What Is Ileus?
Ileus is a condition where there is a temporary lack of movement in the intestines that prevents the normal passage of food, fluids, and gas. It is sometimes called a non-mechanical bowel obstruction because there is no physical blockage—just a disruption in the natural rhythmic contractions (peristalsis) of the intestines.
This condition can affect either the small intestine, the large intestine, or both, and can lead to significant discomfort and complications if not treated promptly.
What Causes Ileus?
Ileus can occur for a variety of reasons. Common causes include:
- Recent abdominal or pelvic surgery – one of the most frequent triggers
- Medications – especially opioids, anticholinergics, and some psychiatric drugs
- Infections or inflammation – such as gastroenteritis or peritonitis
- Electrolyte imbalances – like low potassium or magnesium
- Abdominal trauma or injury
- Severe illness or immobility – especially in hospitalized patients
- Sepsis or shock
- Spinal cord injuries
In some cases, paralytic ileus may develop without a clear cause, especially in critically ill patients.
Who Is at Risk for Ileus?
Risk factors include:
- Recent surgery, especially on the abdomen or pelvis
- Use of opioid pain medications
- Elderly age
- Prolonged bed rest or immobilization
- Underlying inflammatory or infectious diseases
- Chronic illnesses such as diabetes or hypothyroidism
- Electrolyte disturbances
What Are the Symptoms of Ileus?
Symptoms of ileus often resemble those of bowel obstruction but without a physical blockage. They may include:
- Abdominal bloating and distention
- Nausea and vomiting
- Constipation or inability to pass gas
- Loss of appetite
- Abdominal pain or cramping
- Lethargy or discomfort
Severe cases may also cause fever or signs of dehydration, especially if vomiting is persistent.
How Is Ileus Diagnosed?
Diagnosis is based on a combination of symptoms, medical history, and imaging tests:
- Physical examination – reveals a bloated abdomen and decreased or absent bowel sounds
- X-rays of the abdomen – to show dilated loops of bowel with air-fluid levels
- CT scan or ultrasound – to rule out mechanical obstruction and confirm ileus
- Blood tests – to check for electrolyte imbalances, infection, or signs of dehydration
Differentiating between ileus and mechanical bowel obstruction is critical for proper treatment.
How Is Ileus Treated?
Treatment focuses on supportive care and addressing the underlying cause:
- Bowel rest – no eating or drinking until bowel function returns
- Nasogastric (NG) tube – to relieve pressure by removing gas and fluids from the stomach
- IV fluids – to maintain hydration and correct electrolyte imbalances
- Stopping or adjusting medications – especially opioids or anticholinergics
- Encouraging early movement – in post-surgical patients to stimulate bowel activity
- Treating infections or inflammation – if present
Most cases resolve within a few days with conservative treatment. In rare, prolonged cases, additional interventions may be needed.
Can Lifestyle or Post-Surgery Habits Help Prevent Ileus?
Yes, especially in post-operative care, certain practices can reduce the risk:
- Early mobilization after surgery
- Reducing or avoiding opioids by using alternative pain management
- Maintaining good hydration
- Monitoring and correcting electrolytes
- Eating a light diet until bowel function is fully restored
- Regular monitoring in hospitalized patients with risk factors
These steps are especially important in elderly patients and those recovering from major surgeries.
What Is the Outlook for People with Ileus?
In most cases, ileus is temporary and resolves within a few days with appropriate care. However:
- Prolonged or untreated ileus can lead to complications like bowel perforation, infection, or severe dehydration
- The prognosis depends on the underlying cause, overall health, and timely intervention
- In patients with chronic illness or repeated episodes, long-term management may be needed
With proper treatment, full recovery is common.
When Should You See a Doctor?
Seek medical help if you experience:
- Persistent abdominal bloating or pain
- Inability to pass stool or gas
- Nausea or vomiting that doesn’t go away
- Signs of dehydration (dry mouth, low urine output)
- Fever or worsening symptoms after surgery
Early treatment helps prevent serious complications.