[Ogilvie's syndrome]]) [[neostigmine]]. If possible the underlying cause is corrected (e.g. replace electrolytes). | |||
==References== | ==References== | ||
Revision as of 16:09, 20 March 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Ileus is a disruption of the normal propulsive gastrointestinal motor activity from non-mechanical mechanisms.[1][2] Motility disorders that result from structural abnormalities are termed mechanical bowel obstruction. Some mechanical obstructions are misnomers, such as gallstone ileus and meconium ileus, and are not true examples of ileus by the classic definition. [3]
Treatment
Medical Therapy
Nil per os (NPO or Nothing by Mouth) is mandatory in all cases. Nasogastric suction and parenteral feeds may be required until passage is restored. There are several options in the case of paralytic ileus. Most treatment is supportive. If caused by medication, the offending agent is discontinued or reduced. Bowel movements may be stimulated by prescribing lactulose, erythromycin or in severe cases, (Ogilvie's syndrome) neostigmine. If possible the underlying cause is corrected (e.g. replace electrolytes).
References
- ↑ Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. The biological basis of modern surgical practice. 17/e. Elsevier Saunders, 2004.
- ↑ Livingston EH, Passaro EP. Postoperative ileus. Dig Dis Sci 1990;35:121.
- ↑ Feldman M, Friedman LS, Brandt LJ, Sleisenger MH. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Intestinal Obstruction and Ileus. 8/e. Elsevier Saunders, 2006.