Ileus is a temporary and often painful lack of movement in the intestines. It is a serious condition because, if left untreated, it can cut off blood supply to the intestines and cause tissue death.

This can result in an intestinal tear or infection of the abdominal cavity that can be life threatening. Ileus occurs when the intestines do not move food through in the usual way. It often occurs after abdominal surgery.

Read on to learn more about recognizing and treating an ileus.

A pipe marked with a blockage, to represent intestinal blockage that ileus causes.Share on Pinterest
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Typically, muscles in the intestines contract and relax to cause a wave-like motion called peristalsis. This movement helps food travel through the intestines.

When an ileus occurs, it stops peristalsis and prevents food particles, gas, and liquids from passing through the digestive tract.

If people continue to eat solid food, it can lead to a backlog of food particles, which may cause total or partial obstruction of the intestines.

An ileus most commonly occurs after abdominal or pelvic surgery. According to some estimates, ileus, or another bowel obstruction, is the second most common cause for readmission to the hospital within the first month following surgery.

This may be because:

  • normal peristalsis is slow to return after surgery
  • medications prescribed after surgery affect intestinal movement
  • post-surgical scarring can cause a blockage

Some medications that affect muscles and nerves in the digestive tract include:

  • opioid pain-relieving drugs
  • anticholinergics, which treat many conditions, including bladder conditions, COPD, and Parkinson’s disease.
  • calcium channel blockers, which treat heart conditions

Other causes of ileus include infections and disorders of the muscles and nerves, such as Parkinson’s disease.

In children, intussusception or ‘telescoping’ often causes ileus. Intussusception is when part of the intestine slides into itself, much like the closing of a telescope.

Paralytic ileus occurs when the bowel is not moving correctly, and food cannot move through the intestines, creating an obstruction. The condition usually affects the small intestine, but it may also affect the colon and stomach.

Because the bowels do not move, fluids and gas accumulate, which stretch the bowel wall, causing vomiting, decreased bowel sounds, and constipation.

Paralytic ileus happens if the nerves in the intestinal wall are not working as they should.

Causes of paralytic ileus include:

Although the condition may correct itself, it is serious. If it goes on for too long without treatment, it can cause severe, life threatening problems.

Meconium is a newborn baby’s first stool that comprises materials they ingested while in the uterus.

Experts estimate that 80–90% of newborns with meconium ileus have cystic fibrosis.

The meconium in newborns with cystic fibrosis can block a part of their small intestine called the ileum. It happens in around 20% of infants with the condition.

Cystic fibrosis affects cells that produce mucus and digestive juices, meaning they become thicker and stickier. These fluids then block the digestive system and other parts of the body.

Some factors that may increase the risk of ileus include:

Symptoms of ileus include:

Ileus and intestinal obstruction have similarities. However, ileus results from muscle or nerve problems that stop peristalsis, while an obstruction is a physical blockage in the digestive tract.

However, a type of ileus known as paralytic ileus can cause a physical block due to a food buildup in the intestines.

Other causes for obstruction include:

To diagnose ileus, a doctor first asks about symptoms and takes a complete medical history. They may include:

  • current or past medical conditions
  • medication use
  • surgical history

The doctor then performs a physical examination to check for swelling or pain in the abdomen. They may use a stethoscope to listen for bowel sounds. Absent or excessive bowel noises suggest an ileus, although doctors usually require imaging tests to confirm a diagnosis.

Imaging tests

Imaging tests help locate an ileus by highlighting abnormalities in the intestine, such as a gas buildup or an enlarged intestine. Sometimes, there may be a physical blockage. Tests used include:

  • X-ray: An abdominal X-ray may show some obstructions, but they do not always identify ileus or other intestinal problems.
  • Computerized tomography (CT). A CT scan provides more detail than standard X-ray images. These scans are more likely to highlight an ileus because they show the intestines from different angles. Sometimes, a person swallows a special dye that creates a clearer image.
  • Ultrasound. Doctors often diagnose children with a suspected ileus using an ultrasound scan. Ultrasound scans typically show a coiled area in the intestine when intussusception is present.
  • Air or barium enema. This involves inserting air or liquid barium into the colon through the rectum and then taking X-rays of the abdomen. This procedure can resolve an ileus caused by intussusception in some children.

Treatment options for an ileus include waiting for the ileus to resolve, making dietary changes, or adjusting medication use. Sometimes, an individual needs surgery. The treatment depends on the severity of the ileus and its underlying cause.

Possible treatments for an ileus include:

Hospital care

Surgery-related ileus often heals within a few days of surgery, and paralytic ileus usually resolves once a person makes changes to their medication. However, individuals may require a stay in the hospital until the issue resolves fully.

Treatment at the hospital can include:

  • intravenous fluids to prevent dehydration
  • nasogastric decompression, which uses a tube to suction out materials that a person might otherwise vomit up
  • pain relief

Dietary changes

Conditions such as Crohn’s disease and diverticulitis can cause a partial intestinal block. Some bowel material can pass through the intestine, but not all of it.

A doctor may recommend that people with this disease follow a low-fiber diet to make it easier to pass stool. This involves cutting down on whole-grain foods, raw vegetables, and nuts.

Medication changes

Doctors may recommend that the individual stops using the medication that is causing the ileus. However, it is essential to do so only with medical supervision. A person may experience side effects if they stop some antidepressants and other medications suddenly.

Surgery

If medication or dietary changes do not resolve the ileus, or if the blockage is severe, then a person may need surgery.

Surgical procedures involve removing the blockage or repairing or removing the damaged portion of the intestine.

Older adults or people with colon cancer may not be suitable candidates for extensive surgery. Instead, a surgeon may fit a stent (tube) into the person’s intestines to keep the intestine open and allow bowel materials to pass through more easily.

In some cases, a surgeon may need to remove a person’s entire intestine. In this case, the surgeon performs an ostomy. They create an opening in the abdomen, called a stoma, allowing stool to pass from the intestine into a pouch that collects stool.

Although an ostomy requires care, a person can live a healthy life without their intestine.

An undiagnosed and untreated ileus can cause severe and potentially life-threatening complications, such as:

  • Necrosis: Necrosis is tissue death. Necrosis occurs when blood cannot reach the intestine. The intestinal tissue dies and becomes weakened. A weak intestinal wall is prone to tearing, which causes bowel contents to leak out.
  • Infection: Bowel contents are full of bacteria. When they leak into the abdominal cavity, they cause peritonitis, which is a serious infection. Bacterial peritonitis can lead to sepsis, a widespread life threatening infection.

After surgery, intestinal function usually returns to normal within 72 hours. If it persists for longer than this, it is considered a paralytic ileus.

Recovering from an ileus depends on whether the person receives appropriate treatment for the underlying cause.

Ileus is a relatively common condition that is straightforward to treat. It is especially prevalent in those who have undergone recent abdominal or pelvic surgery.

Individuals can improve their outlook and reduce the risk of complications by understanding the symptoms. It is essential to seek prompt medical treatment as soon as symptoms appear.

Ileus means that the intestines are not moving correctly and cannot push food through the digestive system.

Surgery is a common cause of ileus, but medications, cystic fibrosis, other health issues, injuries, and infections can also cause the condition.

Treatment depends on the underlying cause and may involve medications, dietary changes, or surgery.

Anyone experiencing symptoms of ileus, including stomach pain, severe constipation, vomiting, and bloating, should seek medical attention. Ileus can cause severe, life threatening complications if left untreated.