Ileus

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Paralytic ileus
)
Ileus
Gangrene of the bowel causing gangrenous ileus
Pronunciation
SpecialtyGeneral surgery

Ileus is a disruption of the normal propulsive ability of the intestine. It can be caused by lack of peristalsis or by mechanical obstruction.[1] The word 'ileus' is from Ancient Greek eileós (εἰλεός, "intestinal obstruction"). The term 'subileus' refers to a partial obstruction.[2]

Signs and symptoms

Symptoms of ileus include, but are not limited to:[citation needed]

Cause

Decreased propulsive ability may be broadly classified as caused either by bowel obstruction or intestinal atony or paralysis. However, instances with symptoms and signs of a bowel obstruction occur, but with the absence of a mechanical obstruction, mainly in acute colonic

FDA reported gastrointestinal ileus as an adverse effect of the medication semaglutide, with frequency and causal relationship unknown.[3]

Bowel obstruction

A bowel obstruction is generally a mechanical obstruction of the gastrointestinal tract.

Intestinal paralysis

Paralysis of the intestine is often termed paralytic ileus, in which the intestinal paralysis not need to be complete, but it must be sufficient to prohibit the passage of food through the intestine and lead to intestinal blockage. Paralytic ileus is a common side effect of some types of surgery, commonly called postsurgical ileus. It can also result from certain drugs and from various injuries and illnesses, such as acute pancreatitis. Paralytic ileus causes constipation and bloating. On listening to the abdomen with a stethoscope, no bowel sounds are heard because the bowel is inactive.[citation needed]

A temporary paralysis of a portion of the intestines occurs typically after abdominal surgery. Since the intestinal content of this portion is unable to move forward, food or drink should be avoided until

atony or paralysis may be caused by inhibitory neural reflexes, inflammation or other implication of neurohumoral peptides.[citation needed
]

Risk factors

Treatment

Traditionally,

nothing by mouth was considered to be mandatory in all cases, but gentle feeding by enteral feeding tube may help to restore motility by triggering the gut's normal feedback signals, so this is the recommended management initially.[5] When the patient has severe, persistent signs that motility is completely disrupted, nasogastric suction and parenteral nutrition
may be required until passage is restored. In such cases, continuing aggressive enteral feeding causes a risk of perforating the gut.

Several options are available 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

randomized controlled trials that chewing gum, as a form of 'sham feeding', may stimulate gastrointestinal motility in the post-operative period and reduce the duration of postoperative ileus.[6]

If possible the underlying cause is corrected (e.g. replace electrolytes).

Other animals

Ileus is a cause of

prokinetics, and anti-inflammatories.[7]

Terminology

ICD-10 coding reflects both impaired-peristalsis senses and mechanical-obstruction senses of the term as modified by various adjectives.[1] Some authors have argued for trying to reserve the term for the impaired-peristalsis senses,[8][9] under which prescription certain older terms such as "gallstone ileus" and "meconium ileus", although now technically misnomers, are still accepted as correct owing to their long-established usage.[10]

References

  1. ^ a b World Health Organization (WHO), ICD-10 coding. K56.x series., retrieved 2021-07-28.
  2. ^ "Ileus Intestinal Obstruction". www.baermed.ch. Retrieved 2019-10-05.
  3. ^ Zoler, Mitchel L. (28 September 2023). "FDA Gives Ozempic Two Drug Safety–Related Label Changes". Medscape.
  4. PMID 11194218
    .
  5. .
  6. .
  7. ^ a b c Larson, Erica. "Equine Postoperative Ileus Insights". www.thehorse.com. The Horse. Retrieved 4 July 2014.
  8. ^ Townsend CM, Beauchamp RD, Evers BM, Mattox KL (2004). "The biological basis of modern surgical practice". Sabiston Textbook of Surgery (17th ed.). Elsevier Saunders.
  9. PMID 2403907
    .
  10. ^ Feldman M, Friedman LS, Brandt LJ, Sleisenger MH (2006). "Intestinal obstruction and ileus". Sleisenger & Fordtran's Gastrointestinal and Liver Disease (8th ed.). Elsevier Saunders.

External links