A slowing of GI motility that is not associated with mechanical obstruction.
Most commonly presents following surgery and usually lasts 2 to 4 days.
Prolonged postoperative ileus contributes significantly to longer hospitalization and increased healthcare costs.
Treatment includes bowel rest, supportive care, and treatment of any underlying exacerbating factors.
Prevention requires a multimodal approach, including the substitution of postoperative opioid analgesia with nonsteroidal anti-inflammatory drugs and thoracic epidural analgesia, early enteral feeding, early ambulation, and the use of laparoscopy rather than laparotomy whenever possible.
Ileus is a slowing of GI motility accompanied by distention, in the absence of a mechanical intestinal obstruction.  It is a diagnosis of exclusion after bowel obstruction has been ruled out. It usually occurs in response to physiologic stress, including surgery, sepsis, metabolic derangements, and GI diseases.
Digestive Disease Center
Professor and Chair
Department of Colorectal Surgery
SDW has received consulting fees, stock options, and royalties from the following companies. These relationships are ongoing. Consulting - Axonics Medical, Intuitive Surgical, Karl Storz Endoscopy America, LifeBond, Medtronic, Novadaq, TiGenix. Stock options - Asana Medical, LifeBond, Pragma, Renew Medical. Royalties - Covidien, Intuitive Surgical, Karl Storz Endoscopy America, Unique Surgical Innovations. Inactive consulting agreements, but stock options retained for prior consulting - CRH Medical, Intuitive Surgical, Neatstitch, novoGI. There are no relevant disclosures to the submitted work.
Colorectal and Minimally Invasive Surgery
Division of General Surgery
Toronto Western Hospital
Department of Surgery
University of Toronto
ASC declares that he has no competing interests.
Dr Steven D. Wexner and Dr Ahmed Sami Chadi would like to gratefully acknowledge Dr Paula I. Denoya, a previous contributor to this monograph. PID declares that she has no competing interests.
Associate Professor of Pediatric Surgery
University of Pittsburgh School of Medicine
DJH declares that he has no competing interests.
Consultant Colorectal Surgeon
St. Mark's Hospital
JJ declares that he has no competing interests.
Use of this content is subject to our disclaimer