What are the symptoms of ileus (intestinal obstruction)?

From the Guidelines

Ileus is primarily characterized by symptoms of abdominal pain, nausea, vomiting, constipation, and decreased bowel sounds, which are indicative of intestinal obstruction without a physical blockage. These symptoms are a result of the temporary cessation of normal intestinal peristalsis, preventing the normal movement of intestinal contents 1. The condition can occur after abdominal surgery, with certain medications, electrolyte imbalances, or as a result of inflammatory processes in the abdomen.

Key Symptoms

• Abdominal pain, often diffuse and cramping in nature
• Abdominal distension or bloating
• Nausea and vomiting, particularly after eating
• Constipation or inability to pass gas
• Decreased or absent bowel sounds upon auscultation
• Loss of appetite, malaise, and in severe cases, fever and signs of dehydration

According to a narrative review on bowel obstruction, adhesions, hernias, and malignancies are the most common causes of small bowel obstruction, while cancer, volvulus, and diverticular disease are the primary causes of large bowel obstruction 1. It is essential to recognize these symptoms early, as prolonged ileus can lead to complications such as aspiration, malnutrition, or bacterial overgrowth in the intestines.

Importance of Early Recognition

Early recognition of ileus symptoms is crucial to prevent complications and improve patient outcomes. A study published in the World Journal of Emergency Surgery highlights the importance of prompt diagnosis and treatment of bowel obstruction, which can significantly reduce morbidity and mortality 1. Therefore, it is essential to prioritize the diagnosis and management of ileus to minimize its impact on patient quality of life and reduce the risk of complications.

From the Research

Symptoms of Ileus

• Abdominal pain 2
• Adynamic ileus 2
• Constipation 2
• Abdominal bloating 2
• Nausea and emesis 3

Treatment of Ileus

• Metoclopramide may be useful in treating vincristine-induced ileus 2
• Metoclopramide does not have a significant effect on postoperative ileus after exploratory laparotomy 4
• Metoclopramide does not reduce the length of ileus after colorectal surgery 5
• Metoclopramide reduces nausea and emesis postoperatively, but has limited effect on postoperative adynamic ileus 3
• Combination of dexamethasone, octreotide, and metoclopramide ("triple therapy") may be used to manage symptoms of inoperable malignant bowel obstruction, but its effectiveness is still being studied 6