Ileus medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

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).

Contraindicated medications

Paralytic ileus is considered an absolute contraindication to the use of the following medications:

• Hyoscyamine
• Methscopolamine bromide
• Oxycodone
• Polyethylene glycol-electrolyte solution (PEG-ES)