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Q: What does paralytic ileus mean, what causes it, and how can we fix it?
A: Paralytic ileus is the condition in which the bowel is distended with gas and fluid as a consequence of inhibition of its motor function, in the absence of any mechanical obstruction. In plain radiographic films of the abdomen, distended gas and fluid filled loops of small and large intestine are visualized. Symptoms of paralytic ileus include nausea, vomiting, abdominal discomfort, and distention of the abdomen. If the physician listens to the abdomen with the stethoscope, he/she will notice that bowel sounds are diminished to absent.
Causes of paralytic ileus include: 1) peritoneal irritation of any origin, including intraabdominal surgery, bacterial infection within the abdominal cavity, inflammation of the pancreas, inflammation of the appendix, bleeding within the abdominal cavity, ruptured bowel (for example, due to trauma); 2) severe medical illnesses, such as generalized infections, lung infections, respiratory failure requiring intubation, electrolyte abnormalities (such as decreased potassium, decreased magnesium, decreased phosphates, increased calcium), severe forms of diabetes in which the organism becomes acidic, heart attack, fractured ribs; and 3) medications that alter the motility properies of the bowel, such as, for example, opiates.
Treatment of paralytic ileus consists in treating the medical or surgical condition that precipitated the appearance of the ileus. In addition, oral intake is restricted and the bowel is decompressed by means of nasogastric suction.
Updated: 09/12/99
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