Ileus usually persists for 36 to 48 hours, and treatment includes restriction of oral intake and administration of bowel stimulants, enemas, or laxatives.
The use of enemas is contraindicated in patients with a paralytic ileus or chronic obstruction.
Air or barium enema.
This may be done for certain suspected causes of obstruction. During the procedure, the doctor will insert air or liquid barium into the colon through the rectum.
People with colorectal cancer, an enlarged distended colon which may be more prone to perforation, and people who have active inflammatory bowel disease should avoid using enemas, Pothuri says. If you have any questions about the safety of enemas, talk to your doctor.
In most experimental and clinical studies,99-102 giving nonsteroidal anti-inflammatory drugs resulted in decreased nausea and vomiting and improved gastrointestinal transit. Many clinicians use laxatives as a treatment for paralytic postoperative ileus.
Treatment of an ileus requires time and supportive management. Bowel rest, intravenous (IV) fluid therapy, and, if warranted, nasogastric (NG) decompression are important steps. Historically these treatments were thought to lower complications and improve outcomes, but a recent review of the evidence shows otherwise.
Contrast Enema for Large-Bowel Obstruction
Contrast enema can result in bowel perforation, again favoring CT for diagnosis when x-ray is nondiagnostic. Enema is contraindicated when ischemia, perforation, or peritonitis is suspected. Stewart et al.
Prognosis is generally good as postoperative ileus typically resolves within one to three days after diagnosis with supportive care. Should ileus remain for several days or symptoms continue to worsen despite management, further investigation and imaging is warranted.
Ileus usually goes away in a few days. But, if it's left undiagnosed and untreated, it can lead to life-threatening complications. These include: Perforation or blow-out of the intestinal wall.
Having patients chew gum has been advocated as a means of promoting recovery from postoperative ileus. Chewing gum may constitute a form of sham feeding that stimulates gastrointestinal motility.
Causes of paralytic ileus may include: Bacteria or viruses that cause intestinal infections (gastroenteritis) Chemical, electrolyte, or mineral imbalances (such as decreased blood potassium level) Abdominal surgery.
Peripherally selective opioid antagonists are an option for the treatment of postoperative ileus. Methylnaltrexone (Relistor) and alvimopan (Entereg) are approved by the Food and Drug Administration.
A person may find that they cannot have a bowel movement after using an enema. If this happens, they should seek medical attention. A doctor can examine the bowels, and they may suggest using a second enema. A person may need to try lying on their back again to see if the fluid works its way to the bowels.
A warm mineral oil enema is often used to soften and lubricate the stool. However, enemas alone are not enough to remove a large, hardened impaction in most cases. The mass may have to be broken up by hand.
There are many ways to stimulate digestion without the use of enemas. For example, keeping physically active, drinking plenty of water, boosting your intake of fiber, practicing mindful eating, and managing your stress levels may greatly benefit your digestive health.
Hold the water in your rectum as long as possible – at least 15 minutes – then expel it into the toilet.
The best time to do an enema is right before your normal bowel movement or right after having a bowel movement depending on why you are using the enema. A cone enema is a special type of enema bag with a tip shaped like a cone. The cone acts like a plug in order to assist with holding in the fluid.
Without treatment, it can become life-threatening. If ileus persists, 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.
Many surgeons have suggested that postoperative ileus after a bowel resection should last 3 days following a laparoscopic surgery and 5 days in an open approach (16).
Getting up out of bed and walking around several times per day can help to get your bowel function back to normal after surgery. If a medication has caused your ileus, your doctor will likely stop that medicine. He or she will also treat any other condition causing your ileus, if the condition can be treated.