An effective bowel regimen should include a stimulant laxative and a stool softener. These agents may include senna, bisacodyl, and docusate sodium.
Management of ileus starts with correction of underlying medical conditions, electrolyte abnormalities, and acid base abnormalities. Most cases of postoperative ileus resolve with watchful waiting and supportive treatment. Patients should receive intravenous hydration.
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.
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.
The use of enemas is contraindicated in patients with a paralytic ileus or chronic obstruction.
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.
Complications of postoperative ileus include prolonged hospital stay and increased healthcare costs. 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.
Ileus is an occlusion or paralysis of the bowel preventing the forward passage of the intestinal contents, causing their accumulation proximal to the site of the blockage. The passage of intestinal contents can be blocked either partially (subileus, incomplete ileus) or totally (complete ileus).
You will need to avoid eating solid food until you are better. Instead, you will get fluids and nutrition through a vein (I.V.). This also lets your bowel rest. You may have a tube that goes through your nose and into your stomach.
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.
Reduce tough, fibrous fruit and vegetables – chop these foods finely where possible (e.g. celery, mango). Avoid dried fruits, nuts and seeds. Strain fruit and vegetable juices and soups. Avoid wholegrain, high fibre breads and cereals.
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.
An ileus is usually not a severe condition, but it can be very uncomfortable. In most cases, time and TLC will resolve your ileus and lessen your symptoms, but in severe cases you need immediate medical attention.
Endogenous opioids are released after surgery and have been suggested as a cause of postoperative ileus. Their effects on gastric emptying and intestinal smooth-muscle contraction are mediated by the µ-opioid receptor.
Postoperative paralytic ileus refers to obstipation and intolerance of oral intake due to nonmechanical factors that disrupt the normal coordinated propulsive motor activity of the gastrointestinal tract following abdominal or nonabdominal surgery [1-3].
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.
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.
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 of ileus involves continuous nasogastric suction, nothing by mouth, IV fluids and electrolytes, a minimal amount of sedatives, and avoidance of opioids and anticholinergic medications. Maintaining an adequate serum potassium level (> 4 mEq/L [> 4.00 mmol/L]) is especially important.
How do you treat ileus at home? Individuals with mild forms of ileus can be treated at home with bowel rest.
Ileus is usually a temporary reaction of your body to trauma, such as surgery or infection.
The vomiting of feces is an unusual symptom associated with gastrocolic fistulas, coprophagy and violent reverse peristalsis. Feculent vomiting is usually due to mechanical intestinal obstruction but it can be due to paralytic obstruction (adynamic ileus).
Perform stimulation with your finger every day until you start to have a regular pattern of bowel movements. You can also stimulate bowel movements by using a suppository (glycerin or bisacodyl) or a small enema. Some people find it helpful to drink warm prune juice or fruit nectar.
Try to have 6-7 small meals or snacks spread out through the day. o Cut foods into small pieces. o Chew foods well and eat slowly. What to eat through the day o Follow a Low Fibre Diet or a Liquid Diet. o Avoid any food that is tough or stringy (celery, tough meats).