What are the criteria for intestinal ileus (ileus)?

From the Guidelines

Ileus is diagnosed based on criteria including abdominal distention, absence or decreased bowel sounds, nausea and vomiting, inability to pass gas or stool, and abdominal pain, with radiographic findings of dilated loops of bowel with air-fluid levels, as confirmed by imaging studies such as abdominal X-rays or CT scans 1. The diagnosis of ileus involves a combination of clinical and radiographic findings. Key clinical criteria include:

• Abdominal distention
• Absence of bowel sounds or decreased bowel sounds
• Nausea and vomiting
• Inability to pass gas or stool
• Abdominal pain These symptoms are often accompanied by radiographic findings that show dilated loops of bowel with air-fluid levels, which can be confirmed through imaging studies such as abdominal X-rays or CT scans 1. The management of ileus typically involves a multifaceted approach, including:
• Bowel rest
• Nasogastric tube decompression
• Correction of underlying electrolyte abnormalities
• Early ambulation when possible
• Discontinuation of medications that decrease gut motility, such as opioids A multifaceted approach to minimizing postoperative ileus, including minimally invasive surgery, optimized fluid management, opioid-sparing analgesia, early mobilization, early postoperative food intake, laxative administration, and omission/early removal of nasogastric intubation, should be used to prevent and manage ileus 1. It's essential to differentiate ileus from mechanical bowel obstruction, as the treatment approaches differ significantly. Ileus is a functional obstruction without a physical blockage, whereas mechanical bowel obstruction involves a physical blockage of the intestinal lumen. Understanding the underlying cause of ileus is crucial for effective management and prevention of complications.

From the Research

Criteria for Intestinal Ileus

The criteria for intestinal ileus (ileus) can be understood by examining the various types and causes of this condition. Ileus refers to the partial or complete blockage of the small and/or large intestine, which can be caused by either functional (adynamic or paralytic ileus) or mechanical bowel obstruction 2.

Types of Ileus

• Functional ileus: This type of ileus is characterized by a temporary cessation of the normal contractions of the bowel muscles, which can be caused by various factors such as surgery, medications, or certain medical conditions 3, 4.
• Mechanical ileus: This type of ileus is caused by a physical blockage of the intestine, which can be due to various factors such as gallstones, tumors, or adhesions 5, 2.

Clinical Manifestations

The clinical manifestations of ileus can include:

• Abdominal distension
• Pain
• Nausea
• Vomiting
• Inability to pass stools or tolerate a solid diet 3, 6
• Increased luminal pressure and gut wall ischemia, which may lead to increased intra-abdominal pressure (IAP) 2

Risk Factors

The risk factors for the development of ileus can include:

• Significant peripartum hemorrhage leading to unstable hemodynamic status
• Severe constipation
• Use of certain medications such as meperidine for pain relief
• Overt bowel manipulation 6
• Opioid use during and following surgery 3, 4