Paralytic Ileus

Paralysis or pseudo-obstruction is a condition in which the intestinal muscles are paralyzed, so that the digestion of food and other functions is disrupted.

In general, the intestine is used to digest food and drinks so that it can be absorbed by the body. These foods and drinks move through the digestive tract using contraction of the intestinal muscles. The movement that results from contraction of the intestinal muscles is called intestinal peristalsis. If there is interference with the intestinal muscles, the movement of food and drinks in the intestine will meet obstacles.
Paralytic ileus is a serious disease. If left untreated, food and drinks can accumulate in the intestines and cause tears (perforation) in the intestines, endangering the lives of affected people.
 
Causes of paralytic ileus

Surgery, especially abdominal surgery, is often the main cause of paralytic ileum. Usually, bowel activity returns a few hours after surgery, whereas the large intestine returns to normal 3 to 5 days after surgery.

During surgery, anesthesia is given which can slow the contraction of the intestinal muscles. In addition to anesthesia, other drugs can also cause paralytic ileus, such as morphine, amitriptyline, antacids, oxycodone, and chlorpromazine.

Apart from surgery and the influence of drugs, there are other causes of paralytic ileus:
  • Parkinson's disease.
  • Inflammation and infection of the digestive tract, such as Crohn's disease, gastroenteritis, diverticulitis and appendicitis.
  • blood poisoning
  • Acute kidney failure.
  • Post trauma to the ribs or spine.
  • Hyportirodism.
  • AVC
  • Heart attack (acute myocardial infarction).
  • After giving birth.
  • Electrolyte or mineral disorders in the body, especially hypokalemia.
  • Diabetic ketoacidosis.

Although anyone can suffer from paralytic ileus, especially after stomach surgery, the elderly are more susceptible to this condition. In addition, someone with a history of abdominal radiotherapy is also at risk for paralytic ileus.
 
Symptoms of paralytic ileus
The most common symptom in people with paralytic ileus is stomach discomfort with many other symptoms, such as:
  • Stomach cramps.
  • Decreased appetite.
  • Begah.
  • constipation
  • nausea
  • Vomiting and eliminating materials such as impurities.
  • Can't get through the wind.
  • Stomach swells.

Symptoms of paralytic ileus are not much different from symptoms of other digestive tract disorders. It is recommended to consult a doctor immediately to get the right treatment.
 
Diagnosis of paralytic ileus

During the preliminary examination, the doctor will ask about your symptoms, history of the disease, history of surgery, if any, and will do a physical examination. The doctor will listen to stomach sounds (bowel sounds) with a stethoscope. If paralytic ileus occurs, bowel sounds are not heard or weakened. In addition, the stomach will also be enlarged and filled with gas (distension).

To confirm the diagnostic results, several sweep tests will be performed. These include abdominal radiography, abdominal computed tomography and ultrasound (especially for affected children). If necessary, another scanning test using fluoroscopy will be performed. In this test, the doctor inserts air or barium through the rectum (barium enema) into the large intestine, before taking X-ray images.

Treatment of paralytic ileus

Treatment of paralytic ileus will be adjusted to the conditions and triggers. If the drug is a major factor, the doctor will prescribe a replacement drug or stop it. Medications can also be given to stimulate impurities, such as metoclopramide.

For patients with paralytic ileus, treatment will be carried out in hospital. The patient will receive intravenous fluids until the ileum has improved. If necessary, installation of a nasogastric tube (NGT) will be carried out to empty the contents of the stomach (decompression) as long as the intestine has not been able to function optimally. NGT is a tube that is inserted into the stomach through the nostril. It also helps reduce the frequency of vomiting in patients. Usually, patients with postoperative paralytic ileus will improve in 2-4 days. But instead, a repair operation will be carried out.
 
Complications of paralytic ileus

Untreated paralytic ileus can trigger complications such as:
  • Death of cells or intestinal tissue (necrosis).
  • Infection in the abdominal cavity outside the intestine (peritonitis), due to intestinal rupture. This condition can worsen sepsis and trigger organ dysfunction.
  • Damage to the intestinal wall in neonates with paralytic ileus (necrotizing enterocolitis). This disease can trigger lung infections, blood infections and even death.
  • Electrolyte and mineral disorders.
  • Dehydration.

Prevention of paralytic ileus


The cause of paralytic ileus is difficult to prevent. For example, surgery. Every doctor who decides to undergo surgery must have an indication of a health disorder. This can be prevented by avoiding surgery on the stomach area, but this is considered inappropriate because the patient's health condition can be life-threatening if not done. Therefore, be aware of the symptoms and signs of ileus if there are conditions or risk factors that can cause paralysis, is the best prevention.

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