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Ileus occurs when there is a problem with motility in the small or large intestine (bowel). Motility is the process of moving waste through the digestive tract. With normal motility, muscles in the bowel walls contract to move waste along. Signals from nerves tell the muscles when to contract. With ileus, motility slows down or stops completely. As a result, waste cannot move through the bowels and out of the body. This can cause abdominal discomfort and other symptoms. Treatment is needed to restore motility and relieve symptoms.

Causes of Ileus

The digestive tract

Ileus can be caused by the following:

  • Abdominal surgery

  • Certain infections, such as that of the peritoneum (the lining of the abdomen)

  • Injury to blood vessels that supply blood to the abdomen

  • Electrolyte imbalance, such as low levels of sodium or potassium

  • Certain medications, such as strong pain medications

  • Certain kidney or lung diseases

  • Certain medical conditions, such as cystic fibrosis

Symptoms of Ileus

Common symptoms of ileus include:

  • Abdominal swelling or bloating

  • Nausea and vomiting

  • Abdominal cramps

  • Loss of appetite

  • Inability to keep food down

  • Inability to pass stool or gas

Diagnosing Ileus

Your doctor will ask about your symptoms and health history. You'll also have a physical exam. If ileus is suspected, tests may be done to confirm the problem. These can include:

  • Imaging tests. These provide pictures of the bowels. Common tests include x-rays and a computed tomography (CT) scan.

  • Blood tests. These check for infection and other problems such as dehydration.

  • Upper gastrointestinal (GI) series. This test takes x-rays of the upper digestive tract from the mouth to the small intestine. A contrast fluid is used. The contrast fluid coats the inside of the upper digestive tract so that it will show up clearly on x-rays.

Treating Ileus

In most cases, ileus resolves by itself. The goal is to manage symptoms until motility returns to normal. Treatment takes place in a hospital. As part of your care, the following may be done:

  • No food or drink is given by mouth. This allows your bowels to rest.

  • An intravenous (IV) line is placed in a vein in your arm or hand. The IV line is used to give fluids and nutrition. It may also be used to give medications. These may be needed to improve motility or to relieve pain. They may also be needed to treat any underlying infections or conditions you have.

  • A soft, thin, flexible tube (nasogastric tube) is inserted through your nose and into your stomach. The tube is used to remove extra gas and fluid in your stomach and bowels. This helps to relieve symptoms such as pain and swelling.

  • You'll be observed in the hospital until your symptoms improve. Your doctor will tell you when you're well enough to return home. This is usually within a few days.

  • In rare cases, problems may occur. Other treatments, such as surgery, may then be done. Your doctor will tell you more about other treatments, if needed.

Long-term Concerns 

After treatment, most people recover completely. In some cases, you may need to see your doctor for a follow-up appointment.

When to Call the Doctor

Call your doctor right away if you have any of the following:

  • Fever of 100.4°F or higher

  • Abdominal swelling or pain that won't go away

  • Inability to pass stool or gas

  • Nausea and vomiting

  • Getting full very easily with only small amounts of food or drink

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I just wanted to say thank you very much for getting me in promptly and taking very good care of me during my hard times. I appreciate your office following up on my care and making sure all the testing, pre-certs were taken care of so it was less stressful for me. I also appreciate all the care and support from every staff member in your office. It really shows how much you guys care about your patients.
Thank you,
Pete Damico

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