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Colonic ileus is a functional defect of the large intestine that can cause major digestive issues and abdominal pain. It is a different problem than a colonic obstruction, which refers to a physical blockage in the bowel, such as a tumor or congenital abnormality. The muscles and nerves of the bowel may stop working properly because of a surgical complication, a severe infection, trauma to the abdomen, or one of several other risk factors. Colonic ileus may be a temporary or permanent problem, and treatment depends largely on the underlying cause. Most people are able to recover by resting, maintaining a special diet, and taking medications to improve digestion.
The most common cause of this disorder is surgery on the abdomen or gastrointestinal tract. Postoperative complications can arise if muscles and nerves were accidentally damaged or if local anesthetic fails to wear off correctly. In some cases, surgical sites in the abdomen may become irritated and inflamed, leading to ileus symptoms. A person can also experience the problem if he or she has an internal injury, a bacterial infection in the abdomen, or a blood clotting disorder. Certain medications, including antacids and blood thinners, can occasionally cause colonic ileus as well.
The most common signs of colonic ileus are frequent abdominal pains and bloating. An individual may also experience cramps, diarrhea, constipation, or vomiting as a result of poor digestion. Symptoms of nausea, dehydration, loss of appetite, and body aches are likely to develop if medical care is not sought within a few days.
At a doctor's office or emergency room, a physician can diagnose colonic ileus by asking about symptoms and performing a series of tests. He or she listens to the abdomen with a stethoscope to see if abnormal sounds are present that may indicate a physical blockage rather than ileus. Imaging scans such as ultrasounds can also help rule out obstructions and confirm the diagnosis. A doctor may also need to screen blood and stool samples if infection is suspected.
As long as there is no infection at the site, postoperative ileus typically improves on its own in a few days. A patient may be admitted to a hospital so his or her condition can be monitored, and symptoms of dehydration or pain can be treated appropriately. Antibiotics are prescribed if infection is responsible for symptoms, and drug-induced ileus typically gets better when medication use is stopped or adjusted. A person may need to maintain a liquid diet for several days or weeks during the healing phase to avoid irritating the colon further. Most patients are able to make full recoveries in less than one month.