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Paralytic ileus is a slowdown or stoppage of intestinal movement caused by paralysis of the muscles in the gut. It leads to bowel obstruction and can be fatal if not treated. Treatments involve determining the cause and providing appropriate supportive therapy to address the underlying medical issue. A patient may need to stay in the hospital while undergoing treatment, so doctors and nurses can monitor the situation and provide interventions as they become necessary.
Some reasons people can develop paralytic ileus include spinal cord injuries, electrolyte imbalances, certain medications, inflammation, and surgery. The bowel does not need to be completely paralyzed for an obstruction to develop, as even a partial slowdown can cause food to accumulate, blocking the bowel over time. Patients may experience nausea, vomiting, and abdominal pain in association with the obstruction. The lack of movement in the intestines may also lead to adhesions as the intestines rub against each other.
Medical imaging studies can show a blockage and a doctor can listen to the patient's abdomen to collect information about the amount of gut activity. After a doctor diagnoses paralytic ileus, evaluation to determine the cause is the next step. Sometimes the cause is an issue like electrolyte balance or medications is the problem, and it can be easily corrected by changing medications or providing supportive therapy to restore the patient's electrolytes. While the patient is evaluated and treated, nothing is given by mouth, to avoid exacerbating the obstruction. Tubes can be inserted to clear the blockage and provide nutrition.
Sometimes surgery is required for a patient with paralytic ileus. There is a chance of tissue death with some obstructions, requiring a surgeon to remove the involved section of bowel. In other cases, surgery is needed to treat adhesions or other problems the patient may develop as a result of a prolonged obstruction. In cases where the bowels are paralyzed by a permanent issue like a spinal cord injury, the doctor and patient will have to discuss the best approach to managing the problem for life.
Working with a gastroenterologist can help patients achieve the best results. These medical specialists focus on conditions involving the gut. They are familiar with the latest research and treatments, and their track records with numerous other cases can help them identify and treat paralytic ileus faster than regular physicians. In regions where such specialists are not available, it may be possible to meet with one over the phone or through a telemedicine practice, where the doctor treats the patient remotely.