What is ileus

Definition and Types

Ileus refers to the disruption of normal intestinal function, preventing the movement of digestive contents through the bowel. There are two primary types: mechanical ileus, caused by physical obstructions, and functional (paralytic) ileus, resulting from loss of normal muscle contractions.

Mechanical Ileus

Mechanical ileus occurs when something physically blocks the intestinal passage. Common causes include:

• Adhesions from previous abdominal or pelvic surgery
• Hernias where tissue protrudes through weakened muscle
• Tumors or cancerous growths narrowing the intestine
• Impacted stool or foreign objects
• Volvulus (twisted bowel) or intussusception (telescoping bowel)

Functional (Paralytic) Ileus

Paralytic ileus involves temporary loss of normal intestinal muscle contractions without a physical blockage. This commonly occurs after abdominal surgery as the intestines recover. Other causes include severe infections, electrolyte imbalances, medications like opioids, and spinal injuries affecting nerve signals to the intestines.

Symptoms and Diagnosis

Symptoms of ileus include severe abdominal pain, distension, nausea, vomiting, and constipation with inability to pass gas. Diagnosis typically involves physical examination, abdominal X-rays to detect gas patterns, CT scans to identify blockages, and sometimes colonoscopy for lower bowel examination. Blood tests may reveal electrolyte imbalances.

Treatment Options

Conservative treatment for functional ileus includes bowel rest, intravenous fluids, and nasogastric tube placement to relieve pressure. Mechanical ileus often requires surgery to remove the obstruction. Medical management focuses on addressing underlying causes, correcting electrolyte imbalances, and avoiding medications that worsen intestinal motility.