Paralytic Ileus: Symptoms, Causes & Treatment

Paralytic ileus is a functional bowel obstruction where intestinal muscles become paralyzed, halting stool passage. It's a serious condition requiring prompt medical attention.

Symptoms

• Severe abdominal pain (cramping/colicky)
• Nausea and vomiting
• Constipation (obstipation)
• Diarrhea (occasionally, from liquid stool bypassing obstruction)
• Dehydration
• Electrolyte imbalances

Causes

• Abdominal/pelvic surgery (most common)
• Medications (opioids, anticholinergics)
• Electrolyte disturbances (hypokalemia)
• Infections (peritonitis, sepsis)
• Metabolic disorders (hypothyroidism, uremia)
• Spinal cord injury
• Vascular compromise (mesenteric ischemia)

Treatment

• Bowel rest: NPO (nothing by mouth), IV fluids.
• Nasogastric decompression: Tube to remove gastric contents.
• Correct underlying cause: Electrolyte replacement, stop offending drugs, treat infection.
• Prokinetic agents: May stimulate motility (e.g., neostigmine for colonic pseudo-obstruction).
• Surgery: Rarely needed if mechanical obstruction suspected or perforation occurs.

Most cases resolve with supportive care within days. Early intervention prevents complications.