paralytic ileus

Paralytic Ileus: A Temporary Obstruction of the Intestines

Paralytic ileus occurs when the muscle contractions that move food through your intestines are temporarily paralyzed, causing food to get trapped and creating a blockage. This condition is also known as functional obstruction, where the intestinal muscles become impaired due to various stimuli.

Causes of Paralytic Ileus

The common causes of paralytic ileus may include:

• Bacteria or viruses that cause intestinal infections (gastroenteritis) [4][7]
• Abdominal surgery or trauma [8]
• Disorders that affect the muscles and nerves
• Medications

Symptoms of Paralytic Ileus

The symptoms of paralytic ileus may include those of intestinal obstruction, such as:

• Vomiting
• Abdominal pain and tenderness
• Bloating and gas
• Constipation or inability to pass stool

Treatment of Paralytic Ileus

Treatment for paralytic ileus typically involves addressing the underlying cause, such as antibiotics for infections. In some cases, surgery may be necessary to relieve the obstruction.

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Symptoms of Paralytic Ileus

Paralytic ileus, also known as adynamic ileus, is a temporary cessation of the normal contractions of the intestines. This can lead to various symptoms, which are essential to recognize for prompt medical attention.

• Abdominal swelling (distention): The buildup of gas and liquids in the intestines can cause the abdomen to become swollen or distended [8].
• Abdominal fullness, gas: A feeling of fullness or bloating in the abdomen, accompanied by gas production [1], [8].
• Abdominal pain and cramping: Pain and cramping sensations in the abdominal area due to the buildup of gas and liquids [7], [8].
• Breath odor: The presence of a foul breath odor can be a sign of paralytic ileus, as the body's digestive system is not functioning properly [1].
• Constipation: A temporary cessation of bowel movements or difficulty passing stool due to the lack of intestinal contractions [2], [10].
• Diarrhea: In some cases, diarrhea may occur due to the buildup of gas and liquids in the intestines [8].
• Inability to pass gas: The inability to pass gas or have a bowel movement can be a sign of paralytic ileus [1].

Other symptoms

• Nausea and vomiting
• Loss of appetite
• Abdominal tenderness (in some cases)

It's essential to seek medical attention if you experience any of these symptoms, as prompt treatment can help alleviate the condition.

References: [1] - Context result 1 [2] - Context result 2 [7] - Context result 7 [8] - Context result 8 [10] - Context result 10

Diagnostic Tests for Paralytic Ileus

Paralytic ileus, also known as adynamic ileus, is a condition where the normal muscle contractions that move food through the intestines are slowed or stopped. The diagnostic tests used to diagnose paralytic ileus include:

• Physical exam: A physical examination by a doctor to assess symptoms and medical history [1].
• Imaging tests: Such as abdominal X-ray, CT scan, MRI, and ultrasound to visualize the digestive system and identify any blockages or abnormalities [2].
• Blood tests: To measure electrolyte and mineral levels, and to rule out other conditions that could cause similar symptoms [4].
• Laboratory studies: Blood work should focus on evaluations for infectious, electrolytic, and metabolic derangements [7].

In addition to these tests, a CT scan can be used to diagnose paralytic ileus by identifying multiple air-fluid levels throughout the abdomen, elevated diaphragm, and dilatation of both large and small intestines [8].

It's worth noting that distinguishing paralytic ileus from intestinal obstruction is crucial for proper diagnosis. Abdominal radiographs may show gaseous distension in both conditions, but a CT scan can help differentiate between the two [6].

Treatment Options for Paralytic Ileus

Paralytic ileus, also known as postoperative ileus (POI), is a temporary halt in the normal contractions of the bowel muscles after surgery. While most cases resolve on their own with supportive treatment, certain medications can help alleviate symptoms and promote recovery.

Medications to Slow Motility

The following medications are known to slow down bowel motility:

• Anticholinergics
• Opioids (e.g., Dilaudid, Morphine, Oxycodone)
• Tricyclic antidepressants
• Phenothiazines

These medications can help reduce the symptoms of paralytic ileus by slowing down the movement of food through the digestive system. However, they should be used under medical supervision and with caution to avoid prolonged recovery times.

Peripherally Selective Opioid Antagonists

More recent studies have shown that peripherally selective opioid antagonists, such as methylnaltrexone (Relistor) and alvimopan, can be effective in treating postoperative ileus. These medications work by blocking the effects of opioids on the bowel muscles, allowing for normal contractions to resume.

Other Treatment Options

In addition to medication, other treatment options may include:

• Nasogastric tube placement to relieve nausea and vomiting
• Intravenous hydration to prevent dehydration
• Supportive care, such as watchful waiting and monitoring, in most cases

It's essential to note that the majority of cases of paralytic ileus resolve on their own with supportive treatment. However, if symptoms persist or worsen, medical attention should be sought.

Sources:

• [1] Cisapride is a serotonin agonist that facilitates acetylcholine release from the intrinsic plexus.
• [2] Peripherally selective opioid antagonists are an option for the treatment of postoperative ileus.
• [3] Medications known to slow motility include: Anticholinergics, Opioids, Tricyclic antidepressants, Phenothiazines.
• [4] Most cases of postoperative ileus resolve with watchful waiting and supportive treatment.

Paralytic ileus, also known as adynamic ileus, is a condition where there is a temporary halt in the normal contractions of the bowel muscles, leading to a buildup of food, fluids, and gas in the intestines. The differential diagnosis for paralytic ileus involves identifying other conditions that may present with similar symptoms.

According to various medical sources [1][2], some common differentials for ileus include:

• Pseudo-obstruction, also referred to as Ogilvie syndrome
• Mechanical bowel obstruction
• Adhesions or scar tissue that form after surgery
• Gallstones (rare)
• Hernias
• Impacted stool
• Intussusception (telescoping of one part of the intestine into another)

Additionally, the 5 Ps are among the most common causes of paralytic ileus [3]: * Peritonitis (inflammation of the lining surrounding the abdominal organs) * Postoperative (after surgery) * low Potassium levels * Opioids (medications that can slow down bowel movements) * Pelvic/spinal fractures

These conditions can all present with similar symptoms, such as absence of flatus, abdominal distention, and obstipation [4]. A thorough review of medical history and physical assessment is essential for diagnosis, often followed by imaging tests like an abdominal X-ray, CT scan, MRI, or ultrasound to confirm the diagnosis [5].

References: [1] Nov 1, 2021 — The common differentials for ileus are pseudo-obstruction, also referred to as Ogilvie syndrome, and mechanical bowel obstruction. [2] May 14, 2024 — Causes ; Adhesions or scar tissue that form after surgery ; Gallstones (rare) ; Hernias ; Impacted stool ; Intussusception (telescoping of one ... [3] Sep 11, 2023 — The 5 Ps: Peritonitis, Postoperative, low Potassium, oPioids, and Pelvic/spinal fractures are among the most common causes of paralytic ileus. [4] Aug 8, 2020 — The classic symptoms of a prolonged ileus include absence of flatus, abdominal distention, and obstipation. Often these symptoms are associated with nausea and ... [5] Dec 3, 2020 — Diagnosis focuses on a review of medical history and a physical assessment. Imaging tests such as an abdominal X-ray, CT scan, MRI, ultrasound ...