Do you know what an Ileus is?

Your intestines are about 25 feet long. This means the foods you eat have a long way to travel before they’re fully digested or excreted. Your intestines complete this task by moving in a wave-like motion. Known as peristalsis, these muscle contractions move forward your digested food. However, if something slows down or blocks this motion, the result can be a major traffic jam in your intestines.

Ileus is the medical term for this lack of movement in the intestines that leads to a buildup or blockage of food material. An ileus can lead to an intestinal obstruction. This means no food material, gas, or liquids can get through. It can occur as a side effect after surgery. However, there are other causes of this condition.

An ileus is a serious concern. But people often don’t know that food is building up in their intestines and continue to eat. This pushes more and more material toward the blockage. Without treatment, the ileus can perforate or tear the intestine. This causes bowel contents, which have high levels of bacteria, to leak into areas of your body cavity. This can be deadly. If an ileus does occur, it’s important to get treatment as quickly as possible.

What are the symptoms of an ileus?
An ileus can cause extreme abdominal discomfort. Symptoms associated with ileus include:
• abdominal cramping
• appetite loss
• feeling of fullness
• constipation
• inability to pass gas
• stomach swelling
• nausea
• vomiting, especially vomiting stool-like contents

Gastrointestinal symptoms are the most common signs of an ileus. Your stomach and intestines will start to fill with gas that can’t pass out the rectum. This causes the stomach to take on a tight and swollen appearance.
If you experience these symptoms, especially after surgery, it’s important to seek immediate medical attention.

What are the causes of an ileus?
It is common after surgery because people are often prescribed medication that can slow intestinal movement. This is called a paralytic ileus. In this instance, the intestine isn’t blocked. Rather, it isn’t moving properly. The result is little or no movement of digested food through the intestines.
Examples of medicines that can cause a paralytic ileus include:

• hydromorphone (Dilaudid)
• morphine
• oxycodone
• tricyclic antidepressants, such as amitriptyline and imipramine (Tofranil)
However, there are several other causes of an ileus. These include:
• colon cancer
• Crohn’s disease, which causes the intestinal walls to get thicker
• Diverticulitis
• Parkinson’s disease, which affects muscles and nerves in the intestines

These are the most common ileus causes in adults. Children can also be afflicted. According to The Mayo Clinic, intussusception is the most common cause for the disorder in children. This is when the intestine “telescopes,” or slides into itself.

Risk factors
Ileus is the second most common reason for hospital readmission in the first 30 days after surgery. It is more likely if you’ve recently had abdominal surgery.
Surgical procedures on the abdomen usually involve stopping intestinal movement for a period of time; this allows the surgeon to access your intestines. Sometimes peristalsis can be slow to return. Other people are more likely to experience scar tissue that can also lead to an ileus.

A number of medical conditions can increase your risk of ileus. They include:
• electrolyte imbalance, especially for potassium and calcium
• history of intestinal injury or trauma
• history of intestinal disorder, such as Crohn’s disease and diverticulitis
• sepsis
• history of irradiation of or near the abdomen
• peripheral artery disease
• rapid weight loss

Aging also naturally slows down how fast the intestines move. An older adult is at greater risk for having it, especially since they tend to take more medications that could potentially slow digestion.

Treatment

Treatment depends on its severity. Examples include:

Partial obstruction

Sometimes a condition like Crohn’s disease or Diverticulitis will mean that part of the intestine isn’t moving. But some bowel material can get through. In this instance, a doctor may recommend a low-fiber diet. This can help reduce the bulky stool, making it easier to pass. However, if that doesn’t work, surgery to repair or move the affected portion of the bowel may be needed.

Complete obstruction

A complete obstruction is a medical emergency. Treatment will depend upon your overall health. For example, some people can’t handle an extensive abdominal surgery. This includes the very elderly and those with colon cancer. In this case, a doctor may use a metal stent to make the intestine more open. Ideally, food will start to pass with the stent. Abdominal surgery to remove the blockage or the damaged intestine portion may still be needed.

Paralytic ileus

Treatment starts by identifying the underlying cause. If medicine is the cause, a doctor may be able to prescribe another medication to encourage motility (intestine movement). An example is Metoclopramide (Reglan). Discontinuing the medications that caused it, if possible, can also help. However, you shouldn’t stop taking a medicine, especially an antidepressant, without your doctor’s approval.

Treatment without surgery is possible during the early stages, but until the issue is fully resolved you may still require a hospital stay to get the proper fluids. A doctor may also use a nasogastric tube. Known as nasogastric decompression, this procedure calls for a tube to be inserted into your nasal cavity to reach your stomach. Essentially the tube suctions out the extra air and material that you may otherwise vomit.

According to Mount Sinai Hospital, most surgery-related ileus will resolve in two-to-three days. However, some people do require surgery if the condition doesn’t improve.

Considerations for surgery

Your intestines are very long, so you can live without a portion of it. While it may affect the digestive process, most people do live a healthy life with a part of their intestine removed.
In some instances, a doctor may have to remove the entire intestine. In this case, a doctor will create a special pouch called an ostomy. The bag allows stool to drain from the stomach. You have to care for the ostomy, but you can live without your intestine after an ileus.

Outlook
An ileus is common, but it’s highly treatable. If you’ve had a recent surgery, or have other risk factors, you should be aware of the symptoms. Seeking medical care is important in the hope it can be resolved without invasive medical treatment.