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Ileus occurs when there is a problem with motility in the small or large intestine (bowel). Motility is the process of moving ingested food and waste through the digestive tract. With normal motility, muscles in the bowel walls contract to move waste along. Signals from nerves tell the muscles when to contract. With ileus, motility slows down or stops completely. As a result, waste cannot move through the bowels and out of the body. This can cause abdominal discomfort and other symptoms. Treatment is needed to restore motility and relieve symptoms.
Ileus can be caused by the following:
Certain infections, such as that of the peritoneum (the lining of the abdomen)
Injury to blood vessels that supply blood to the abdomen
Electrolyte imbalance, such as low levels of sodium or potassium
Certain medications, such as strong pain medications
Certain kidney or lung diseases
Certain medical conditions, such as cystic fibrosis
Common symptoms of ileus include:
Abdominal swelling or bloating
Nausea and vomiting
Loss of appetite
Inability to keep food down
Inability to pass stool or gas
Your doctor will ask about your symptoms and health history. You’ll also have a physical exam. If ileus is suspected, tests may be done to confirm the problem. These can include:
Imaging tests. These provide pictures of the bowels. Common tests include X-rays and a computed tomography (CT) scan.
Blood tests. These check for infection and other problems such as dehydration.
Upper gastrointestinal (GI) series. This test takes X-rays of the upper digestive tract from the mouth to the small intestine. A contrast fluid is used. The contrast fluid coats the inside of the upper digestive tract so that it will show up clearly on X-rays.
In most cases, ileus resolves by itself. The goal is to manage symptoms until motility returns to normal. Treatment takes place in a hospital. As part of your care, the following may be done:
No food or drink is given by mouth. This allows your bowels to rest.
An intravenous (IV) line is placed in a vein in your arm or hand. The IV line is used to give fluids and nutrition. It may also be used to give medications. These may be needed to improve motility or to relieve pain. They may also be needed to treat any underlying infections or conditions you have.
A soft, thin, flexible tube (nasogastric tube) is inserted through your nose and into your stomach. The tube is used to remove extra gas and fluid in your stomach and bowels. This helps to relieve symptoms such as pain and swelling.
You’ll be observed in the hospital until your symptoms improve. Your doctor will tell you when you’re well enough to return home. This is usually within a few days.
In rare cases, problems may occur. Other treatments, such as surgery, may then be done. Your doctor will tell you more about other treatments, if needed.
After treatment, most people recover completely. In some cases, you may need to see your doctor for a follow-up appointment.
Call your doctor right away if you have any of the following:
Fever of 100.4°F (38°C) or higher
Abdominal swelling or pain that won’t go away
Getting full very easily with only small amounts of food or drink