Ileus: Causes, consequences, tests, and treatment
Intestine is an important organ. It digests the food you eat. Food provides energy and multiple nutrients. They help to meet needs of day to day life. Ileus is a condition that affects your intestine.
Ileus is a movement disorder of part of the intestine. We will see in detail today about this condition.
What is ileus?
Ileus is a condition in which part of the intestine fails to move the food through it causing stagnation in an area which is proximal.
In this condition part of the intestine is paralysed. The cause can be disease of muscle forming intestines or neurons supplying intestines.
It is a painful condition creating difficulty for the affected person. If not treated with immediate attention may lead to life threatening consequences.
How does it affect you?
The basic function of our intestine is digesting food. Food that you eat needs to undergo a process in the intestine. This process is called digestion. It makes intestine to absorb the energy and nutrients in food.
The food moves forward in the intestine with a wave-like movement of the intestine. The enzymes in the intestine process the food in different parts of the intestine.
In ileus the part of the intestine is not moving. It is unable to move the food in forward direction. The food accumulates proximal to this part. It is not able to move forward.
The proximal part of the intestine which is normal tries to move the food. This leads to excessive movements proximal to ileus.
These movements of the intestine in the proximal part are forceful. They cause pain in the abdomen.
What are the causes?
The most important cause of ileus is the most common one too. It is a post-surgical complication. You may experience this condition after a surgery of the abdomen.
Causes of ileus are:
- Inflammatory disease of the intestine like crohn’s disease.
- Medicines that slow the movement of intestine like morphine
- Antidepressants like amitriptyline
- Antidiarrheal drug like diphenoxylate.
- Parkinson’s disease.
- Electrolyte imbalance like serum potassium.
- Tumour of intestines.
What are the symptoms of ileus?
Symptoms of this condition are related to the gastrointestinal tract. This condition can present with mild symptoms to very severe ones.
Most common patient has a history of abdomen surgery. Surgery of the abdomen in the near past is an important history.
List of symptoms of ileus:
- Abdominal pain.
- Abdominal discomfort.
- Vomiting and intractable vomiting.
- Not able to pass gas (Obstipation)
- Feeling of fullness of abdomen.
- Enlarged size of abdomen with swelling.
- Not feeling like eating and loss of appetite.
Multiple conditions can cause ileus and sometimes patients may show symptoms of underlying illness in these cases.
Which are tests for diagnosis of ileus?
Your history and physical examination are important. Your doctor will make clinical diagnosis based on them and suggest following tests.
USG Abdomen shows organs and intestines in the abdomen. This test is helpful in children and does not need anaesthesia. Your radiologist can do this test quickly. Only drawback is it is not sensitive enough.
X-ray abdomen is helpful in diagnosis and It can detect the proximal enlarged part of the intestine. It can also detect the presence of gas in and outside the intestine. The drawback of this test is its less sensitivity. The radiation exposure makes this test not possible in pregnant patients.
CT abdomen is most sensitive. It is a computed tomography of the abdomen. CT abdomen can detect ileus and its complications. It is frequently combined with the dye taken orally or by injection. Again the drawback of this test is, it is not useful in pregnant patients because of risk of radiation exposure.
Barium enema is also helpful for the diagnosis of the condition. The dye is inserted in the rectum and X ray is taken at the same time.
What are its consequences?
Ileus can lead to various consequences as complications. Some of those consequences are as follows:
Necrosis of intestine excess accumulation of food in the proximal part increases the pressure in the intestine. This pressure may block the blood supply to the area. The result is the affected area gets less blood supply. It does not require oxygen. This causes death of local tissue. It is called necrosis.
Rupture of intestine Occurs when the necrosed part of the intestine stretches. It tears a hole in the wall of the intestine. It causes severe pain and bleeding in the abdomen.
Peritonitis is inflammation of the peritoneum. Peritoneum is the covering of the intestine in the abdomen. This inflammation is because of the rupture and necrosis of the intestine. This condition also occurs because of spread of inflammation from intestinal wall to peritoneum.
Shock is a condition in which the blood pressure of the patient falls. The blood circulation fails. Oxygen and nutrients can not reach various organs of the body and the condition may cause death.
What is the treatment of ileus?
Ileus is an emergency. It is treated based on whether it is partial ileus or complete ileus.
For mild cases with partial ileus patients are suggested a diet that contains less fibre. So bulky stools are not formed. The food can easily pass through the intestines.
For severe cases the food should be stopped. The already consumed food is removed from the stomach with a ryles tube.
You will need surgery. The surgery removes the affected part. As the intestine is large, removal of short parts is generally tolerable.
During the entire therapy supportive care is important.