Ileus after Surgery
What is an ileus?
An ileus is a blockage of the intestines (also called the bowel). The ileus prevents the movement of food, fluid, and gas through the intestines. The blockage is due to the lack of movement of the intestinal muscles. The intestinal tract is made up of small bowel and large bowel. The small bowel has three parts: the duodenum, the jejunum, and the ileum. The large bowel has four parts: the ascending, transverse, descending, and sigmoid colon. An ileus can occur anywhere in the intestinal tract.
What causes an ileus?
An ileus may be caused by any type of surgery, trauma, or pain medicines (such as morphine and oxycodone). A lack of activity also may cause an ileus. A chemical reaction occurs in your body causing any part of your intestines to stop working as they should.
How will my health care team know that I have an ileus?
These are the signs and symptoms of an ileus.
- Nausea and vomiting
- Stomach cramps
- Bloating
- Lack of bowel movements and gas
These are the tests and procedures you may need.
- Physical exam
- Daily x-rays of stomach and intestines
- Imaging studies like a CT scan. You may have to drink a liquid contrast so the doctors can see your GI tract clearly in the CT scan.
- Blood tests
How will I be treated?
- Often, you will not be allowed to eat or drink.
- Intravenous (IV) fluids will be given to keep you hydrated.
- Your electrolytes (like potassium and magnesium) will be checked with blood tests. Many times these levels drop when you cannot eat or drink. IV electrolytes will be given to keep your blood values normal.
- A nasogastric tube (NG tube) may be put in your nose. The NG tube goes through your nose, down your esophagus, and into your stomach. The NG tube is able to suck air and gastric juices out of your stomach to make you feel better. The doctors and nurses will measure the amount of liquid that comes out of the tube.
- Medicines may be given to help your intestines move as well.
- Bisacodyl suppository is a medicine inserted in your rectum to stimulate a bowel movement.
- Docusate senna is a tablet given once or twice a day to soften your stool.
- Miralax is a powder mixed in liquid that helps to soften your stool.
- Fleets enema is a liquid medicine inserted in your rectum to stimulate a bowel movement.
- Metoclopramide is a medicine put into your IV by the nurse to promote upper GI tract movement.
How will I know my ileus is gone?
Eating and drinking
Most often you will not be able to eat or drink anything at first. Sometimes, the doctors allow you to drink small sips of water. As your intestines begin to wake up, you will be able to start drinking small amounts of clear liquids. Slowly, you will be able to have thicker liquids and more solid food based on your surgery or injuries.
Bowel activity
Your health care team will be watching for signs that your intestines are working. At first, your bowels will not be working. Your doctors and nurses will listen to your stomach for sounds that your intestines are waking up. Your doctors and nurses will also ask if you have passed gas or moved your bowels. When you begin to pass gas, it means your gastrointestinal system is working in a normal way again. It is normal to have a bowel movement even if you have not eaten for a few days. You may be given medicines to help you have bowel movements.
Physical activity
It is important to be as active as you can while you recover from your ileus. Walking around the unit and getting out of bed to sit in a chair will help your intestines to wake up. This is one of the best treatments. We understand you need rest periods during the day, but being out of bed as much as possible will help you recover.
Signs and symptoms my ileus is healed
- The doctors and nurses will hear bowel sounds when they listen to my stomach.
- Low amount of liquid coming out of NG tube.
- Passing gas.
- Having bowel movements.
- Decreased bloating, soft abdomen.
- No nausea or vomiting.
- Able to drink clear liquids without a problem.
Did I do something wrong to get an ileus?
NO! Your intestines are very sensitive to medicines used during and after surgery and inactivity. Even though all of your other organs wake up quickly after surgery, your intestines are expected to take the longest. People who develop an ileus after surgery simply do. There is little that can be done to prevent it. It simply takes time and patience for it to heal. It is important to remember that the healing time of an ileus varies from person to person.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 05/05/2010
Copyright © 05/05/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7013
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