Patients with post-operative ileus, opioid-induced constipation, or a soft stool will benefit from a stimulant laxative, such as senna or picosulphate. *In resistant cases, additional therapy can be given via manual evacuation.
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.
An effective bowel regimen should include a stimulant laxative and a stool softener. These agents may include senna, bisacodyl, and docusate sodium.
Signs of ileus may follow signs of intestinal obstruction; in this context, ileus is an ominous sign. Other causes of paralytic ileus are drugs (phenothiazines, narcotics, laxative abuse, atropine), electrolyte disturbances (hypokalemia, hypercalcemia), endocrinopathies (hypothyroidism), or injuries (spinal fractures).
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.
Patients with post-operative ileus, opioid-induced constipation, or a soft stool will benefit from a stimulant laxative, such as senna or picosulphate. *In resistant cases, additional therapy can be given via manual evacuation.
Ileus Treatment
Your doctor might suggest: No food or fluids by mouth for 24 to 72 hours. Your doctor may also stop or cut back on strong pain relievers (opioid analgesics) or other medications that may be causing your symptoms. IV fluids to help correct any electrolyte imbalance.
Most cases of bowel obstruction need some form of medical intervention. Treatment options for bowel obstruction can include: Medication: Opioids can lead to constipation. If this occurs, laxatives and stool softeners can help.
Complicating conditions. Laxative use can be dangerous if constipation is caused by a serious condition, such as appendicitis or a bowel obstruction. If you frequently use certain laxatives for weeks or months, they can decrease your colon's ability to contract and actually worsen constipation.
Avoid excessive doses of laxatives.
Excessive doses of bulk-forming laxatives, or inadequate fluid intake with bulk-forming laxatives, cause intestinal obstruction rather than diarrhoea. If intestinal obstruction is suspected, do not use laxatives.
Following abdominal surgery, a period of "physiologic" ileus is expected to last for 0 to 24 hours in the small intestine, 24 to 48 hours in the stomach, and 48 to 72 hours in the colon.
The symptoms of ileus are abdominal bloating and pain caused by a buildup of gas and liquids, nausea, vomiting, severe constipation, loss of appetite, and cramps. People may pass watery stool.
Treatment / Management
Treatment of an ileus requires time and supportive management. Bowel rest, intravenous (IV) fluid therapy, and, if warranted, nasogastric (NG) decompression are important steps.
Paralytic ileus
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: electrolyte imbalances.
The use of enemas is contraindicated in patients with a paralytic ileus or chronic obstruction.
Postoperative ileus typically resolves within a few days, although continued ileus introduces complications associated with lack of enteral intake, electrolyte derangements, malnutrition, and poor patient satisfaction.
Do not use DULCOLAX if you have, or have had, any of the following conditions: • an acute abdominal condition including appendicitis • acute inflammatory bowel disease • severe abdominal pain associated with nausea and vomiting • blockage of the bowel (ileus) • a blockage of the intestine • severe dehydration Page 2 If ...
You should not use this medicine if you are allergic to polyethylene glycol, or if you have a bowel obstruction or intestinal blockage. If you have any of these conditions, you could have dangerous or life-threatening side effects from polyethylene glycol 3350.
Obstruction of the bowel may be due to: A mechanical cause, which means something is blocking the bowel. Ileus, a condition in which the bowel does not work correctly, but there is no structural problem causing it.
Do not take any type of laxative: if you have signs of appendicitis or inflamed bowel (such as stomach or lower abdominal pain, cramping, bloating, soreness, nausea, or vomiting). Instead, check with your doctor as soon as possible.
Fennel – A natural laxative that is mild and has a pleasant smell. You can add roasted fennel to warm water for a tasty evening drink. Fennel seeds help stools to move through the colon by increasing gastric enzymes in the digestive system.
In most cases, time and TLC will resolve your ileus and lessen your symptoms, but in severe cases you need immediate medical attention. An ileus is a condition in which the small intestine doesn't work normally. Normally, the muscles of the small intestines squeeze to move air, fluid, and food through it.
Conservative management. One of the most important steps in tackling ileus is early mobilization. That means getting patients out of the bed to walk in order to exert a mechanical stimulation of intestines.