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Paralytic Ileus: Causes, Symptoms & Treatment

Instructor: Marisela Duque

Marisela teaches nursing courses at the college level. She also works as a unit educator, teaching experienced nurses about changes in nursing practice.

After completing this lesson, you will be able to define paralytic ileus and describe its causes, symptoms and treatment. A short quiz follows this lesson to help you test your knowledge.

Defining Paralytic Ileus

The ileum is the lowest portion of the small intestine, and so the term paralytic ileus describes an ileum that is paralyzed; therefore, it is no longer pushing food down the digestive tract. Even though the term 'ileum' is in the title, this condition can occur anywhere in the small or large intestine.

Normally, the bowels move food through the digestive system through an involuntary process called peristalsis. This occurs through the movement of the walls of the digestive tract. The movement of peristalsis is a lot like an ocean wave moving through the digestive tract muscle. There is an initial narrowing and then the narrowed part pushes the food forward. The food rides these waves all the way through the digestive system. When these waves slow down or stop, such as with paralytic ileus, then the food becomes stuck causing a pseudo-obstruction. Even though there is no actual obstruction, you will still experience the same symptoms.

Symptoms

During paralytic ileus, you should watch out for:

  • Abdominal cramping that comes and goes
  • Vomiting
  • Diarrhea
  • Constipation
  • Nausea
  • Abdominal swelling (distention)
  • Abdominal fullness (gas)
  • Inability to pass stool or gas

What Causes Paralytic Ileus?

Many things can cause this condition, including:

  • Bacteria and viruses
  • Electrolyte imbalance (such as low potassium)
  • Medications (especially narcotics and antidepressants)
  • Decreased blood supply to the intestines
  • Pelvic surgery
  • Infections (such as appendicitis)
  • Muscle and nerve disorders (such as Parkinson's disease)

How is Paralytic Ileus Treated?

Initially you will not be allowed to eat or drink anything until your bowels start working again. This is because the obstruction will only get worse if you keep adding food into your digestive system when it is not working properly. Therefore, you will need an I.V. (intravenous catheter) to stay hydrated and a nasogastric tube. The nasogastric tube is inserted through your nose and into your stomach. Don't worry, it sounds worse than it is. In reality, this procedure is quick and you will likely feel better afterwards because the tube will allow gas that can accumulate in your stomach to escape. Abdominal x-rays will also be done so that doctors can see exactly where the obstruction is.

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