How do you treat postoperative ileus?

Nonsteroidal anti-inflammatory drug therapy may improve postoperative ileus by allowing the clinician to reduce the amount of opioid given by 20% to 30%. An additional benefit on bowel motility may be derived from the anti-inflammatory properties of nonsteroidal anti-inflammatory drugs.

What is the pathophysiology of postoperative ileus?

Postoperative ileus, which develops after each abdominal surgical procedure, is an iatrogenic disorder characterized by a transient inhibition of gastrointestinal motility. Its pathophysiology is complex involving pharmacological (opioids, anesthetics), neural, and immune-mediated mechanisms.

What are some interventions to prevent postoperative paralytic ileus?

Preventing ileus Although the effectiveness of early feeding varies, many patients simply can’t tolerate early feedings after abdominal surgery. Gum chewing has been proposed as a cost-effective and easy-to-implement intervention to reduce the incidence of postoperative ileus following abdominal surgery.

Does enhanced recovery reduce postoperative ileus after colorectal surgery?

Conclusion. In our study, compliance with an ERAS protocol improved recovery of intestinal motility with a decreased interval to passage of flatus, passage of stool, and tolerance of oral alimentation of solids. The direct consequence of strong adherence to the protocol is a reduced risk of postoperative ileus.

What does it mean to have a post operative ileus?

A post-operative ileus is simply a delay in the return of normal bowel function. As a result, the symptoms of post-operative ileus may be the same as those of a mechanical obstruction.

What are bowel sounds like after ileus surgery?

On examination, there will be abdominal distention and absent bowel sounds (whereas in mechanical obstruction there are classically ‘tinkling’ bowel sounds present) In the patients with suspected post-operative ileus, the aim of the investigations are to rule out more serious pathologies and determine any underlying cause.

When to reinsert the NG tube for ileus?

The NG tube may require reinsertion if the patient again displays evidence of ongoing ileus with abdominal distention and vomiting. Studies have shown that routine NG decompression is unnecessary and may be detrimental. Therefore, NG decompression is reserved for selective use. [79]

Can a prolonged ileus lead to mechanical bowel obstruction?

However, when ileus is prolonged, it leads to patient discomfort, dissatisfaction, and prolonged hospitalization, and it must be differentiated from mechanical bowel obstruction or other postoperative complications. The epidemiology, clinical features, and diagnosis of postoperative ileus are reviewed here.