Ileus is a lack of movement in the intestines that can lead to pain, nausea, bloating, and other symptoms. Abdominal surgery is a major risk factor. If complications develop, ileus may be life threatening in some cases.

Ileus occurs when the intestines do not move food through in the usual way. Postoperative ileus can occur after an operation, most commonly abdominal surgery.

If ileus persists, it can cut off the blood supply to the intestines and cause tissue death. This can result in an intestinal tear or infection of the abdominal cavity that can be life threatening.

Seeking immediate medical help as soon as there are concerns about ileus is essential. Read on to learn more about recognizing and treating ileus.

Symptoms of ileus include:

Typically, muscles in the intestines contract and relax to cause a wave-like motion called peristalsis. This movement helps food travel through the intestines.

When ileus occurs, it stops peristalsis and prevents food particles, gas, and liquids from passing through the digestive tract.

If people continue to eat solid food, it can lead to a backlog of food particles, which may cause total or partial obstruction of the intestines.

An ileus commonly occurs after abdominal or retroperitoneal surgery.

Other causes of ileus include:

  • lower gastrointestinal (GI) surgery
  • spinal surgery
  • opioid use
  • peritonitis
  • sepsis
  • complications surrounding surgery, such as pneumonia, abscess, or bleeding
  • hypokalemia, or low blood potassium levels
  • delayed placement of an enteral nutrition or nasogastric (NG) tube
  • peritoneal carcinomatosis, or cancer in the peritoneum

Paralytic ileus

Paralytic ileus occurs when the bowel is not moving correctly, and food cannot move through the intestines, creating an obstruction. The condition usually affects the small intestine.

Because the bowels do not move, fluids and gas accumulate, which stretch the bowel wall, causing vomiting, decreased bowel sounds, and constipation.

Paralytic ileus happens if the nerves in the intestinal wall are not working as they should.

Causes of paralytic ileus include:

Although the condition may correct itself, it is serious. If it goes on for too long without treatment, it can cause severe, life threatening problems.

Meconium ileus

Meconium is a newborn baby’s first stool that comprises materials they ingested while in the uterus.

Experts estimate that 80% to 90% of newborns with meconium ileus have cystic fibrosis.

The meconium in newborns with cystic fibrosis can block a part of their small intestine called the ileum. It happens in around 20% of infants with the condition.

Cystic fibrosis affects cells that produce mucus and digestive juices, meaning they become thicker and stickier. These fluids then block the digestive system and other parts of the body.

To diagnose ileus, a doctor may first begin by asking about symptoms and taking a complete medical history.

They may then perform a physical examination to check for swelling or pain in the abdomen. They may use a stethoscope to listen for bowel sounds. Absent bowel noises suggest ileus, but imaging tests are usually necessary to confirm the diagnosis.

Imaging tests for ileus can include X-rays and computed tomography (CT) scans.

Treatment options for ileus can include:

  • movement or walking
  • continuous nasogastric suction
  • intravenous fluids and electrolytes
  • total parenteral nutrition (TPN)
  • pain relief medication
  • treatment for infections or other underlying conditions

Surgery is not usually necessary to treat ileus. However, a healthcare professional may recommend surgery if potentially life threatening complications occur.

A person’s healthcare team will provide information about the type of surgery they recommend and answer any questions about what to expect.

Without an accurate diagnosis and treatment, ileus can cause severe and potentially life threatening complications. These can include:

  • Necrosis: Necrosis is tissue death. Necrosis occurs when blood cannot reach the intestine. The intestinal tissue dies and becomes weakened. A weak intestinal wall is prone to tearing, which causes bowel contents to leak out.
  • Infection: Bowel contents are full of bacteria. When they leak into the abdominal cavity, they cause peritonitis, which is a serious infection. Bacterial peritonitis can lead to sepsis, a widespread life threatening infection.

Ileus and bowel obstruction have similarities. However, ileus results from muscle or nerve problems that stop peristalsis, while an obstruction is a physical blockage in the digestive tract.

However, a type of ileus known as paralytic ileus can cause a physical blockage due to food buildup in the intestines.

Other causes of bowel obstruction include:

Ileus means that the intestines are not moving correctly and cannot push food through the digestive system.

Surgery is a common cause of ileus. Medications, inflammation, and cancer in the peritoneum can also cause ileus.

Treatment for ileus depends on the underlying cause and may involve IV fluids and pain relief. Treating an underlying cause may also be necessary.

Anyone experiencing symptoms of ileus, including stomach pain, severe constipation, vomiting, and bloating, should seek medical attention. Ileus can cause severe, life threatening complications without proper treatment.