After completing this lesson, you will be able to define paralytic ileus and describe its causes, symptoms and treatment. A short quiz follows this lesson to help you test your knowledge.

Defining Paralytic Ileus

The ileum is the lowest portion of the small intestine, and so the term paralytic ileus describes an ileum that is paralyzed; therefore, it is no longer pushing food down the digestive tract. Even though the term ‘ileum’ is in the title, this condition can occur anywhere in the small or large intestine.

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Normally, the bowels move food through the digestive system through an involuntary process called peristalsis. This occurs through the movement of the walls of the digestive tract. The movement of peristalsis is a lot like an ocean wave moving through the digestive tract muscle. There is an initial narrowing and then the narrowed part pushes the food forward. The food rides these waves all the way through the digestive system. When these waves slow down or stop, such as with paralytic ileus, then the food becomes stuck causing a pseudo-obstruction. Even though there is no actual obstruction, you will still experience the same symptoms.

Symptoms

During paralytic ileus, you should watch out for:

  • Abdominal cramping that comes and goes
  • Vomiting
  • Diarrhea
  • Constipation
  • Nausea
  • Abdominal swelling (distention)
  • Abdominal fullness (gas)
  • Inability to pass stool or gas

What Causes Paralytic Ileus?

Many things can cause this condition, including:

  • Bacteria and viruses
  • Electrolyte imbalance (such as low potassium)
  • Medications (especially narcotics and antidepressants)
  • Decreased blood supply to the intestines
  • Pelvic surgery
  • Infections (such as appendicitis)
  • Muscle and nerve disorders (such as Parkinson’s disease)

How is Paralytic Ileus Treated?

Initially you will not be allowed to eat or drink anything until your bowels start working again. This is because the obstruction will only get worse if you keep adding food into your digestive system when it is not working properly. Therefore, you will need an I.V. (intravenous catheter) to stay hydrated and a nasogastric tube. The nasogastric tube is inserted through your nose and into your stomach. Don’t worry, it sounds worse than it is. In reality, this procedure is quick and you will likely feel better afterwards because the tube will allow gas that can accumulate in your stomach to escape. Abdominal x-rays will also be done so that doctors can see exactly where the obstruction is.

On the bright side, this condition is generally temporary, but you may still need to be hospitalized for a few days to be closely monitored. Treatment depends on the underlying cause of the condition. If your paralytic ileus is caused by a bacterial infection, then treating the infection will help to restart peristalsis. If your bowels do not restart on their own, then your doctor may prescribe certain medications, such as Pyridostigmine bromide, that can stimulate muscle contractions, which will help to move food through your intestinal tract. Surgery can be required in some instances.

Lesson Summary

Paralytic ileus is a medical condition in which the peristalsis that normally occurs in the digestive tract slows down or stops completely. This causes a pseudo-obstruction in which the food gets stuck in your bowels. Symptoms of bowel obstruction include: abdominal cramps that come and go, vomiting, diarrhea, constipation, nausea, abdominal distention, abdominal fullness and inability to pass stool or gas. Some causes of paralytic ileus include infections, electrolyte imbalances, surgery, and medications. Treatment depends on the underlying cause. Medications, such as Pyridostigmine bromide, can help to kick start peristalsis by stimulating muscle contractions.

Medical Disclaimer: The information on this site is for your information only and is not a substitute for professional medical advice.