The following are the signs and symptoms of paralytic ileus:
An abdominal x-ray would also be required to analyze the nature of the obstruction. A serial abdominal x-ray with dyes may demonstrate the progression of ileus recovery in post-operative patients . In addition, CT scan of the abdomen would also be done. A diagnostic procedure known as upper GI and small bowel series is a type of x-ray that is done to study the internal features of the abdomen. In this test, the patient is given barium milkshake to drink prior to the procedure. When the contrast media stays more than 4 hours in a bowel region, this is already suggestive of an obstructive process . Going forward an x-ray of the abdomen will be done.
Treatment of paralytic ileus is largely dependent on relieving the underlying causative factors. This would help resolve the condition in some days. Primary management care is focused on correcting electrolyte imbalances and dehydration. Intravenous hydration is administered to replenish for the lost fluids. In addition, a tube may be required to be inserted through the nasal route to relieve the symptoms of distention and vomiting.
If the above supportive treatment regime fails to show any effect then medications are prescribed to facilitate peristalsis. Current studies have identified the drug alvimopan to hasten bowel peristalsis in postoperative patients . If there are signs of tissue death then surgery may be required.
Prognosis of the condition depends on the severity of the disease. Usually with prompt diagnosis and treatment, the prognosis is expected to be good. Paralytic ileus is a temporary phenomenon and gets resolved with proper treatment. Other abdominal surgery like laparoscopic resection of the colon may have a short lived ileus compared to the rectal surgery which may have an extended ileus consequently affects morbidity rate and duration of hospital sate .
Paralytic ileus inhibits the ability of the intestines to absorb nutrients from the food and also does not allow the passage of digested food through the digestive system. Thus, electrolyte imbalance and dehydration are some of the notable complications of paralytic ileus. In addition, this condition can also bring along the following complications if treatment is not initiated on time.
Paralytic ileus is not caused due to any kind of physical obstruction. It is purely the result of malfunctioning of the intestinal muscles and nerves. As a result of the malfunctioning, the normal process of digestion, absorption and elimination does not take place calling for an emergency situation. The causes of paralytic ileus are described as below:
Statistics reveal that about 50% of patients undergoing abdominal surgery suffer from paralytic ileus as a secondary complication to the surgical procedure . It is a common condition for patients undergoing any kind of abdominal surgical procedure. It has also been estimated that, paralytic ileus is the main cause of intestinal obstruction in children and infants.
Under normal circumstances, the food that is digested in the stomach passes through the intestine where the nutrients are absorbed. In condition of paralytic ileus, the muscles and nerves of the intestine get paralyzed. When such a condition takes place, the nutrients from the food are not absorbed and the passage of fluid and food through the digestive tract is disrupted. This causes an accumulation of fluid and gas.
In many cases, development of paralytic ileus cannot be prevented. Conditions such as hernias and tumors should be promptly treated. It is also necessary to avoid medications such as opiates like morphine which are known to promote development of ileus . The thoracic epidural administration option with combined local anesthetics during abdominal surgery may shorten the course of the ileus postoperatively . The administration of preoperative celcoxib in patients have significantly prevented post-operative ileus compared to other non-steroidal anti-inflammatory drugs (NSAIDs) .
Paralytic ileus is a condition characterized by hypomotility of the intestine. Such a condition does not result from any kind of physical obstruction; but occurs due to malfunctioning of the nerves and muscles of the intestine. This condition is also known as pseudoobstruction and is a common compliant amongst children and infants.
Physiologic ileus resolves within 2 to 3 days; thus, ileus persisting beyond 3 days are already considered adynamic or paralytic etiologically . Paralytic ileus is an emergency and should receive prompt treatment to avoid serious complications going forward. This condition hinders with the absorption of the nutrients from the food that is digested. Due to malfunctioning of the intestine, the nutrients are not absorbed and the residue does not pass through the system causing buildup of fluid and gas in the stomach.
Paralytic ileus also known as pseudoobstruction is a disorder characterized by malfunctioning of the muscles and nerves of the intestine. In this condition, there is no mechanical obstruction. Paralytic ileus is most common cause of intestinal obstruction in children and infants. Such a condition hinders the passage of food through the intestine.
Causes of paralytic ileus include intestinal infections due to bacteria or fungi, mineral imbalances, postoperative complications, lung disease, kidney disorders, mesenteric ischemia, certain medications and appendicitis.
Symptoms of paralytic ileus begin with vomiting and dehydration. The patient may also experience abdominal bloating and distention followed by severe pain. Other symptoms include dehydration, diarrhea, constipation, electrolyte imbalance, inability to pass gas and breathe odor.
A physical examination of the abdomen would reveal distention and fullness. In addition, imaging studies such as CT scan would be done to reveal the nature of the obstruction. X-ray of the abdomen using barium milkshake would help in examination of the internal structures. Blood tests are required to determine electrolyte imbalance and dehydration.
The primary goal of treating paralytic ileus is to correct the underlying cause of the condition. Once this is achieved then the ileus resolves by itself. In addition to this, several methods to relieve symptoms are employed. Administration of intravenous fluids is done to replenish the lost fluids through vomiting and diarrhea. A tube is also inserted through the nasal route to relieve the distention. Medications may also be required to ensure the muscles of the intestine work.