Your intestines are about 28 feet long. This means the foods you eat have a long way to travel before they’re fully digested and excreted.
Your intestines complete this task using muscle contractions that move in a wave-like motion. Known as peristalsis, these muscle contractions move your digested food forward.
However, if something such as muscle or nerve problems 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 somewhere in the intestines that leads to a buildup and potential 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. However, people with an ileus often don’t know that food is building up in their intestines, so they continue to eat. This pushes more and more material toward the buildup.
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.
An ileus is common after surgery because people are often prescribed medication that can slow intestinal movement. This is a type of paralytic ileus.
In this instance, the intestine is not blocked. Rather, it isn’t moving properly. The result is little to no movement of digested food through your intestines.
Examples of medications that can cause a paralytic ileus include:
- hydromorphone (Dilaudid)
- tricyclic antidepressants, such as amitriptyline and imipramine (Tofranil)
However, there are several other possible causes of an ileus. These include:
- intestinal cancer
- Parkinson’s disease, which affects muscles and nerves in the intestines
- Crohn’s disease, which rarely causes a blockage but may cause the intestinal walls to thicken due to autoimmune inflammation
These are the most common causes of an ileus in adults. Children can also have an ileus.
Intussusception is the most common cause of an ileus in children. This is when a part of the intestine “telescopes” or slides into itself.
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 abdomen to take on a tight and swollen appearance.
If you experience these symptoms, especially after surgery, it’s important to seek immediate medical attention.
The treatment for an ileus depends on its severity. The severity can depend on whether it’s causing a partial or complete intestinal obstruction, or if it’s a paralytic ileus.
Sometimes a condition like Crohn’s disease or diverticulitis will mean that part of the intestine is not moving. However, some bowel material can get through.
In this instance, if you are otherwise stable, your 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 may be needed to repair or move the affected portion of the bowel.
A complete obstruction is a medical emergency.
Treatment will depend on your overall health. For example, extensive abdominal surgery is not suitable for some people. This includes older adults 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, however.
Treatment for a paralytic ileus starts by figuring out the underlying cause.
If medication is the cause, your doctor may be able to prescribe another medication to stimulate gastrointestinal motility (intestine movement). One medication they may prescribe is metoclopramide (Reglan).
If possible, discontinuing the medications that caused the ileus can also help. However, you should not stop taking a medication, especially an antidepressant, without your doctor’s approval.
Treatment without surgery is possible during the early stages of a paralytic ileus. You may still require a hospital stay to get the proper fluids intravenously until the issue is fully resolved.
In addition to intravenous fluid hydration, your doctor may use nasogastric decompression. During this procedure, a tube is inserted into your nasal cavity to reach your stomach. The tube suctions out the extra air and material that you may otherwise vomit.
Most surgery-related ileus will resolve within 2 to 4 days after surgery. However, some people do require surgery if the condition does not improve.
Considerations for surgery
Your intestines are very long, so you can live without a portion of them. While it may affect the digestive process, most people do live a healthy life with part of their intestine removed.
In some instances, your doctor may have to remove your entire intestine. In this case, your doctor will create a special pouch called an ostomy. This bag allows stool to drain from your remaining gastrointestinal tract.
You have to care for the ostomy, but you can live without your intestine after an ileus.
An ileus can cause extreme abdominal discomfort.
Symptoms associated with an ileus include:
Your doctor will usually first listen to a description of your symptoms. You’ll likely be asked about any history of medical conditions, prescribed medications, and surgeries, especially recent procedures.
Your doctor may then conduct a physical exam, looking at your abdomen for signs of swelling or tightness. Your doctor will also listen with a stethoscope to your abdomen for typical bowel sounds.
If your bowels aren’t moving because of an ileus, your doctor may not hear anything or may hear excessive bowel sounds.
Imaging studies are usually ordered after a thorough physical exam. These can indicate where an ileus is located by showing a buildup of gas, an enlarged intestine, or even an obstruction. Your doctor may use these to identify areas where your bowel content seems to be concentrated.
Examples of imaging studies include:
- Plain film X-ray. This may show signs of trapped gas and possibly the obstruction, but plain film X-rays aren’t always the most conclusive way to diagnose an ileus.
- CT scan. This scan provides more detailed X-ray images to help your doctor identify the potential area where the ileus is located. A CT scan typically uses contrast agents injected intravenously or taken orally.
- Ultrasound. An ultrasound is more commonly used to identify an ileus in children.
In some instances, your doctor may use a diagnostic procedure known as an air or barium enema.
During this procedure, the doctor inserts air or barium sulfate, a radiopaque substance, through your rectum into your colon. While the doctor does this, a technician takes X-rays of your abdomen. The air or barium shows up on the X-ray to help the technician view any potential obstruction.
In some children, this procedure can treat an ileus caused by intussusception.
According to 2015 research, ileus is the
Surgical procedures on the abdomen that involve handling the intestines commonly cause a stoppage of intestinal movement for a period of time. This allows the surgeon to access your intestines.
Sometimes normal peristalsis can be slow to return. Other people are more likely to later experience scar tissue formation that can also lead to an ileus.
A number of medical conditions can increase your risk of ileus. They include:
- electrolyte imbalance, such as those involving potassium and calcium
- history of intestinal injury or trauma
- history of intestinal disorder, such as Crohn’s disease and diverticulitis
- history of exposure to high-energy radiation (irradiation) 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 ileus, especially since they tend to take more medications that could potentially slow the movement of material through the intestines.
An ileus is referred to as a “nonmechanical bowel obstruction” because it occurs when the digestive tract stops normal movement. However, some conditions may cause a physical blockage, or mechanical obstruction, of the intestines.
Conditions that may cause a physical blockage of the intestines include the following:
An ileus can develop into a serious and potentially life threatening situation.
Two of the most severe complications are necrosis and peritonitis.
Necrosis is the untimely death of cells or tissue. It can happen when an obstruction cuts off the blood supply to the intestine.
Without blood, oxygen cannot get to the tissue, causing it to die. Dead tissue weakens the intestinal wall, making it easy for the intestine to tear and leak bowel contents. This is known as a bowel perforation.
A bowel perforation due to necrosis can cause peritonitis. This is a serious inflammation in the abdominal cavity caused by bacteria or fungus.
Your bowel contains many bacteria, like E. coli. The bacteria are supposed to remain in your intestines, not roam free in your body cavity. Bacterial peritonitis can turn into sepsis, a life threatening condition that can result in shock and organ failure.
Most of the risk factors associated with an ileus, such as injury or chronic illness, are not preventable.
If you’re going to have surgery, the possibility of getting an ileus should be considered. However, it should not keep you from having needed surgery.
Being aware of the symptoms of an ileus is important in seeking prompt treatment to keep it from getting worse.
An ileus is highly treatable.
If you’ve had a recent surgery or have other risk factors for an ileus, you should be aware of the symptoms.
Seeking medical care as soon as possible is important so the ileus can potentially be resolved without invasive medical treatment.