Highlights & Basics
- Ileus is a slowing of gastrointestinal motility that is not associated with mechanical obstruction.
- Most commonly presents following surgery and usually lasts 2-4 days.
- Prolonged postoperative ileus contributes significantly to longer hospitalization and increased healthcare costs.
- Treatment includes bowel rest, supportive care, and treatment of any underlying exacerbating factors.
- Prevention requires a multimodal approach, including the substitution of postoperative opioid analgesia with nonsteroidal anti-inflammatory drugs and thoracic epidural analgesia, early enteral feeding, early ambulation, and the use of laparoscopy rather than laparotomy whenever possible.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
CT scan with intravenous and oral contrast showing fluid-filled small intestine and cecum in ileus
CT scan with intravenous and oral contrast showing fluid-filled small intestine in ileus
Small bowel series showing dilated small bowel loops in ileus; nasogastric tube is seen curled in the stomach.
Small bowel series showing dilated contrast-filled small bowel loops in ileus; some contrast is visible in the right colon
CT scan showing significantly dilated stomach
Nasogastric tube
Citations
Wattchow D, Heitmann P, Smolilo D, et al. Postoperative ileus- an ongoing conundrum. Neurogastroenterol Motil. 2021 May;33(5):e14046.[Abstract]
Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS(®)) society recommendations: 2018. World J Surg. 2019 Mar;43(3):659-95.[Abstract][Full Text]
American College of Radiology. ACR Appropriateness Criteria: suspected small-bowel obstruction. 2019 [internet publication].[Full Text]
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57. U.S. Food and Drug Administration. FDA label: Entereg (Alvimopan) capsules. May 2008 [internet publication].[Full Text]
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