Ileus

Ileus is when your intestines can’t push food along the GI tract. There’s nothing blocking your intestines, but the muscles and nerves that trigger their natural movements (called peristalsis) aren’t working like they’re supposed to. As food, gas and fluids settle in your intestines, you can have unpleasant symptoms like bloating and nausea.

Ileus is an acute condition. This means it’s temporary and reversible if you get treatment for the underlying cause. Your digestion may return to normal within two or three days.

Healthcare providers also use other names for ileus, like:

• Postoperative ileus
• Paralytic ileus
• Adynamic ileus
• Functional ileus
• Paresis

Symptoms of ileus

Symptoms of ileus may include:

• Bloating
• Constipation
• Nausea and vomiting
• Not being able to pass gas
• Swelling in your belly (distention)

These symptoms have many possible causes. If they’re severe or last more than three days, see a healthcare provider.

Ileus causes

Many different things can lead to ileus. Surgery is the most common cause (postoperative ileus). Surgeons expect and plan for it after operating on your abdomen. But surgeries on other body parts can trigger it, too.

Other causes include:

• Inflammation: When your abdomen gets inflamed, it can disrupt peristalsis. Local irritation (like appendicitis and pancreatitis) and toxic infections (like botulism and sepsis) can cause this issue.
• Medications: Some medications can delay the natural movements of your intestines. These include opioids, tricyclic antidepressants, phenothiazines and anticholinergics.
• Electrolyte imbalances: Electrolyte disturbances can impact your metabolism. This may happen when you’re low on potassium, calcium, magnesium and phosphate.

Complications of ileus

Typically, ileus is an unpleasant but temporary problem. If it lasts more than three days, it’s called prolonged ileus. This can lead to complications, including:

• Aspiration
• More nausea and vomiting

How doctors diagnose this condition

If you have symptoms of bowel function disruption, a healthcare provider will want to see whether the issue is functional or mechanical. A functional problem means that your intestines have simply stopped working like they’re supposed to. A mechanical problem means that something (like a blockage) is physically keeping your GI tract from moving things along.

Your provider can use an X-ray to get a better idea of what’s going on in your specific case. If these findings aren’t clear, a CT scan — especially one that uses contrast dye — can make some details easier to see.

Your provider can also use blood tests to check your electrolyte and mineral levels.

How is ileus treated?

If an infection or illness is causing your case of ileus, your provider will treat that first. If you have ileus after surgery, your care team will already have a treatment plan in place.

Treatments include:

• Bowel rest: This means you won’t eat or drink anything by mouth until your GI tract starts moving again. Instead, you may receive the nutrients you need through your veins (total parenteral nutrition).
• Chewing gum: You read that right. Chewing gum can sometimes trigger a reflex that kickstarts peristalsis.
• Nasogastric (NG) tube: In severe cases, you’ll have a thin tube go through your nose and into your stomach to drain air and fluid.
• Light activity: Your care team will encourage you to get out of bed and walk around. This will help your intestine recover faster.

Can you prevent ileus after surgery?

It isn’t always possible to prevent ileus after surgery. But your care team has protocols in place before, during and after your operation to promote gut movement shortly after you wake up.

For example, they might give you a medication before surgery on your intestines. They’ll get you up and moving once you’re able. They’ll encourage you to have a limited amount of food and water by mouth. And they may even give you chewing gum before there are any signs of ileus.

Your team will keep a close eye on your bowels until everything is working as it should. But if you experience any ileus symptoms, be sure to let them know.

When should I seek care?

Reach out to a healthcare provider if you:

• Can’t poop or pass gas
• Can’t stop vomiting
• Have a swollen belly that’s not going away
• Have persistent pain in your abdomen that you can’t explain

What can I expect if I have ileus?

Once your care team treats the cause, ileus typically resolves on its own within a few days. If you were treated for dehydration or other deficiencies, you should gradually reintroduce your normal eating habits.

If ileus lasts longer than a week, your healthcare provider may take another look to see whether something else is going on.